American Journal of Public Health, Vol 91, Issue 2 213-218, Copyright © 2001 by American Public Health Association
Ten-year changes in smoking among young adults: are racial differences explained by socioeconomic factors in the CARDIA study?
CI Kiefe, OD Williams, CE Lewis, JJ Allison, P Sekar and LE Wagenknecht
Department of Medicine, University of Alabama at Birmingham, 1717 11th Ave S, MT 700, Birmingham, AL 35205-4785, USA. ckiefe@uab.edu
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.