Drug addiction is a chronic disease defined by compulsive drug-seeking behaviors that has the potential for recurrence, relapse and recovery1. While addiction is a medical disease, it remains a stigmatized disease, which affects substance dependence research, prevention, treatment services and legal policy in the United States. In 2015, almost a quarter of adults and adolescents in the United States (66 million Americans) reported binge drinking within the past month2. In the same year, 27 million Americans reported dependence or misuse of illicit or prescription drugs2. Despite, relatively uniform rates of substance abuse among racial and ethnic populations, there is a disproportionate rate of drug arrests for African-Americans3 . In addition, members of racial and ethnic minority groups are most likely to experience barriers that impede their ability to access substance abuse treatment. We must re-examine how to best make accessible, retain, engage and support African-Americans individuals who are seeking to end their substance dependency. During the month of February, we commemorate African-American Heritage Month. This month, the Ethnicity and Health in America Series will be raising public awareness about substance abuse and addiction among African-Americans. We are featuring the work Hope Landrine, PhD, a psychologist examining the geographic and sociocultural factors in disparities in chronic disease and health behavior among African-Americans and Latinos.
The three articles featured here focus on African-American cigarette smoking and use of other smoked substances; copies of the full articles can be download free of charge by clicking the link. The first article, "Sociocultural correlates of cigarette smoking among African-American men vs. women," examines gender differences in the predictors of smoking. It reveals that low-acculturation is associated with smoking among women only, and notes that smoking cessation interventions that are culturally-tailored for low-acculturated African-Americans may be appropriate only for women4. The second, "Polytobacco use and multiple product smoking," examines African-American smoking of cigarettes, cigarillos, blunts, marijuana and other products. The study found that 49 percent of cigarette-smokers and 15 percent of cigarette non-smokers smoke numerous other products (little cigars and blunts in particular), and highlights implications for racial disparities in smoking related cancers5. The third,"Telephone surveys underestimate cigarette smoking," examines self-reported smoking among African-Americans who were sampled simultaneously in two different ways: Through a random, digit-dial telephone survey (i.e., the manner used in many nationwide studies) versus door-to-door in person; both samples were random, statewide samples. Smoking prevalence among the community sample was 33 percent and among the telephoned sample it was 19 percent. This suggests that telephone surveys (e.g., Behavioral Risk Factor Surveillance System) may significantly underestimate the prevalence of smoking among African-Americans6.
References
1U.S. Department of Health and Human Services (HHS), Office of the Surgeon General, Facing Addiction in America: The Surgeon General's Report on Alcohol, Drugs, and Health. Washington, DC: HHS, November 2016.
2U.S. Department of Health and Human Services (HHS), Office of the Surgeon General, Executive Summary: The Surgeon General's Report on Alcohol, Drugs, and Health. Washington, DC: HHS, November 2016. Retrieved from: https://addiction.surgeongeneral.gov/executive-summaryopens in new window .
3National Association for the Advancement of Colored People. Criminal Justice Fact Sheet . NAACP, n.d. Web. 25 Jan 2017
4Landrine, H. & Corral, I. (2016). Sociocultural correlates of cigarette smoking among African- American men versus women: implications for culturally specific cessation interventions . Journal of Health Psychology . 21 (6). 954-961.
5Landrine, H., Corral, I., Simms, D. A., Roesch, S. C., Pichon, L. C., Ake, D., & Villodas, F. (2013). Telephone Surveys Underestimate Cigarette Smoking among African- Americans. Frontiers in Public Health , 1 (36). https://doi.org/10.3389/fpubh.2013.00036opens in new window
6Corral, I., Landrine, H., Simms, D. A. & Bess, J. J. (2013) Polytobacco use and multiple-product smoking among a random community sample. BMJ Open. 3 (12). 1-8. doi: 10.1136/bmjopen- 2013-003606
Selected Articles
African-Americans have significantly higher rates of smoking-related cancers, diseases and deaths than whites 1-2, but they do not differ from whites in smoking prevalence rates (i.e., roughly 19 percent of African-Americans and of whites are smokers 3-4). How then does one explain racial disparities in smoking-related diseases? Hope Landrine, PhD, attempts to address these concerns in the following articles below.
References
DeSantis CE, Siegel RL, Sauer AG, Miller KD, Fedewa SA, Alcaraz KI, Jemal A (2016). Cancer statistics for African Americans, 2016: Progress and opportunities in reducing racial disparities. CA Cancer J Clin; 66(4):290-308.opens in new window
US Department of Health & Human Services (2014). The health consequences of smoking — 50 years of progress: A report of the Surgeon General . Atlanta: US Department of Health & Human Services.
Agaku IT, King BA, Dube SR (2014). Current cigarette smoking among adults — United States, 2005-2012. Morbidity & Mortality Weekly Report,63(2):2.
Trinidad DR, Pérez-Stable EJ, White MM, et al (2011). A nationwide analysis of US racial/ethnic disparities in smoking behaviors, smoking cessation, and cessation-related factors. Am J Public Health; 101:699–706
Articles
2016
Hope Landrine
Irma Corral
Abstract
Low socioeconomic status, racial discrimination and low acculturation are the major sociocultural correlates of smoking among African-American adults. This study is the first to examine all three variables simultaneously and to analyze gender differences in their association with smoking. Results for the sample revealed that low education and low acculturation predicted smoking but racial discrimination did not. For women, low acculturation was the sole predictor of smoking, whereas for men, socioeconomic status variables were the sole predictors. This suggests that low acculturation may be associated with smoking among African-American women only. Hence, culturally specific smoking cessation programs designed for low-acculturated African-Americans might be effective for African-American women alone.
Citation
Landrine, H. & Corral, I. (2016). Sociocultural correlates of cigarette smoking among African-American men versus women: implications for culturally specific cessation interventions . Journal of Health Psychology. 21 (6). 954-961.
Telephone surveys underestimate cigarette smoking among African-Americansopens in new window
2013
Hope Landine
Irma Corral
Denise Adams Simms
Scott C. Roesch
Latrice C. Pichon
Diane Ake
Feion Villodas
Abstract
This study tested the hypothesis that data from random digit-dial telephone surveys underestimate the prevalence of cigarette smoking among African-American adults. A novel, community-sampling method was used to obtain a statewide, random sample of N = 2118 California (CA) African-American/Black adults, surveyed door-to-door. This black community sample was compared to the blacks in the California Health Interview Survey (N = 2315), a statewide, random digit-dial telephone survey conducted simultaneously. Smoking prevalence was significantly higher among community (33 percent) than among telephone survey (19 percent) Blacks, even after controlling for sample differences in demographics. Telephone surveys underestimate smoking among African-Americans and probably underestimate other health risk behaviors as well. Alternative methods are needed to obtain accurate data on African-American health behaviors and on the magnitude of racial disparities in them.
Citation
Landrine, H., Corral, I., Simms, D. A., Roesch, S. C., Pichon, L. C., Ake, D., & Villodas, F. (2013). Telephone Surveys Underestimate Cigarette Smoking among African-Americans. Frontiers in Public Health , 1 (36). https://doi.org/10.3389/fpubh.2013.00036
Polytobacco use and multiple-product smoking among a random community sampleopens in new window
2013
Irma Corral
Hope Landrine
Denise Adams Simms
Jukelia J. Bess
Abstract
Little is known about polytobacco use among African-American adults. This study is the first to explore this among a random, statewide, community sample of African-American adults. Community-based sampling obtained a random, household-probability sample of African-American adults from California, surveyed door to door in randomly selected census tracts statewide. Participants were a statewide, random household sample of N=2118 African-American adults from California who completed a survey on past 30-day smoking of cigarettes, blunts, bidis, kreteks, cigarillos, marijuana and cigars. Results: almost half (49.3 percent) of the African-American cigarette-smokers and 14.9 percent of the cigarette nonsmokers had smoked at least one non-cigarette product in the past 30 days. Smokers had a substantial prevalence of smoking cigarillos (28.7 percent) and blunts (27.7 percent). Logistic regressions revealed that the odds of smoking most of the non-cigarette products were higher for cigarette smokers and men, inversely related to age and unrelated to socioeconomic status. However, smoking of blunts, bidis and kreteks was not predicted by cigarette smoking. Smoking of cigarillos (eg, Phillies, Black & Mild) and blunts may be prevalent among African-American cigarette-smokers and non-smokers alike, but such products are not examined in most population-level smoking research. Smoking of these products should be included in surveillance studies, in cancer prevention programmes and in healthcare provider-assessment of smoking, and addressed in smoking cessation programmes as well.
Citation
Corral, I., Landrine, H., Simms, D. A. & Bess, J. J. (2013) Polytobacco use and multiple-product smoking among a random community sample. BMJ Open. 3 (12). 1-8. doi: 10.1136/bmjopen-2013-003606