Ten-year changes in smoking among young adults: are racial differences explained by socioeconomic factors in the CARDIA study?

Abstract

We used a population-based longitudinal study of African American and White young adults in 4 US cities to (1) compare regular smoking prevalence, cessation, and initiation rates in African American and White young adults over a 10-year period and (2) examine whether potential differences are explained by socioeconomic factors. MethodsThe Coronary Artery Risk Development in Young Adults (CARDIA) study, a biethnic, prospective, multicenter epidemiologic study of the evolution of risk factors in young adults, has been described in detail elsewhere. 19 Briefly, from 1985 to 1986, 5115 African American and White individuals aged 18 to 30 years were examined in Birmingham, Ala; Chicago, Ill; Minneapolis, Minn; and Oakland, Calif. At the Birmingham, Minneapolis, and Chicago sites, participants were randomly selected from total communities or from specific census tracts. In Oakland, participants were randomly selected from members of the Kaiser Permanente medical care program.Recruitment was stratified to achieve nearly equal numbers at each site in terms of race (African American, White), sex, education (high school or less, more than high school), and age (18-24 years, 25-30 years). Fifty percent of individuals contacted were examined (47% of African Americans and 60% of Whites) and became the CARDIA cohort.Objectives. This study investigated whether socioeconomic factors explain racial/ethnic differences in regular smoking initiation and cessation.Methods. Data were derived from the CARDIA study, a cohort of 5115 healthy adults aged 18 to 30 years at baseline (1985)(1986) and recruited from the populations of 4 US cities. Respondents were followed over 10 years.Results. Among 3950 respondents reexamined in 1995-1996, 20% of Whites and 33% of African Americans were smokers, as compared with 25% and 32%, respectively, in 1985-1986. On average, African Americans were of lower socioeconomic status. Ten-year regular smoking initiation rates for African American women, White women, African American men, and White men were 7.1%, 3.5%, 13.2%, and 5.1%, respectively, and the corresponding cessation rates were 25%, 35.1%, 19.2%, and 31.3%. After adjustment for socioeconomic factors, most 95% confidence intervals of the odds ratios for regular smoking initiation and cessation in African Americans vs Whites included 1.Conclusions. Less beneficial 10-year changes in smoking were observed in African Americans, but socioeconomic factors explained most of the racial disparity. (Am J Public Health. 2001;91:213-218) Tobacco smoking is a powerful and preventable risk factor for cardiovascular disease and also markedly increases the risk of lung, oropharyngeal, and esophageal cancers; chronic obstructive pulmonary disease; peptic ulcer disease; and osteoporosis, among others.1 A recent National Institutes of Health task force report noted that "elimination of cigarette smoking is potentially one of the most important public health interventions that can be undertaken."The prevalence of cigarette smoking has decreased markedly in th...

APC Modeling of Smoking Prevalence Among US Adolescents and Young Adults

“…27,28 Every year there are approximately 4 million children entering adolescence and furthering through young adulthood. Although a declining trend in adolescent smoking has appeared in the US since 1996-97, such declining trend could be due to the persistent tobacco control effect since the early 1990s.…”

“…Another studies using longitudinal data from the Coronary Artery Risk Development in Young Adults (CARDIA) data collected in 1985-86 and 1995-96 among young adults 18-30 years old indicated declines in current smoking among Whites and Black males but increases smoking among Black females. 28 Young adulthood represents a high risk period for tobacco use and they also represent a primary marketing target by tobacco industries after tobacco marketing that targeted adolescents were probibited. 29,30 …”

The effects of residential proximity to bars on alcohol consumption

“…Most studies based on CARDIA data used the first few sets of CARDIA interviews (Braun et al 1996; Braun et al 1997; Dyer et al 1990; Greenfield and Weisner 1995; Hoegerman et al 1995; Kiefe et al 2001; Sidney et al 1993; Slattery et al 1992; Son et al 1997; Wagenknecht et al 1992a; Wagenknecht et al 1998; Wagenknecht et al 1990; Wagenknecht et al 1992b). …”

Racial/Ethnic and Nativity Patterns of U.S. Adolescent and Young Adult Smoking

“…The public health literature has given greater attention to racial/ethnic differences in smoking initiation patterns (Anderson and Burns 2000; Ellickson et al 2004; Johnson and Hoffman 2000), smoking behaviors (Fagan et al 2009; Trinidad et al 2009), and persistence of smoking (Griesler, Kendel, and Davies 2002; Kiefe et al 2001; Stahre et al 2010). The most recent report of the U.S.…”