A nationwide analysis of US racial/ethnic disparities in smoking behaviors, smoking cessation, and cessation-related factors

Evidence shows that racial/ethnic minorities develop more smoking-related illnesses, like cancer and heart disease, over time than non-Hispanic Whites. These minority populations, especially African Americans, are less likely to quit smoking and stay quit, even though they have lower overall rates of smoking and include more light or intermittent smokers. The findings “...suggest that the pathology of cigarette addiction and the quitting process may be different for racial/ethnic minority smokers than has been traditionally conceptualized.”

In an effort to clarify how tobacco disparities manifest themselves in different groups and to identify possible approaches for mitigating them, researchers analyzed national data. Using the 2003 Tobacco Use Supplement to the Current Population Survey (TUS-CPS), they focused on adults aged 20 to 64 years who self-reported their smoking status. They looked for patterns of tobacco use and cessation as well as clues about why those patterns might exist.

Methods associated with higher rates of smoking cessation have traditionally focused on heavy smokers. They include:

• being advised by a doctor to quit
• using nicotine replacement therapy (NRT)
• having a total smoking ban within the home

According to this analysis, the rates of being advised by a doctor to quit smoking were surprisingly similar between minority groups and non-Hispanic Whites, despite the fact that the minority groups do not smoke as heavily. Among those whose doctors did suggest quitting, the use of NRT as an aid was much less common among the minority groups.

A total smoking ban was most likely to be found in Hispanic/Latino homes and Asian American/Pacific Islander homes, but their quit rates do not appear to be significantly better than the other groups studied. African Americans were the least likely group to have total smoking bans in the home. They are also significantly less successful at quitting than the other groups.

This analysis implies that smoking cessation interventions are just as important in populations of light or intermittent smokers as they are in those of heavy smokers. The researchers “...underscore the need for focused efforts to increase cessation rates among racial/ethnic groups, especially African Americans.” They also suggest that these interventions need to be nuanced. Interventions that carefully consider and engage a target population and tailor approaches to that group are more likely to be successful and to help reduce smoking-related illnesses in all populations and among all types of smokers.

The research, “A Nationwide Analysis of US Racial/Ethnic Disparities in Smoking Behaviors, Smoking Cessation, and Cessation-Related Factors” was conducted by Dennis R. Trinidad, PhD, MPH; Eliseo J. Perez-Stable, MD; Martha M. White, MS; Sherry L. Emery, PhD, MBA; and Karen Messer, PhD. The article was published on February 17, 2011 in the American Journal of Public Health and is available for paid, short-term access here: http://ajph.aphapublications.org/cgi/content/abstract/101/4/699. AJPH subscribers and APHA members can download it for free.