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TOBACCO USE in DIVERSE POPULATIONS

This study examines the prevalence of adult smoking by race/ethnicity in the United States in 2007. It explores the health disparities and inequalities related to tobacco use, including initiation, current use, exposure to secondhand smoke, and smoking cessation behaviors. The study also highlights ethnic differences in smoking behaviors and the impact of tobacco marketing on minority communities.

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TOBACCO USE in DIVERSE POPULATIONS

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  1. TOBACCO USE in DIVERSE POPULATIONS

  2. PREVALENCE of ADULT SMOKING, by RACE/ETHNICITY—U.S., 2007 36.4% American Indian/Alaska Native* 19.8% Black* 21.4% White* 13.3% Hispanic 9.6% Asian* * non-Hispanic Centers for Disease Control and Prevention. (2008). MMWR 57:1221–1226.

  3. HEALTH DISPARITY/INEQUALITY Health disparities are potentially avoidable differences in health between groups of people who are more and less advantaged socially Used to describe unequal health conditions or indicators (e.g., tobacco use initiation, current use, ETS, CPD, quitting, treatment access, relapse, cancer). Fagan et al (2007); Braveman (2006)

  4. Lung Cancer Incidence and Cardiovascular-Related Mortality for US Adults, 2002-2006 CDC, Health, United States, 2008; SEER Cancer Statistics Review, 1975-2006

  5. ETHNIC DIFFERENCES in SMOKING BEHAVIORS • Initiation • Middle/high school: Latinos/Hispanics • Middle school: Native Americans, Pacific Islanders • High school: Asian Americans (experimentation) • After 18: African Americans (experimentation/regular use) & Asian-Americans (regular use) Fagan et al., 2007 ; Kandel et al., 2004; Trinidad et al., 2004

  6. ETHNIC DIFFERENCES in SMOKING BEHAVIORS • 75% of African Americans smoke menthol cigarettes • ≤ 10 cigarettes per day • Latinos: 59% men, 75% women • African Americans: 42.9% men, 59.7% women • 53% Japanese American women; 22% men • ≤ 15 cigarettes per day • 70% Pacific Islanders • 50% American Indians/Alaska Natives Fagan et al., 2007; Haiman et al., 2006; Eichner et al., 2005; U.S.DHHS, 1998

  7. SECONDHAND TOBACCO SMOKE • Youth: 10% Mexicans, 16% other Latin countries, 35.5% Puerto Ricans • African American youth: 46% youth exposed to secondhand smoke (highest of any ethnic group) • Higher serum cotinine levels compared to white and Latino youth • Data needed for Asian and Native Americans • Home exposure is likely high for American Indians • 31% of Vietnamese American women exposed daily Fagan et al., 2007; Freeman et al., 2003; Stamatakis et al., 2002

  8. SMOKING CESSATION Quit 1+ days in past 12 months • Blacks (47%) > Whites (42%) • 45-46%: Hispanics, Asians, American Indians • No ethnic differences in lifetime quit attempts or desire to quit National Health Interview Survey Results, 2007

  9. AFRICAN-AMERICANS • Nicotine accumulates in tissue containing melanin • Higher serum and hair cotinine levels in black youth compared to white and Latino youth • Tobacco industry has a 70 year relationship with African American organizations Yerger et al., 2007; Yerger & Malone, 2006; Yerger & Malone, 2002; Tang et al., 1999

  10. Yerger & Malone (2002)

  11. MARKETING DEATH

  12. Bates # 507137655

  13. Inner City Menthol Marketing Blitz Yerger, Przewoznik, & Malone (2007)

  14. Bates # 85625435

  15. SALEM’S (1989) MARKETING RESEARCH REPORT Bates #

  16. TEENS & MENTHOL • Newport is the second most popular brand (21% in 2006) of middle & high school smokers (MMWR, 2009) • 93% (n=551) inner-city Baltimore youth (54% white) calling a study line for cessation smoked menthol cigarettes (Moolchan, 2003)

  17. Bates # 501244549

  18. SUMMARY • Ethnic differences exist in smoking rates and level of use, types of tobacco smoked (menthol), and secondhand smoke exposure. • The cause of the disparity in the prevalence of tobacco-related diseases among African Americans is unknown. • The tobacco industry has a long history of targeting ethnic minorities with their products.

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