Elsevier

Addictive Behaviors

Volume 36, Issues 1–2, January–February 2011, Pages 14-17
Addictive Behaviors

Race and sex associations to weight concerns among urban African American and Caucasian smokers

https://doi.org/10.1016/j.addbeh.2010.08.001Get rights and content

Abstract

This study compared general weight concerns (Drive for Thinness, Body Dissatisfaction, and Cognitive Restraint) and smoking-specific weight concerns among adult African American and Caucasian women and men smokers enrolled in a smoking cessation clinical trial. Participants were 119 African Americans (73 female) and 182 Caucasians (90 female). Results revealed that general weight concerns were higher in Caucasians versus African Americans, and in women compared with men but there were no race by sex interactions. Drive for Thinness and Body Dissatisfaction was higher in women compared with men, and Cognitive Restraint was highest in Caucasian women. Finally, smoking-specific weight concerns were higher in Caucasian women than both Caucasian and African American men, with African American women intermediate. Results indicate that while Caucasian women preparing to quit smoking exhibited the highest levels of concern about weight, smoking-specific weight concerns, and certain sub-components of general weight concerns were also prevalent among African Americans and Caucasians. Future research is needed to elucidate how race and sex differences in weight concerns may impact smoking cessation.

Research Highlights

►General weight concerns were higher in Caucasians versus African Americans, and in women compared with men but there were no race by sex interactions. ►Drive for Thinness and Body Dissatisfaction was higher in women compared with men, and Cognitive Restraint was highest in Caucasian women. ►Smoking-specific weight concerns were higher in Caucasian women than both Caucasian and African American men, with African American women intermediate.

Introduction

Numerous studies have shown that weight concerns are related to both cigarette smoking initiation (French et al., 1994, Pomerleau, 1996) and maintenance (Klesges & Klesges, 1988), and may also be a barrier to cessation (Doherty et al., 1996, Jeffery et al., 2000, Meyers et al., 1997). Although the majority of prior studies on weight concerns among smokers have been conducted among Caucasians, recently there has been an increased interest in examining these issues in African American smokers. This interest likely derives from African Americans’ lower smoking cessation quit rates and higher levels of obesity and post-cessation weight gain compared with other racial/ethnic groups (for a review, see Sanchez-Johnsen, 2005). Characterizing the role of weight concerns among Caucasian and African American women and men smokers preparing to quit smoking may be important in terms of developing comprehensive interventions on smoking-related weight issues for all smokers, as well as potential targeted materials specifically designed for sex or race subgroups.

Due to cultural differences in weight and body image, weight control has been suggested to play a lesser role in motivation to smoke among African Americans than Caucasians (e.g., Jeffries et al., 2004). Specifically, African American smokers have been shown to be less concerned about weight (Pollak, Namenek Brouwer, Lyna, Taiwo & McBride, 2003), as well as less likely to exercise to control weight and more satisfied with their body shape than Caucasian women smokers (Pomerleau, Zucker, Namenek Brouwer, Pomerleau & Stewart, 2001). On the surface, studies such as this appear to suggest that the majority of African American smokers may not have a high level of concern for their weight. However, not all studies uniformly support this premise. For example, Caucasian and African American smokers have been shown to be similar on dissatisfaction with body shape and drive to be thin (Sanchez-Johnsen, Spring, Sommerfeld & Fitzgibbon, 2005), and African American women smokers may be less tolerant of any weight gain when they quit smoking versus Caucasian women smokers (Pomerleau et al., 2001). Together, these findings suggest that at least among some African American women smokers, certain aspects of weight control that are typically associated with Caucasian women smokers, may also be prevalent among African Americans.

In addition to racial differences in weight concerns, there are also important sex differences or race by sex interactive effects in weight concerns. Although weight concerns have been studied extensively among women smokers, weight concerns are also important to study among men due to their high rates of being classified as overweight or obese based on BMI levels (73.9% and 72.9% in African American and Caucasian men, respectively) (ACS, 2009). In fact, in one of the few studies examining sex differences in weight concerns among African Americans (n = 367), Pollak et al. (2003) found that African American men (19%) and women (25%) smokers were equally likely to be weight concerned. In contrast, in another study of African American light smokers, women reported greater weight control expectancies than men (Thomas et al., 2008). These mixed findings support the notion that additional research is needed on weight concerns among men and women smokers.

Overall, there is a relative dearth of research examining weight concerns in smokers across ethnic or racial groups, and only a handful of studies have examined weight concerns specifically among African Americans. Moreover, no study to our knowledge, has examined weight concerns using comprehensive measures of both general weight concerns and smoking-specific weight concerns in a large sample of African American and Caucasian women and men smokers. Such studies are important in order to further examine deeper constructs related to weight concerns and whether there are sex and race differences associated with weight concerns in African American and Caucasian women and men smokers. Therefore, the primary aim of this study was to compare general and smoking-specific weight concerns in African American and Caucasian women and men smokers enrolled in a smoking cessation clinical trial. It was hypothesized that Caucasians would report greater general and smoking-specific weight concerns than African Americans, and that women would report greater general and smoking-specific weight concerns than men.

Section snippets

Procedures

Participants were 301 adult cigarette smokers (119 African Americans, 61% female and 182 Caucasians, 49% female) enrolled in a smoking cessation clinical trial examining a combined pharmacological and behavioral intervention [Chicago STOP Smoking Trial (C-STOP)]. The trial included 10 study visits over a 3-month treatment interval, as well as participation in follow-up interviews up to 52 weeks after the quit date. To be eligible for C-STOP, participants had to be within the ages of 18 to 65,

Demographic and smoking characteristics

Table 1 depicts general characteristics and smoking background variables separately for African American and Caucasian men and women. African Americans (vs. Caucasians) were older [F(1,297) = 23.85; p < .001], had fewer years of education [F(1,297) = 20.89; p < .001], and were of lower socioeconomic status [F(1,293) = 21.29; p < .001]. Men and women were similar on most characteristics except that women were older [F(1,297) = 11.31; p < .01]. Finally, African American women had higher BMI's than both Caucasian

Discussion

While conventional wisdom held that African Americans are satisfied with their bodies and less concerned about weight issues than Caucasians (Flynn & Fitzgibbon, 1998), results from this study do not unilaterally support this premise among smokers. While overall weight concerns were heightened in Caucasian versus African American smokers, these race groups did not differ on two specific sub-dimensions of weight concerns, including dissatisfaction with body shape and drive to be thin. Therefore,

Role of Funding Sources

This study was supported by a grant from the National Institute of Drug Abuse (#R01-DA016834).

Contributors

All authors contributed to and have approved the final manuscript. Lisa Sanchez-Johnsen conducted literature searches and provided summaries of previous research studies. Michelle Carpentier conducted the statistical analysis. Andrea King designed the study and wrote the protocol.

Conflict of Interest

There are no conflicts of interest to report.

Acknowledgements

We thank the Howard Brown Health Center and Respiratory Health Association of Metropolitan Chicago for their overall support and for providing satellite study locations. Appreciation is extended to Ryan Stachoviak, Ayodele Gomih, Toni Harris, and Constantine Trela for their role in data collection and database management. We would like to gratefully acknowledge the technical assistance of Gabriela Juarez, B.A. and Kathleen Rivero, B.A. for their help in formatting this manuscript.

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