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Black Youths Likelier to Quit Smoking

Study cites parental disapproval, less exposure to peers who smoke

TUESDAY, Feb. 3, 2004 (HealthDayNews) -- Most black teens try smoking cigarettes, but they're much less likely than whites and Hispanics to become regular smokers as adolescents and young adults, new research finds.

The Rand Corp. study, published in the February issue of the American Journal of Public Health, found 62 percent of black youths had lit up by age 13, compared with 69 percent of Hispanics, 52 percent of whites and 36 percent of Asian-Americans.

But by age 15, just 7 percent of blacks in the study had become regular smokers, compared with 20 percent of whites and Hispanics and 8 percent of Asian-Americans.

Rand researchers attribute the drop-off in smoking among blacks to factors including parental disapproval, communication with parents about personal problems, having fewer friends who smoke, and receiving fewer offers of cigarettes from peers.

"What we find really intriguing is that this parental disapproval of smoking really seems to have an impact that African-American kids really pay attention to," says study author Phyllis L. Ellickson.

Ellickson, director of the Rand Center for Research on Maternal, Child and Adolescent Health, says the results suggest steps such as getting parents to talk to their children about smoking, improving family bonds and dampening peer pressure to smoke might help keep youths from becoming regular smokers.

For the study, researchers tracked more than 6,000 blacks, whites, Hispanics and Asian-Americans for 10 years, from ages 13 to 23. Rand recruited the study participants from 30 California and Oregon middle schools for a study on substance abuse.

Students completed surveys about substance abuse, smoking and psychological, social and behavioral factors.

By age 23, the survey showed, 19 percent of blacks smoked regularly, compared with 32 percent of whites, 29 percent of Hispanics and 16 percent of Asian-Americans.

Along with influence of peers and parents, researchers looked at risk factors that could be related to decisions on whether to smoke, such as school grades and "problem behavior" such as rebelliousness and marijuana or alcohol use.

Asian-Americans did well in school and were less likely than others to drink alcohol, smoke marijuana, or be exposed to "pro-smoking influences," Ellickson says.

Blacks, by contrast, had significantly worse grades than whites throughout middle school and high school. "But," Ellickson adds, "it appears to be counteracted by positive influence from parents and less exposure to smoking."

For example, the proportion of black youths with a best friend who smokes dropped after age 13 or 14, the study says.

Edwin Fisher, a professor of psychology, medicine and pediatrics at Washington University in St. Louis, says parents play a crucial role in keeping kids from becoming smokers.

"An overlooked aspect of preventing smoking in adolescents is parental involvement and parental wisdom in treating smoking as a health problem, not a discipline problem," says Fisher, a spokesman for the American Lung Association.

"So it's not a matter of simply saying, 'You don't smoke because you're my child and it's my house.' It's a matter of explaining to young people why smoking is so dangerous, and providing them opportunities for showing independence in doing things their own way in healthy ways without needing to show their independence by doing things like smoking."

Preventing smoking during the teen years is critical. Tobacco use typically begins by age 16, and the first smoke almost always occurs before high school graduation, the American Lung Association says. At least 4.5 million American adolescents smoke, and each day 6,000 U.S. children under 18 smoke their first cigarette, the association says. Moreover, smoking-related diseases kill about 430,700 Americans each year.

Adolescent smoking has been linked not only to significant health problems, but also involvement in fights, carrying weapons, engaging in high-risk sexual behavior and using alcohol and other drugs.

Four decades after the landmark Surgeon General's Report on Smoking and Health provided the first official U.S. recognition that smoking causes cancer and other serious diseases, other new studies also have looked at the demographics of those who smoke.

The Dana-Farber Cancer Institute, a teaching affiliate of Harvard Medical School, found that occupation is a significant factor in determining which adults smoke. People in working-class, non-supervisory positions, including blue-collar and service jobs, had the highest smoking rates. The study also showed those with less education and lower income smoked more than others.

The findings appear in the same issue of the American Journal of Public Health, along with results of a separate Dana-Farber study on one of the first workplace programs to successfully reduce smoking rates among blue-collar workers. The study concluded that smoking cessation combined with broader occupational safety and health worked much better than smoking cessation offered alone.

Researchers tested the two approaches at 15 Massachusetts manufacturing firms for two years. Smoking quit rates for those who had smoking cessation as part of the broader health-promotion efforts were more than twice that of those who underwent only smoking cessation.

In an analysis of national survey data from 1999 to 2001, the U.S. Centers for Disease Control and Prevention found 8.2 percent of blacks aged 12 to 17 had smoked during the preceding month. That compares with 29.5 percent of American Indians and Alaska natives, 14.9 percent of white youths, 11.4 percent of Hispanics and 8.8 percent of those from Asian ethnic groups, according to the survey, which appears in the Jan. 30 issue of the CDC publication Morbidity and Mortality Weekly Report.

More information

Get help on how to quit smoking from the American Lung Association or the CDC's Tips 4 Youth.

SOURCES: Phyllis L. Ellickson, Ph.D., director, Rand Center for Research on Maternal Child and Adolescent Health, Santa Monica, Calif.; Edwin Fisher, Ph.D., professor, psychology, medicine and pediatrics, Washington University, St. Louis, and spokesman, American Lung Association; February 2004 American Journal of Public Health; Jan. 30, 2004, Morbidity and Mortality Weekly Report
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