Heterogeneity in the Smoking Behavior of African American Women Gary King, PhD; Anthony Polednak, PhD; Pebbles Fagan, PhD, MPH Tamika Gilreath, MS; Ellen Humphrey, BA; Anita Fernander, PhD Robert Bendel, PhD; Farzad Noubary, MS Objective: To assess the association between sociodemographic variables and smoking behavior patterns of African American women. Methods: Six years of data (N=14,903) from the National Health Interview Surveys were analyzed using multiple logistic regression. Results: African American women in the South were more likely to never smoke and to start smoking later. Positive smoking outcomes (never smoking, initiat-
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moking is a major contributor to the burden of disease among women and in particular lung and other cancers, cardiovascular and respiratory illnesses.1-3 Although a number of studies have documented differences in cigarette use and consequences between African American and other ethnic populations
Gary King, Associate Professor, The Pennsylvania State University, University Park, PA; Anthony Polednak, Adjunct Professor, University of Connecticut Health Center, Farmington, CT; Pebbles Fagan, Research Scientist, National Cancer Institute, Bethesda, MD. Tamika Gilreath, Graduate Student; Ellen Humphrey, Graduate Student, The Pennsylvania State University, University Park, PA. Anita Fernander, Assistant Professor, University of Kentucky, Lexington, KY; Robert Bendel, Research Professor, Washington State University, Spokane, WA; Farzad Noubary, Graduate Student, The Pennsylvania State University, University Park, PA. Address correspondence to Dr King, The Pennsylvania State University, 315 E. Health and Human Development, University Park, PA 16802. E-mail:
[email protected] Am J Health Behav.™ ™ 2006;30(3):237-246
ing smoking at later ages, and quitting) were associated with higher education, higher income, and being married. Conclusions: Variations among African American women suggest the need for targeting specific subgroups at greater risks to reduce disparities in smoking and smoking-related diseases. Key words: African American/ Black women, smoking, cessation, initiation Am J Health Behav. 2006;30(3):237-246
and racially classified social groups,3-10 few investigations have adequately investigated heterogeneity or differences within specific subgroups of African American women.11 This shortcoming has resulted in broad generalizations and has not provided policy makers and interventionists with sufficient data to target demographic populations where the problem is most severe. Targeting specific African American subgroups could more effectively result in reducing overall disparities between majority and minority populations. The objective of this paper is to assess the association between sociodemographic variables (such as age, education, income, region of residence, and marital status) and smoking behavior of a national sample of African American women. The findings should contribute to our understanding of the social heterogeneity of quitting among African American women and may help in developing smoking prevention and cessation programs that ultimately reduce the prevalence of smoking and smoking-related diseases
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Heterogeneity in the Smoking Behavior
Table 1 Smoking Behavior by Sociodemographic Characteristics Among African American Women: 1995 – 2001a,b Frequency of Respondents n=14,903 (%)
Never Smokers %c
Variables Age 20-34 yrs 35-54 yrs 55 and over Education 18 yrs of age
Mean Agec
>15 CPD
Mean CPDsc
35.0 41.2 23.8
77.7f 58.4 61.2
55.2f 59.4 66.6
18.1f 19.3 20.6
32.6 37.4 38.1
12.7 13.0 13.0
24.4 31.6 29.0 15.0
57.9f 64.0 69.4 75.7
51.4f 60.0 65.6 74.8
18.8f 19.4 19.8 20.3
41.5e 35.7 32.6 25.9
14.3f 12.7 11.9 11.2
54.7 19.3 19.0 7.0
68.9f 59.9 62.9 66.5
62.8f 61.5 53.0 60.1
19.7e 19.4 18.6 19.4
37.8 36.5 33.0 31.4
13.2 13.0 12.5 11.6
42.1 58.0
61.1f 69.4
56.7f 64.1
19.1d 19.6
40.4f 31.9
13.9f 12.0
65.8 34.2
64.1f 69.1
59.0d 63.5
19.4 19.4
36.2 36.4
13.0 12.8
16.1 16.8 16.8 17.3 17.3 15.8
61.9f 65.1 66.4 64.6 67.1 70.2 65.9
65.2 59.4 57.1 60.6 59.1 60.8 60.3
19.7d 18.9 19.2 19.4 19.4 19.8 19.4
45.5d 37.5 33.3 33.0 32.9 34.6 36.1
14.8e 13.2 12.5 12.4 12.1 12.5 12.9
Note. a National Health Interview Data b Women aged 20 and older c P values associated with the overall effect of each variable d P
