Racial convergence in cigarette use from adolescence to the mid-thirties



On World AIDS Day, the American College of Physicians (ACP) is giving doctors a call-to-action to routinely encourage HIV screening to all of their patients older than 13 years. This new practice guideline appears on the Annals of Internal Medicine Web site at www.annals.org. HIV affects more than one million people in the United States.

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African-Americans are much less likely to smoke than whites are during their teens.

However, a new study finds that most of this advantage disappears by mid-adulthood.

“There is a puzzle here in that usually the health disadvantages in African-Americans show up early in life and get worse as they get older,” says Fred Pampel, Ph.D., a sociology professor at the University of Colorado at Boulder. “For cigarette smoking, African-Americans tend to act in a more healthy way during their teens, but that advantage goes away by middle age.”

The study appears in the December issue of the Journal of Health and Social Behavior . Pampel used data from two surveys to make his conclusions.

The National Youth Survey followed the same group of people between ages 12 to 18 in 1977 for 15 years through 1992. The National Health Interview Survey questioned different samples of people 18 and older for 30 years ending in 2006. Pampel looked at groups of white and black teens to see how their cigarette smoking patterns changed as they aged.

“The analysis found that this change is indeed real,” said Pampel, and “the disappearance at older ages of the African-American advantage during the teens is more apparent among younger generations than older ones.

“The narrowing differential appears to result from the greater resources that are available to whites than African-Americans. Resources such as higher income, more education, better access to medical care and greater use of nicotine replacement products help whites quit at a faster rate,” Pampel said.

C. Tracy Orleans, Ph.D., of the Robert Wood Johnson Foundation, said the study did not factor in possible socio-demographic differences in exposure to higher tobacco prices and taxes, which “deter youth onset and promote quitting, especially among low-income smokers, and protection by worksite and comprehensive smoke-free airs laws, which affect adult cessation more than youth initiation.”

Gary Giovino, Ph.D., at the University at Buffalo, State University of New York, does not necessarily agree with the study’s conclusions.

“I have seen the substantially reduced smoking prevalence among African-American adolescents carry over to young adults aged 30 to 34 years, suggesting greater progress and resilience than is indicated by this article,” Giovino said.

The Journal of Health and Social Behavior is the quarterly journal of the American Sociological Association. Contact Jackie Cooper, Media Relations Officer, at (202) 247-9871 or j cooper@asanet.org

Pampel FC. Racial convergence in cigarette use from adolescence to the mid-thirties. J Health Soc Behav 49(4), 2008.

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