Despite historically low overall adult smoking rates in California, the rates for African American men and women in 2010 were about the same as the rates were for Non-Hispanic Whites in 1999. This eleven year lag is accompanied by the fact that African Americans have some of the highest smoking rates of all racial/ethnic groups in California. One consequence is that African Americans bear a disproportionate burden of smoking-related diseases. While progress has been made in recent years to reduce racial/ethnic disparities in various aspects of smoking, the current and persisting disparities indicate that many key issues remain to be addressed, especially for African Americans in California. The Specific Aims of the proposed project are:
1. Examine trends in the prevalence of various smoking behaviors (e.g., consumption levels including non-daily smoking, light smoking and heavy smoking; menthols; and successful cessation) among African Americans in California. Analyses will also examine California’s progress relative to other states in the U.S.
2. Research has shown that smokers can be categorized along a quitting continuum. We will report on the population distribution of African American smokers along the quitting continuum.
2.a. Hypothesis: Because previous research has suggested that African Americans are more likely to be light and non-daily smokers compared to non-Hispanic whites, the population distribution of African American smokers along the quitting continuum will appear as if African Americans will experience greater quitting success in the future compared to non-Hispanic whites. However, this will not be associated with actual higher rates of successful cessation at the population level in subsequent survey years. Such results would suggest that conceptualizations of the quitting process among African Americans need to be reassessed and perhaps new models developed.
3. Evaluate the applicability of smoking cessation treatment modalities to African Americans.
3.a. We will first describe the prevalence of factors previously associated with successful quitting, including being advised by a physician to quit smoking, reducing consumption, making prior quit attempts, use of cessation aids (e.g., quitlines, nicotine replacement therapy), family/social support, and the presence of complete home smoking bans.
3.b. We will then examine how these factors affect the smoking cessation process (i.e., distribution along the quitting continuum) for African Americans.
4. Examine menthol cigarette smoking among African Americans and factors associated with smoking menthols, and the role of menthols in Specific Aims #1, #2 and #3 .
4.a We will then compare these factors with those associated with smoking light cigarettes to see if smoking such cigarettes can be considered analogues to menthol smoking. If so, then lessons learned from those domains of tobacco control could be applicable to menthols.
This application proposes a secondary data analysis of the rich yet somewhat under-utilized population datasets on smoking in the U.S., the Tobacco Use Supplements to the Current Population Survey and the California Tobacco Surveys. All analyses will be conducted for African Americans in general, specific sociodemographic subgroups of African Americans, and in comparison to non-Hispanic whites. Analyses will also be conducted for both menthol and non-menthol users. Results from this proposal can significantly and positively impact the smoking research field and lead to a better understanding of tobacco dependence and the smoking cessation process among African Americans, who are more likely to be light and non-daily smokers. The outcome can provide valuable insight on smoking cessation models and how they can possibly be modified for African Americans. Application of these results can lead to reductions in disparities in overall smoking rates, smoking cessation and smoking-related diseases in African Americans.