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Cancer Control Research

Trinidad, Dennis Ryan


DESCRIPTION (provided by applicant): Racial/ethnic minorities bear a disproportionate burden of smoking-related diseases and exhibit higher rates of adult smoking and lower rates of quitting compared to Non-Hispanic Whites. Conceptualizations of smoking cessation have been based on Non-Hispanic White populations that are heavy or daily smokers. Racial/ethnic minority groups are more likely to be light and intermittent smokers, thus our understanding of smoking cessation should be examined for their applicability to such populations. Results from this project will have implications for the design and focus of smoking cessation programs for racial/ethnic minority groups. We propose a secondary data analysis of the Tobacco Use Supplements to the Current Population Survey and the California Tobacco Surveys. All analyses will be conducted for major racial/ethnic groups (African Americans, Asian Americans, Hispanics/Latinos, Native Americans and Non-Hispanic Whites) and their subgroups (e.g., Korean Americans, Hispanics of Mexican descent, etc.), and by gender, age group, English language use, and educational level. Specific Aim 1: Among racial/ethnic minorities, conduct between-group and within-group analyses to better understand light and intermittent smoking in specific population segments. a) Provide an overview of light and intermittent smoking for racial/ethnic groups, especially specific subgroups that do not have published research, which includes Asian Americans (e.g., Chinese Americans) and Hispanics/Latinos of Mexican descent, and for African Americans in various geographic regions of the U.S. b) Investigate the effects of state-level tobacco control policy on the distribution of light and intermittent smoking around the country over time for various racial/ethnic groups. Specific Aim 2: Research has shown that smokers can be categorized along a quitting continuum. We will report on the population distribution of smokers from different racial/ethnic groups along the quitting continuum. c) Hypothesis: The distribution of racial/ethnic minority smokers along the quitting continuum will be skewed and appear as if they will experience greater quitting success in the future compared to Non-Hispanic Whites. However, this will not be associated with actual higher rates of successful cessation. Such results would suggest that conceptualizations of the quitting process among minorities need to be reassessed. Specific Aim 3: Evaluate the applicability of smoking cessation treatment modalities to racial/ethnic minorities, particularly among those who are light and intermittent smokers. d) We will evaluate the prevalence of previously identified predictors of cessation, such as reducing consumption, making prior quit attempts, use of cessation aids (e.g., quitlines, nicotine replacement therapy), physician advice to quit, and the presence of complete home smoking bans across racial/ethnic groups. We will then examine how these factors affect the smoking cessation process across groups. PUBLIC HEALTH RELEVANCE: The goal of this proposed study is to examine the process of quitting smoking among racial/ethnic minority groups to better understand why their quitting rates are lower than Non-Hispanic Whites given that minority groups are more likely to be lighter and non-daily smokers. The traditional understanding of the quitting process has been based on populations that were heavy and daily smokers so it might not be applicable to racial/ethnic minority groups. Our findings can have implications for how smoking cessation programs are designed for racial/ethnic minorities and lead to a reduction of disparities in smoking and smoking-related diseases.

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