Race Differences in Cigarette Trajectories

Introduction: Cigarette smoking remains the leading cause of preventable deaths. Compared to their racial/ethnic counterparts, Black youth show greater increases in cigarette smoking behaviors as they age into adulthood and experience disproportionate cigarette-related consequences. Preliminary findings suggest that biracial Black youth may have more problematic patterns of cigarette use than monoracial Black youth. The purpose of this study was to examine the cigarette smoking trajectories of de-aggregated biracial Black youth (i.e., Black-American Indian, Black-Hispanic, Black-White) compared to their corresponding monoracial counterparts (Black, White, Hispanic, and American Indian).

Methods: This study used a subset of data from the National Longitudinal Study of Adolescent and Adult Health (Add Health). Add Health is an ongoing, longitudinal study with a nationally representative sample of U.S. adolescents and adults who have been followed from adolescence into adulthood via four waves of data collection. The analytic sample included 9,421 participants who self-identified as biracial Black or monoracial Black, White, Hispanic, or American Indian. Data were analyzed by applying a cohort sequential design, and analyses were conducted using Mplus version 6.1. All analyses incorporated stratification and survey weights. Latent growth curve modeling (LGM) was used to test the study hypotheses. We used a series of Wald’s chi-square tests to examine whether significant differences exist between the smoking trajectories of the biracial groups and their two corresponding monoracial groups. To adjust for multiple testing, we use False Discovery Rate (FDR) correction at the 0.05 level.

Results: Controlling for sociodemographic variables, results indicate that there is a significant difference between Black-Hispanics and Hispanics, and Black American-Indians and American-Indians in lifetime cigarette use over time. Significant differences were found between Black American-Indians and Blacks, and between Black American-Indians and American-Indians in number of days smoked cigarette days during the past 30 days and for those who reported smoking cigarettes regularly during their lifetimes. Results also show significant differences between Black-Hispanics and Hispanics, Black-American Indians and Blacks, and between Black-American Indians and American Indians in the number of cigarettes smoked each day.

Conclusions: Results indicate that cigarette trajectories vary significantly by race over time. Biracial Black youth demonstrated more rapid escalation in cigarette use than monoracial Black youth. Theses findings highlight the need for substance abuse prevention to both target adolescents and young adults cultural backgrounds and explore within group differences in mechanisms of cigarette smoking trajectories.