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Explaining racial differences in smoking

Institution: Public Health Foundation Enterprises, Inc.
Investigator(s): Hope Landrine, Ph.D.
Award Cycle: 1999 (Cycle 8) Grant #: 8RT-0013 Award: $149,280
Subject Area: Public Health, Public Policy, and Economics
Award Type: Research Project Awards
Abstracts

Initial Award Abstract
Studies indicate that the prevalence of cigarette smoking among Black adults (30-56%) far exceeds that of White adults (20-27%) even when controlling for income and education (socioeconomic status, SES). Blacks also have lower rates of quitting smoking and higher levels of nicotine dependence than Whites, with these also transcending SES. Consequently, Blacks continueto suffer smoking-related diseases and death at a significantly higher rate than Whites. In addition, Blacks have the lowest rate of smoking as adolescents but the highest rate of smoking as adults. This pattern is not an artifact of differences in smoking among Blacks born in different generations but instead suggests that something happens to Blacks at ages 18-24 that leads many to initiate smoking at those late ages, and to then be unable to quit.

Although these racial differences are well-known, the explanation for them remains unknown and unexamined. Understanding the factors underlying these differences is crucial to tobacco control for the state's ethnically diverse population however, and so investigating Black smoking and racial differences in smoking is one of the five challenges ahead for TRDRP. This project responds to that challenge by examining one variable that might explain these differences: racial discrimination. Our preliminary studies revealed that racial discrimination is a stronger predictor of smoking among Black adults than all SES variables, and revealed that only Blacks who experience high discrimination have higher smoking prevalence rates than Whites. These initial data suggest that racial discrimination may be asociocultural stressor unique to Blacks that many Blacks cope with by smoking: What happens to Blacks at ages 18-24 that leads many to initiate smoking may be the onset of racial discrimination when they become adults and enter a hostile White work-world.

Hence, this project entails a survey on smoking and racial discrimination mailed to a random sample of 4,000 Black and 2,000 White California adults. We will test the hypothesis that racial discrimination accounts for Black-White differences in 1) smoking prevalence, 2) age of initiation of smoking, 3) degree of nicotine addiction, 4) difficulty quitting smoking, and 5) stage of readiness to quit smoking. We theorize that Blacks who experience frequent discrimination will differ from Whites on all five variables, whereas Blacks who experience infrequent discrimination will not. We further hypothesize that the age at which Blacks began their first full-time job will be a strong predictor of the age at which they initiated smoking. Our data then can be used to design new, culturally-tailored smoking prevention and cessation programs for Blacks that might reduce the high cost of Black tobacco use in the state. Simultaneously, we will examine the effects of various incentives and survey manipulations on response rates from Blacks and Whites, and provide data on the best procedures for getting Blacks to return surveys about their tobacco use.
Publications

Depressive symptoms and smoking among Black adults: absence of a relationship?
Periodical: Journal of Health Psychology Index Medicus:
Authors: Klonoff EA, Landrine H ART
Yr: 0 Vol: Nbr: Abs: Pg:

Adults buy cigarettes for underage youth
Periodical: American Journal of Public Health Index Medicus:
Authors: Klonoff EA, Landrine H, Lang D, Alcaraz R, Figueroa-Moseley C ART
Yr: 2001 Vol: Nbr: Abs: Pg:

Racial discrimination and smoking among Blacks: findings from two studies
Periodical: Ethnicity and Disease Index Medicus:
Authors: Landrine H, Klonoff EA ART
Yr: 2000 Vol: 10 Nbr: 2 Abs: Pg: 195-202

Racial segregation and cigarettte smoking among Blacks: findings at the individual level
Periodical: Journal of Health Psychology Index Medicus:
Authors: Landrine H, Klonoff EA ART
Yr: 2000 Vol: 5 Nbr: 2 Abs: Pg: 211-219

Is skin color a marker for racial discrimination? explaining the skin color-hypertension relationship
Periodical: Journal of Behavioral Medicine Index Medicus:
Authors: Klonoff EA, Landrine H ART
Yr: 2000 Vol: 23 Nbr: 4 Abs: Pg: 329-338

Revising and improving the African American acculturation scale
Periodical: Journal of Black Psychology Index Medicus:
Authors: Klonoff EA, Landrine ART
Yr: 2000 Vol: 26 Nbr: 2 Abs: Pg: 235-261