Brief report
Cigarette Smoking Among Low-Income African Americans: A Serious Public Health Problem

https://doi.org/10.1016/j.amepre.2005.05.004Get rights and content

Background

This study examines the current prevalence of cigarette smoking and the number of cigarettes smoked in a community-based sample of 1021 low-income African-American men and women.

Methods

Participants were selected using a two-stage, area probability sample design. Data were collected in 2002–2003 in face-to-face interviews and analyzed in 2005. All data and analyses were weighted to account for the complex sampling design.

Results

Fifty-nine percent of men and 41% of women were current smokers, with younger individuals apparently initiating smoking at an earlier age than older individuals.

Conclusions

The high prevalence of cigarette use provides further evidence that the excess burden of tobacco-related disease among low-income African-American families may be on the rise. This is of great concern, and if confirmed by further research, indicates an urgent need for preventive intervention.

Introduction

Considerable progress has been made toward reducing tobacco use in the United States, and recent trends show a continuous decline in prevalence.1 However, such positive trends mask the substantial burden of tobacco-related morbidity and mortality that persists among low income, less-educated, and underserved racial/ethnic minority populations.2, 3, 4, 5 In contrast to the recent decline in prevalence and incidence of cigarette use among younger populations and non–racial-ethnic minorities, cigarette use among low-income African Americans appears to remain high and unchanged when compared to earlier years.6, 78 This disparity is of great concern, as tobacco use is the single largest preventable cause of death and has a disproportionate impact on African Americans. In this article we provide estimates of current cigarette use among a large randomly selected community-based sample of low-income African-American men and women residing in the 39 poorest census tracts in Detroit, Michigan.

Section snippets

Study Sample

The study was conducted by the Detroit Center for Research on Oral Health Disparities, one of five Centers funded by the National Institute of Dental and Craniofacial Research to reduce oral health disparities. The sample includes 1021 African-American men (n=55) and women (n=966) who are participating in a community-based randomized clinical trial (RCT) aimed at improving the oral health of African-American children and their primary caregivers. Overall, the response rate for the 1021 families

Results

The prevalence of current cigarette smoking for the entire sample was nearly 42%. For men it was 59.3%, and for women 41.0%, with adult and older participants having a significantly higher prevalence than those aged <21 years of age (Table 1). A significantly higher proportion of participants without a high school education smoked (50.7%) than those with a high school degree (33.5%) and those with some college education (36.7%). Older participants and those without a high school education

Discussion

The findings of this study point to what may be a more recent phenomenon, that African-American men and women may now be initiating cigarette use at a younger age. Recent studies suggest that while the prevalence of cigarette use among African-American youth remains lower than that of other groups, the incidence rate may have surpassed that of whites and other racial/ethnic groups.10 Given that tobacco companies have made it a priority to more aggressively market their products to African

Conclusion

Although the proportion of the general population that smokes cigarettes is decreasing, the findings presented here point to an important and disturbing disparity—the large proportion of low-income African-American men and women who currently smoke cigarettes, a phenomenon that seems quite stable. The present study highlights the urgent need for the public health field to pay greater attention to preventing and reducing cigarette smoking among vulnerable populations that do not appear to be

References (10)

  • Cigarette smoking among adults—United States, 2002

    MMWR CDC Surveill Summ

    (2004)
  • P. Fagan et al.

    Eliminating tobacco-related health disparitiesDirections for future research

    Am J Public Health

    (2004)
  • L. Haviland

    A silence that kills

    Am J Public Health

    (2004)
  • Tobacco use among U.S. racial/ethnic minority groups—African Americans, American Indians and Alaska Natives, Asian Americans and Pacific Islanders, and Hispanicsa report of the Surgeon General.

    (1998)
  • B. Parnes et al.

    Tobacco cessation counseling among underserved patientsa report from CaReNet

    J Fam Pract

    (2002)
There are more references available in the full text version of this article.

Cited by (56)

  • Trying is believing: A pilot study of in-vivo nicotine replacement therapy sampling in disadvantaged Black adults who smoke cigarettes

    2022, Drug and Alcohol Dependence
    Citation Excerpt :

    The smoking prevalence among U.S. adults has declined from 20.9% in 2005 to 12.5% in 2021, with similar rates among White (14%) and Black (13.1%) adults (CDC, 2022). However, this trend masks the high rates of tobacco use among low-income urban Black adults, with estimated smoking rates as high as 40% in this subpopulation (Delva et al., 2005; Drope et al., 2018). This disparity has been attributed to numerous socio-demographic barriers faced by Black adults who smoke cigarettes, including increased discrimination and trauma exposure, which are both associated with higher rates of nicotine use and lower cessation efficacy (Berg et al., 2017; Calixte-Civil and Brandon, 2021).

  • Health Disparities in Lung Cancer Screening

    2022, Lung Cancer Screening: Practical Aspects for Primary Care
View all citing articles on Scopus
View full text