tobacco use in diverse populations. prevalence of adult smoking, by race/ethnicity—u.s., 2007...
TRANSCRIPT
PREVALENCE of ADULT SMOKING, by RACE/ETHNICITY—U.S., 2007
Centers for Disease Control and Prevention. (2008). MMWR 57:1221–1226.
* non-Hispanic
0 10 20 30 409.6% Asian*
36.4% American Indian/Alaska Native*
19.8% Black*
21.4% White*
13.3% Hispanic
HEALTH DISPARITY/INEQUALITY
Health disparities are potentially avoidable differences in health between groups of people who are more and less advantaged socially
Used to describe unequal health conditions or indicators (e.g., tobacco use initiation, current use, ETS, CPD, quitting, treatment access, relapse, cancer).
Fagan et al (2007); Braveman (2006)
Lung Cancer Incidence and Cardiovascular-Related Mortality for US Adults, 2002-2006
0
50
100
150
200
250
300
Heart Disease Stroke Lung & Bronchus Cancer
Smoking-related diseases
Ag
e-ad
just
ed d
eath
s p
er 1
00,0
00
Whites
Blacks
Hispanic
American Indian/Alaska Native
Asian/Pacific Islander
CDC, Health, United States, 2008; SEER Cancer Statistics Review, 1975-2006
ETHNIC DIFFERENCES in SMOKING BEHAVIORS
Initiation Middle/high school: Latinos/Hispanics Middle school: Native Americans,
Pacific Islanders High school: Asian Americans
(experimentation) After 18: African Americans
(experimentation/regular use) & Asian-Americans (regular use)
Fagan et al., 2007 ; Kandel et al., 2004; Trinidad et al., 2004
75% of African Americans smoke menthol cigarettes
≤ 10 cigarettes per day Latinos: 59% men, 75% women African Americans: 42.9% men, 59.7% women 53% Japanese American women; 22% men
≤ 15 cigarettes per day 70% Pacific Islanders 50% American Indians/Alaska Natives
Fagan et al., 2007; Haiman et al., 2006; Eichner et al., 2005; U.S.DHHS, 1998
ETHNIC DIFFERENCES in SMOKING BEHAVIORS
SECONDHAND TOBACCO SMOKE
Youth: 10% Mexicans, 16% other Latin countries, 35.5% Puerto Ricans
African American youth: 46% youth exposed to secondhand smoke (highest of any ethnic group) Higher serum cotinine levels compared to
white and Latino youth
Data needed for Asian and Native Americans Home exposure is likely high for American
Indians 31% of Vietnamese American women exposed
daily
Fagan et al., 2007; Freeman et al., 2003; Stamatakis et al., 2002
SMOKING CESSATION
Quit 1+ days in past 12 months
Blacks (47%) > Whites (42%)
45-46%: Hispanics, Asians, American Indians
No ethnic differences in lifetime quit attempts or desire to quit
National Health Interview Survey Results, 2007
AFRICAN-AMERICANS
Nicotine accumulates in tissue containing melanin Higher serum and hair cotinine levels
in black youth compared to white and Latino youth
Tobacco industry has a 70 year relationship with African American organizations
Yerger et al., 2007; Yerger & Malone, 2006; Yerger & Malone, 2002; Tang et al., 1999
TEENS & MENTHOL
Newport is the second most popular brand (21% in 2006) of middle & high school smokers (MMWR, 2009)
93% (n=551) inner-city Baltimore youth (54% white) calling a study line for cessation smoked menthol cigarettes (Moolchan, 2003)
SUMMARY
Ethnic differences exist in smoking rates and level of use, types of tobacco smoked (menthol), and secondhand smoke exposure.
The cause of the disparity in the prevalence of tobacco-related diseases among African Americans is unknown.
The tobacco industry has a long history of targeting ethnic minorities with their products.