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      Adult Tobacco Use Among Racial and Ethnic Groups Living in the United States, 2002–2005

      research-article
      , PhD, MPH , , MA, MPH, , BA, , MPH
      Preventing Chronic Disease
      Centers for Disease Control and Prevention

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          Abstract

          Introduction

          U.S. data on adult tobacco use and the relationship between such use and tobacco-related health disparities are primarily limited to broad racial or ethnic populations. To monitor progress in tobacco control among adults living in the United States, we present information on tobacco use for both aggregated and disaggregated racial and ethnic subgroups.

          Methods

          We used data from the nationally representative sample of adults aged 18 years or older who participated in the National Survey on Drug Use and Health conducted 4 times during 2002–2005. We calculated 2 outcome measures: 1) use of any tobacco product (cigarettes, chewing or snuff tobacco, cigars, or pipes) during the 30 days before each survey and 2) cigarette smoking during the 30 days before each survey.

          Results

          The prevalence of tobacco use among adults aged 18 years or older varied widely across racial or ethnic groups or subgroups. Overall, about 3 of 10 adults living in the United States were tobacco users during the 30 days before being surveyed. The population groups or subgroups with a tobacco-use prevalence of 30% or higher were African Americans, American Indians or Alaska Natives, Native Hawaiians or other Pacific Islanders, Puerto Ricans, and whites.

          Conclusion

          These results indicate that the prevalence of adult tobacco use is still high among several U.S. population groups or subgroups. Our results also support the need to design and evaluate interventions to prevent or control tobacco use that would reach distinct U.S. adult population groups or subgroups.

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          Most cited references35

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          Ethnic-immigrant differentials in health behaviors, morbidity, and cause-specific mortality in the United States: an analysis of two national data bases.

          This study examines the extent to which various ethnic-immigrant and US-born groups differ in their risks of all-cause and cause-specific mortality, morbidity, and health behaviors. Using data from the National Longitudinal Mortality Study, 1979-1989, we estimated, for major US racial and ethnic groups, mortality risks of immigrants relative to those of the US-born. The Cox regression model was used to adjust mortality differentials by age, sex, marital status, rural/urban residence, education, and family income. Logistic regression was fitted to the National Health Interview Survey data to determine whether health status and behaviors vary among ethnic-immigrant groups and by length of US residence. Compared with US-born whites of equivalent socioeconomic and demographic background, foreign-born blacks, Hispanics, and Asians/Pacific Islanders (APIs), US-born APIs, US-born Hispanics, and foreign-born whites had, respectively, 48%, 45%, 43%, 32%, 26%, and 16% lower mortality risks. While American Indians did not differ significantly from US-born whites, US-born blacks had an 8% higher mortality risk. Black and Hispanic immigrants experienced, respectively, 52% and 26% lower mortality risks than their US-born counterparts. Considerable differentials were also found in mortality for cancer, cardiovascular, respiratory, infectious disease, and injury, and in morbidity and health behaviors, with API and Hispanic immigrants generally experiencing the lowest risks. Consistent with the acculturation hypothesis, immigrants' risks of smoking, obesity, hypertension, and chronic condition, although substantially lower than those for the US-born, increased with increasing length of US residence. Given the substantial nativity differences in health status and mortality, future waves of immigrants of diverse ethnic and cultural backgrounds will likely have a sizeable impact on the overall health, disease, and mortality patterns in the United States.
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            Cigarette smoking behavior among US Latino men and women from different countries of origin.

            This study sought to compare smoking behavior among Latino men and women from different countries of origin. A telephone-administered survey was conducted in 8 cities with Latino men and women of different national origin living in census tracts with at least 70% Latino individuals. A total of 8882 participants completed the survey; 53% were women. The average age of respondents was 44 years; 63% were foreign-born, and 59% preferred Spanish for the interview. Current smoking was more prevalent among men (25.0%, 95% confidence interval [CI] = 23.7, 26.3) than among women (12.1%, 95% CI = 11.1, 13.0). Smoking rates were not significantly different by national origin among men, but Puerto Rican women had higher rates of smoking than other women. Central American men and women had the lowest smoking rates. Foreign-born respondents were less likely to be smokers (odds ratio [OR] = 0.77, 95% CI = 0.66, 0.90) than US-born respondents, and respondents with 12 years or less of education had an increased odds of smoking (OR = 1.17, 95% CI = 1.01, 1.35). High ac culturation was associated with more smoking in women (OR = 1.12, 95% CI = 1.00-1.25) and less smoking in men (OR = 0.86, 95% CI = 0.78-0.95). Puerto Rican and Cuban respondents were more likely to be current smokers and to smoke more than 20 cigarettes per day. Older, US-born, and more-educated respondents were less likely to be current smokers. Respondents of Puerto Rican and Cuban origin were more likely to smoke. Acculturation has divergent effects on smoking behavior by sex.
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              Eliminating tobacco-related health disparities: directions for future research.

              Certain groups in the United States remain at high risk and suffer disproportionately from tobacco-related illness and death despite progress made in reducing tobacco use. To address gaps in research on tobacco-related disparities and develop a comprehensive agenda aimed at reducing such disparities, representatives from funding agencies, community-based organizations, and academic institutions convened at the National Conference on Tobacco and Health Disparities in 2002. Conference participants reviewed the current research, identified existing gaps, and prioritized scientific recommendations. Panel discussions were organized to address research areas affecting underserved and understudied populations. We report major research recommendations made by the conference participants in several scientific domains. These recommendations will ultimately help guide the field in reducing and eliminating tobacco-related disparities in the United States.
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                Author and article information

                Contributors
                Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention
                ,
                Coordinating Center for Terrorism Preparedness and Emergency Response, Centers for Disease Control and Prevention, Atlanta, Georgia
                Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Rockville, Maryland
                Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
                Journal
                Prev Chronic Dis
                Preventing Chronic Disease
                Centers for Disease Control and Prevention
                1545-1151
                July 2008
                15 June 2008
                : 5
                : 3
                : A78
                Affiliations
                Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention
                Coordinating Center for Terrorism Preparedness and Emergency Response, Centers for Disease Control and Prevention, Atlanta, Georgia
                Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Rockville, Maryland
                Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
                Article
                PCDv53_07_0116
                2483561
                18558028
                1cd7908d-a13b-45a0-844a-c724b143bc42
                Copyright @ 2008
                History
                Categories
                Original Research
                Peer Reviewed

                Health & Social care
                Health & Social care

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