Why does adult African-American smoking prevalence in California remain higher than for non-Hispanic whites?
OBJECTIVE
To explain why, contrary to national trends, adult California African-American (AA) smoking prevalence remains higher than for non-Hispanic Whites (W) and to explore how future rates might change.


METHODS
Data from the random-digit-dialed California Tobacco Surveys from 1990 to 2002 (N=16,000-21,000) allowed for the examination of differences in current smoking prevalence, ever smoking (uptake), and successful smoking cessation over time by race/ethnicity and age group.


RESULTS
African-American (AA) adolescent (12-17 years) smoking prevalence was lower than Ws through 1996, but similar thereafter because of marked declines for Ws. After 1990, AA young adult (18-29 years) smoking prevalence was consistently 25% lower than Ws', and no evidence of delayed AA smoking initiation was seen. However, among older age groups (30-44 years and 45+ years), AA smoking prevalence was much higher, yielding higher overall adult (18+ years) prevalence. While ever smoking (uptake) was generally lower among AAs, successful cessation (5+ years) was much lower among AA adults, especially older age groups.


CONCLUSIONS
Continued higher adult California AA smoking prevalence results from less successful quitting in older age groups. Increased successful cessation is critical for reducing near-term prevalence. Long-term forecasting is difficult because both AA and W adolescents now smoke at comparably low rates.
Trinidad
Dennis R
DR
Cancer Prevention and Control Program, Cancer Center, University of California, San Diego, La Jolla, CA 92093-0645, USA.
Gilpin
Elizabeth A
EA
White
Martha M
MM
Pierce
John P
JP
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D017677:Age Distribution; D002140:California / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D008875:Middle Aged; D015995:Prevalence; D012907:Smoking / Q000208:ethnology*; D016540:Smoking Cessation / Q000706:statistics & numerical data; D044465:White People / Q000706:statistics & numerical data