摘要：Objectives. We used data gathered from 6259 youths between the ages of 13 and 23 years to compare trends in smoking among 4 racial/ethnic groups. Methods. We weighted trend data to represent baseline respondent characteristics and evaluated these data with linear contrasts derived from multiple regression analyses. Results. Although African Americans exhibited higher initiation rates than Whites, they exhibited consistently lower rates of regular smoking than both Whites and Hispanics. This seeming anomaly was explained by African Americans’ lower rates of transition to regular smoking and greater tendency to quit. Racial/ethnic disparities were accounted for by differences in pro-smoking influences. Conclusions. Reducing racial/ethnic disparities in smoking may require reducing differences in the psychosocial factors that encourage smoking. National surveys reveal striking racial/ethnic disparities in adolescent smoking behavior. Whites and Hispanics are more likely than African Americans to be current or daily smokers throughout adolescence 1– 5 and also appear to initiate smoking earlier. 6, 7 Asian youths tend to exhibit lower rates of smoking than Whites and Hispanics but not African Americans. 2, 8, 9 Previous studies have not revealed White/non-White differences in smoking cessation rates during adolescence 10, 11 ; however, specific racial/ethnic subgroup differences have not been thoroughly examined. Documenting racial/ethnic differences in smoking is only a starting point in understanding disparities in cigarette use. Such differences raise important questions about what factors foster group differences in smoking behavior and whether sufficient variation exists to warrant tailoring prevention and cessation programs to specific groups. 12 A better understanding of the racial/ethnic context of cigarette use might shed light on how to curb its initiation and escalation during adolescence and young adulthood. 13 Previous research suggests important racial/ethnic variations in 4 psychosocial and behavioral risk domains relevant to smoking: social bonds (families, school, religion), exposure to pro-smoking social influences, engagement in problem behavior, and pro-smoking attitudes. Studies have shown that, in comparison with Whites, Hispanics 14, 15 and Asians 16 exhibit stronger levels of family attachment and that Asians 17– 20 exhibit greater levels of commitment to academic achievement, factors that may result in these groups being less vulnerable to pro-smoking influences and attitudes. Among African Americans, stronger religious ties 6 and greater parental disapproval of smoking 21, 22 seem particularly protective. In contrast, White youths typically have more friends who smoke and approve of doing so, and they may be more vulnerable than other groups to peer influences 6, 23, 24 and parental smoking. 6, 16, 25, 26 Risk taking is a stronger predictor of smoking behavior among African Americans, 25, 26 whereas behavior problems are more strongly associated with smoking among Whites. 26 Finally, smoking-related attitudes are important determinants of smoking behavior, 27– 29 and there is some evidence that their impact on smoking may vary according to race/ethnicity (e.g., the belief that smoking improves one’s self-image predicts smoking onset among White and Hispanic youths but not African American or Asian youths). 26 The goal of our study, which involved a sample of youths from 4 racial/ethnic groups, was to describe trends in lifetime, past-year, and regular (weekly) smoking behaviors occurring between the ages of 13 and 23 years. We expected that, in comparison with African American and Asian youths, White and Hispanic youths would exhibit higher rates of smoking initiation by the age of 13 years and higher rates of weekly smoking over the 10-year period under study. We also examined the extent to which racial/ethnic disparities in smoking behavior could be explained by predictors drawn from the 4 described risk factor domains.
