Blacks are more likely to be lifetime nonsmokers than whites

Blacks are more likely to be lifetime nonsmokers than whites, but they're less likely to quit smoking once they've started, according to a new study of more than 240,000 Americans.

However, differences in rates of quitting were based on social and economic factors, not race, the study says.

"Disparities in smoking cessation among racially classified social groups are strongly influenced by socioeconomic status and do not appear as fixed attributes reflecting biological or genetic differences between African Americans and whites," says lead study author Gary King, Ph.D., of Pennsylvania State University.

The research, which examines data gathered between 1990 and 2000, appears in the November issue of the American Journal of Public Health.

During the 1990s, an average of 59 percent of African Americans had never smoked, compared to 49 percent of whites surveyed. On average, only 15 percent of Africans Americans had quit smoking, compared to 26 percent of whites, King says. About 26 percent of respondents in both racial groups were current smokers when surveyed.

Cultural influences like parental prohibition or social disapproval of smoking may have kept black teenagers and black women from starting to smoke, King says. He adds that preventive programs reflecting those cultural values played a greater role in reducing current smoking than cessation efforts did. In addition, the gap between blacks and whites in cessation rates began to narrow after 1994. A higher proportion of African American former smokers had quit in the 10 years before they were surveyed than white former smokers, and a higher proportion of women quit than men.

These new patterns may foreshadow greater equality in rates of quitting smoking between the two racial groups, King says.

"As a greater number of older African American smokers die, it is likely that the pool of future smokers will be smaller and younger," he speculates. "It is possible that these individuals will make more successful attempts to quit because of less severe physiological addiction, improved socioeconomic status, greater concern about the consequences of smoking and better access to cessation therapies."

Multidisciplinary and culturally appropriate public health efforts have targeted smoking prevention and cessation among African American adults for at least a decade. Those programs will need to be continued and intensified if the disparities in cessation are to be narrowed, King says.

The research was supported in part by the Minority International Research Training Program of the Fogarty International Center at the National Institutes of Health.