摘要：Adult cigarette smoking prevalence trends among African Americans (AAs) and Whites are similar. However, during the decline in youth smoking that occurred between the mid-1970s and the early 1990s, the drop in smoking rates among AA adolescents was more than double that among Whites. We examined the evidence for potential explanations for this phenomenon. On the basis of our findings, we propose that racial differences in parental attitudes, religious ties, negative perceptions and experiences of the health effects of smoking, worsening poverty, increased use of food stamps, and price sensitivity were major factors contributing to the more rapid decrease in and continued lower rates of smoking among AA youths. Tobacco smoking remains the leading cause of preventable death in the United States. 1 African Americans (AAs) have particularly high rates of smoking-related morbidity and mortality, 2 although their current smoking rates are similar to those of Whites. 3 , 4 During the 1970s there was a substantial overall decline in teen smoking; however, the extent of the reduction differed substantially among racial and ethnic groups. Prevalence declined more rapidly among AA youths than it did among White and Hispanic youths. Smoking prevalence for AA youths continued to drop even as smoking prevalence for other groups stabilized in the 1980s. 5 , 6 Figure 1 shows the change in past-30-day cigarette use prevalence over time across racial/ethnic groups. Open in a separate window FIGURE 1 Thirty-day prevalence of cigarette use among African American, White, and Hispanic high school seniors: United States, 1976–2005. Source . Nelson et al. 7 Printed with permission. Given nicotine's addictive power and health consequences, and given that most adult smokers began smoking in adolescence, 8 – 10 reducing smoking among youths is a public health priority. An identification of the reasons behind the smoking decline among AA youths might inform policies and public health programming intended to reduce tobacco use among all youths. Previous studies examining the decline in smoking among AA adolescents during the 1970s and 80s 7 , 11 speculated that alternative drug use, 12 religious affiliations, 13 and cigarette pricing 12 were likely contributing factors in the decline. We reviewed the literature to explore these and other hypotheses that may account for the sharp decline in smoking among AA youths and the differential reduction rates between AA and White youths.
