Racial/Ethnic Differences in Cigarette Use Trends in the United States among Multiracial and Other Youth, 1994-2008

• Author: Sebastian Teran Hidalgo,Trenette Clark Goings,Patricia P. McGovern
• DOI: 10.1177/0022042617731338
• Date: 01 January 2018
• Published date: 01 January 2018
• Subject Matter: Articles

https://doi.org/10.1177/0022042617731338

Journal of Drug Issues

2018, Vol. 48(1) 90 –105

© The Author(s) 2017

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DOI: 10.1177/0022042617731338

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Article

Racial/Ethnic Differences in

Cigarette Use Trends in the United

States among Multiracial and Other

Youth, 1994-2008

Trenette Clark Goings1, Sebastian Teran Hidalgo1,

and Patricia P. McGovern1

Abstract

Tobacco use among the multiracial population is grossly underresearched. This study

explored the cigarette-smoking trends of multiracial individuals over time in comparison with

monoracial individuals and assessed the relationship between cigarette smoking and factors

at the individual, family, peer, school, and state levels. This study used data collected by the

National Longitudinal Study of Adolescents and Adult Health from 1994 to 2008. This study

examined a subsample of 9,421 respondents who self-identified as Black, Asian, American

Indian, Hispanic, White, or multiracial. Generalized estimating equations were used to analyze

the population-level data. Findings suggest that multiracial individuals reported high rates of

cigarette use over time. The most consistent correlates of cigarette use were family factors,

peer cigarette use, and school policies that prohibit staff from smoking on school premises.

Additional research is needed to identify the correlates and causes of cigarette use among

multiracial adolescents and young adults.

Keywords

tobacco, mixed-race, smoking, biracial

Introduction

Cigarette smoking remains the leading cause of preventable death in the United States (U.S.

Department of Health and Human Services, 2014). Smoking initiation in adolescence is one of

the strongest predictors of regular smoking in adulthood (Paavola, Vartianinen, & Huakkala,

2004). Indeed, about 90% of adults who smoke daily started smoking before 18 years of age

(U.S. Department of Health and Human Services, 2012). These findings highlight the critical

need to prevent adolescent smoking. At present, approximately 10% of 16- to 17-year-olds are

current smokers (Substance Abuse and Mental Health Services Administration, 2014). In addi-

tion, among U.S. high school seniors, 35% reported smoking cigarettes at least once in their

lifetime, 14% reported smoking within the past 30 days, and almost 7% reported regular smoking

(Substance Abuse and Mental Health Services Administration, 2014).

1University of North Carolina at Chapel Hill, USA

Corresponding Author:

Trenette Clark Goings, Associate Professor, School of Social Work, University of North Carolina at Chapel Hill, 325

Pittsboro Street, CB 3550, Chapel Hill, North Carolina 27599, USA.

Email: ttclark@email.unc.edu

731338JODXXX10.1177/0022042617731338Journal of Drug IssuesGoings et al.

research-article2017

Goings et al. 91

Smoking is a health risk for all adolescents. However, prevalence of adolescent smoking varies

across racial/ethnic groups. Between the ages of 12 and 17 years, American Indian (11.4%), White

(9.9%), and multiracial (8.9%) adolescents report higher rates of smoking in the past 30 days than

Hispanic (5.5%), Black (4.9%), and Asian (2.9%) adolescents (Substance Abuse and Mental

Health Services Administration, 2014). These findings suggest that some adolescent groups are at

greater risk of smoking than other groups. Furthermore, these elevated smoking risks are seen

across the life course. Among adults older than 25 years, American Indians (42.4%), multiracials

(34.7%), Blacks (29.8%), and Whites (27.2%) maintain higher levels of smoking over the past 30

days than either Hispanics (19.2%) or Asians (9.4%; Substance Abuse and Mental Health Services

Administration, 2014). Of special note, during the transition to adulthood, the risk of past 30-day

smoking increases at a greater rate than other groups for both Black and multiracial individuals

(Substance Abuse and Mental Health Services Administration, 2014). These findings suggest that

for some racial/ethnic groups, the risk of smoking increases over time.

The first steps toward developing culturally competent prevention efforts require understand-

ing the differences in cigarette smoking among racial/ethnic groups and the differential impact of

factors associated with cigarette smoking across these groups. The current study focused on ciga-

rette smoking and correlates of smoking among monoracial adolescents as compared with multi-

racial adolescents. Multiracial individuals comprise the fastest-growing population group (U.S.

Census Bureau, 2012), and as noted earlier, report high rates of cigarette use. However, little is

known about how cigarette use has changed over time as well as the determinants of cigarette use

among multiracial individuals.

Factors That Contribute to Cigarette Smoking Among Adolescents and Young

Adults

Many factors have been found to contribute to cigarette smoking among adolescents and young

adults, including individual characteristics, peer smoking, family factors, and state-level policy.

However, most smoking research has focused on monoracial individuals, leaving a substantial

knowledge gap around the correlates of cigarette use among multiracial youth and young adults.

Individual-level factors. Individual-level factors associated with smoking outcomes include a range of

factors including religiosity/spirituality, judgment, and delinquency. Studies have found that religi-

osity was associated with lower rates of smoking among Hispanic, White (Wallace et al., 2007),

Asian Primack et al., 2014), and Black adolescents (Hestick, Perrino, Rhodes, & Sydnor, 2001).

However, this relationship was particularly salient for Black adolescents and young adults (Hestick

et al., 2001). One study that investigated the role of religiosity among multiracial youth found a

negative relationship among religiosity and smoking among biracial Black–White girls and a posi-

tive relationship among Black-White boys (Goings, Butler-Bente, McGovern, & Howard, 2016).

Adolescents with deficits in executive functioning, such as poor judgment and lack of playfulness,

have been found to be at greater risk of cigarette use (Pentz et al., 2015). In addition, delinquency

has been shown as increasing risk of smoking among Black, Hispanic, and White adolescents (Fer-

guson & Meehan, 2010; Griesler & Kandel, 1998; Van Den Bree, Whitmer, & Pickworth, 2004).

The role of executive functioning and delinquency on multiracial smoking remains unexplored.

Peer smoking. Generally, peer smoking is found to influence smoking outcomes among adolescents

(Racicot, McGrath, Karp, & O’Loughlin, 2013) and young adults (Harakeh & Vollebergh, 2012).

Peer smoking is seen as a consistent risk factor among American Indian (Unger, Baezconde-Gar-

banati, & Soto, 2004), Asian (Xie, Palmer, Li, Lin, & Johnson, 2013), Hispanic (Warheit et al.,

1995) and White adolescents (Hestick et al., 2001). Findings on the influence of peer smoking are

mixed. One study found that peer smoking impacted smoking rates of White adolescents more than

Black adolescents (Robinson et al., 2006). In another study, peer smoking was found to influence