OBJECTIVE:To determine if hypothesized differences in attitudes and beliefs about cigarette smoking between Latino and non-Latino white smokers are independent of years of formal education and number of cigarettes smoked per day.
DESIGN:Cross-sectional survey using a random digit dial telephone method. ncreasing ethnic diversity in the United States mandates the development of culturally appropriate health-related interventions supported by background research. 1 To develop interventions applicable at the community level or in clinical circumstances, similarities and differences in attitudes, beliefs, and behaviors related to the outcomes of interest must be evaluated in the target population. Health care researchers and policy makers should not assume that an intervention program effective with non-Latino whites (henceforth whites) will have similar results in other ethnic groups.
SETTING:Cigarette smoking is the leading cause of preventable morbidity and mortality in the United States among all ethnic groups. 2 Most cigarette smokers who successfully quit do so on their own, motivated by a variety of psychological, social, and health-related reasons. 3 Policies regulating smoking, media campaigns against smoking, welldesigned self-help cessation materials, and advice from clinicians are potential elements of a public health strategy to promote nonsmoking. 4 Given the substantial differences in sociocultural background among ethnic groups in the United States, it is reasonable to postulate that ethnic differences in cigarette smoking behavior, attitudes, and beliefs should influence the content of smoking cessation interventions.National and regional surveys have found that, on average, fewer Latinos smoke than whites, and among current smokers Latinos average fewer cigarettes per day. [5][6][7][8] Our previous work with convenience samples showed that compared with whites, Latinos are less likely to smoke in response to habitual cues, as likely to smoke in response to emotional cues, and more likely to want to quit because of cigarette smoke's effects on others' health, interpersonal relationships, and their own health. [9][10][11][12][13][14] Whether these differences in attitudes, beliefs, and behavior are related to ethnicity or are confounded by differences in education and level of nicotine dependence remains unclear. Level of formal education is likely to influence culturally driven beliefs and attitudes, and more important, affect knowledge and access to information regarding the effects of smoking and reasons to quit. Because of the differences in level of nicotine dependence, it is plausible to postulate that the "attitude" or "belief" Latinos may hold about quitting smoking or continuing to smoke is in part driven by less-intense addiction. Lessdependent smokers are more likely to find it easier to quit under any circumstances; thus, they are also more likely