Overview
Racial-Ethnic Groups
Socioeconomic Status (SES)
Resources
Citations
Overview
While an estimated 20.2% of all adults (45.1 million people) smoke cigarettes in the United States, smoking and tobacco use rates are not uniform across the population.1 Some geographic areas have higher prevalence rates than others. The states of Kentucky (28.6%), West Virginia (25.7%), Oklahoma (25.1%), and Mississippi (25.1%) have the highest number of adult smokers. On the other hand, Utah has the lowest percentage of smokers (9.8%).1 Evidence shows that tobacco use also varies by racial and ethnic group, socioeconomic status, and level of education. It is important for employers to acknowledge the disparities in tobacco use so that they can tailor smoking cessation materials to meet the needs of specific employee populations.
Racial-Ethnic Groups
Below is the prevalence of cigarette smoking across different ethnicities, compared to an average rate of 20% for all U.S. adults.1
- 32.0% American Indians/Alaska Natives
- 21.9% Whites
- 21.5% African Americans
- 16.2% Hispanics
- 13.3% Asians [excluding Native Hawaiians and other Pacific Islanders]
American Indians and Alaska Natives
American Indians and Alaska Natives have the highest rate of smoking of all racial and ethnic groups. It is important to keep the following in mind when developing smoking cessation initiatives for this group:
- Tobacco use is cultural for many American Indians and Alaska Natives. Tobacco is considered a sacred gift, and is used during religious ceremonies and as traditional medicine.
- Although American Indians have the highest rates of smoking in the United States, they are less likely to be heavy smokers. In a 2005 study, 57.3% of American Indian and Alaska Native smokers reported using fewer than 15 cigarettes per day. Only 47.1% of white smokers smoke less that 15 cigarettes a day.2
- American Indian and Alaska Native lands are sovereign nations; they are not subject to state or federal laws prohibiting the sale and promotion of tobacco products to minors or to tobacco taxes.2
African Americans
Rates of tobacco use are not uniform across different racial-ethnic populations and tobacco use can impact different populations in different ways.
- White men consume more cigarettes (about 30% to 40% more) than African American men, but African American men are 37% more likely than white men to develop lung cancer. Similar trends exist for African American women.3
- Research is not conclusive as to why the rates of lung cancer are so high among African Americans. Possible theories are:
- African Americans are more likely to use menthol cigarettes which are shown to be more carcinogenic.4
- Previous research in adults showed that black smokers take in 30% more nicotine per cigarette and take longer to rid their bodies of the drug, compared to white smokers.5
- Heart disease, a complication of smoking, is twice as high among African Americans as it is for whites.3
Hispanics
There are significant variations in smoking rates among Hispanic subgroups.
- In 2005, 16.7% of Cuban-Americans smoked compared to 23.6% of Puerto Ricans, 21.2% of Mexican Americans, 14.3% of Dominicans, and 12.2% of Central-South Americans.6
- In 2005, 21.1% of Hispanic men and 11.1% of Hispanic women in the United States smoked.6
Employers with a large Hispanic employee population may want to ensure that smoking cessation materials are published in Spanish as well as English.
Asian Americans and Pacific Islanders
The rate of smoking for Asian Americans and Pacific Islanders is significantly lower than the national average. This group is also more likely to quit than whites, but less likely to remain abstinent.
- Smoking rates among Asian women are over 50% less than the rates of women in other racial/ethnic groups.7
- In 2004, 4.8% of Asian American women smoked.7
- Southeast Asians (i.e., people from Vietnam, Cambodia, Laos) and Chinese men tend to have much higher rates of smoking than population groups from other Asian locations (i.e., Philippines, Korea, Japan).2
- The average number of cigarettes smoked per day by Chinese men increases with the time they live in the United States.2
- Over 300 million men in China — more than the entire U.S. population — are smokers.8
Socioeconomic Status (SES)
Socioeconomic status is determined by income, education, and employment. People with low SES typically:
- Have less than 12 years of education.
- Have low incomes or are unemployed.
- Live in areas that are medically underserved.
People with low SES are more likely to smoke.
- Americans below the poverty line are 40% more likely to smoke than those at or above the poverty line.9
- Studies show that people with lower levels of education are more likely to smoke.10 Employers with a large population of employees with lower levels of education may want to ensure that smoking cessation materials are written at a lower literacy level.
- 43.2% of smokers have a high school or General Education Development (GED) diploma.
- 32.6% of smokers completed grades 9-11 in high school.
- 10.7% of smokers graduated from college.
- 7.1% of smokers have a graduate degree.
Resources
For more information about tobacco use and American Indians and Alaska Natives see:
The Surgeon General's Report on American Indians and Alaska Natives and Tobacco
For more information see about tobacco use and African Americans see:
The Surgeon General's Report on African Americans and Tobacco
Pathways to Freedom: Winning the Fight Against Tobacco
For more information on tobacco use and Hispanics see:
The Surgeon General's Report on Hispanics and Tobacco
The National Latino Council on Alcohol and Tobacco Prevention
For more information see on tobacco use and Asian-Americans and Pacific Islanders see:
The Surgeon General's Report on Asian Americans and Pacific Islanders and Tobacco
For more information on tobacco use and socioeconomic status see:
The National Network on Tobacco Prevention and Poverty
For more information on tobacco use and disparities see:
CDC - Smoking and Health Disparities
Prevalence of Cigarette Use Among 14 Racial/Ethnic Populations — United States, 1999-2001
National Survey on Drug Use and Health — Past Month Cigarette Use Among Racial and Ethnic Groups
Citations
1 Centers for Disease Control and Prevention. State-Specific Prevalence of Cigarette Smoking Among Adults and Quitting Among Persons Aged 18-35 Years — United States, 2006. MWWR. 2007;56(28):993-996.
2 U.S. Department of Health and Human Services. Tobacco use among U.S. racial/ethnic minority groups - African Americans, American Indians and Alaska Natives, Asian Americans and Pacific Islanders, and Hispanics: A report of the Surgeon General. Washington, DC: Office of the Surgeon General; 1998. Available at: http://www.surgeongeneral.gov/library/reports.htm. Accessed April 18, 2008.
3 American Cancer Society. Cancer facts and figures for African Americans, 2007-2008. Available at: http://www.cancer.org/downloads/STT/CAFF2005AACorrPWSecured.pdf. Accessed October 1, 2007.
4 Harvard School of Public Health. Harvard researchers gather more evidence implicating menthol in health disparities between white and black smokers. Available at: http://www.hsph.harvard.edu/news/press-releases/2005-releases/press08182005.html.
5 Science Daily. Black, White Teens Show Differences In Nicotine Metabolism. Available at: http://www.sciencedaily.com/releases/2006/02/060201232537.htm. Accessed November 21, 2007.
6 American Lung Association. Smoking and Hispanics. Available at: http://www.lungusa.org/site/pp.aspx?c=dvLUK9O0E&b=36002&printmode=1. Accessed November 15, 2007.
7 Centers for Disease Control and Prevention. Cigarette smoking among adults—United States, 2004. MWWR. 2005;54(44).
8 Muggli ME, Pollay RW, Law R, Joseph AM. Targeting of Asian Americans and Pacific Islanders by the tobacco industry: Results from the Minnesota tobacco document depository. Tobacco Control. 2002;11(3):201-209.
9 National Network on Tobacco Prevention and Poverty. Smoking habits and prevention strategies in low socio-economic status populations. 2004. Available at: http://www.nntpp.org/pdf/preres.pdf. Accessed on October 17, 2007.
10 Centers for Disease Control and Prevention. Tobacco use among adults—United States, 2005. MMWR. 2006;42(42):1145.
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