Influence of experiences of racial discrimination and ethnic identity on prenatal smoking among urban black and Hispanic women.
BACKGROUND
Although the prevalence of prenatal smoking among minority women exceeds the projected 2010 national objective, data on the determinants of prenatal smoking among minorities remain sparse.


METHODS
We examined associations between self-reported experiences of racial discrimination on prenatal smoking among urban black and Hispanic women aged 18-44 years (n=677). Our main independent variable was created from the Experiences of Discrimination (EOD) scale. Multivariable logistic regression models were estimated to examine the relationship between EOD (moderate EOD as the referent group) and smoking for the entire sample and then separately by race/ethnicity adjusted for sociodemographic variables. We also examined the role of ethnic identity (EI) as a buffer to racial discrimination (n=405).


RESULTS
The prevalence of smoking was 18.1% versus 10% for black and Hispanic women, respectively (p=0.002). There were no significant differences in the level of EOD based on race. In multivariate regressions, compared to those reporting moderate EOD, women reporting high discrimination (OR 2.64, 95% CI 1.25 to 5.60) had higher odds of smoking. In stratified analyses, this relationship remained significant only in black women. Results suggest that foreign-born Hispanic women with higher EI were less likely to smoke compared to their low-EI counterparts (3.5 vs 10.1%; p=0.08).


CONCLUSIONS
These are the first data in pregnant minority women showing an association between discrimination and increased risk of smoking particularly among black women. Ethnic identity and nativity status were also associated with smoking risk. Smoking cessation programmes should consider such factors among childbearing minority women.
Helen Diller Family Comprehensive Cancer Center, University of California, 1450 3rd Street, San Francisco 94111, USA. nguyenk@cc.ucsf.edu
Kim Hanh
KH
Nguyen
S V
SV
Subramanian
Glorian
G
Sorensen
Kathy
K
Tsang
Rosalind J
RJ
Wright
D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000175:diagnosis; D044383:Black People / Q000523:psychology*; D001900:Boston / Q000453:epidemiology; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D016015:Logistic Models; D011287:Prejudice; D011295:Prenatal Care; D011446:Prospective Studies; D012907:Smoking / Q000453:epidemiology* / Q000208:ethnology*; D012938:Social Perception; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000208:ethnology; D011795:Surveys and Questionnaires; D014505:Urban Population / Q000706:statistics & numerical data*; D001741:Black or African American