African American students continue to have the lowest rates of smoking among the nation's 8th, 10th, and 12th graders, according to results from the 2000 Monitoring the Future Study, an annual survey that tracks drug and alcohol use by secondary school students. However, extensive research also demonstrates the disproportionate effects of tobacco use among African Americans, who are at greater risk of developing long-term consequences, such as smoking-related coronary heart disease, stroke, and lung cancer, than are their non-African-American counterparts. The new study reinforces these findings and clarifies some of the distinguishing characteristics of tobacco addiction among adolescent African Americans.
"This study indicates that African American youth may be in danger of experiencing the negative effects of tobacco earlier in their smoking histories, and assessments and interventions need to be tailored to their specific needs," says Dr. Alan I. Leshner, director, National Institute on Drug Abuse (NIDA). "Until we are able to provide this level of service to young people of all ethnic backgrounds, we will continue to have increasing numbers of nicotine-addicted adults."
The study was led by Dr. Eric T. Moolchan, a pediatrician and researcher at NIDA's Intramural Research Program in Baltimore, Maryland. Dr. Moolchan also is the director of NIDA's Teen Tobacco Addiction Treatment Research Clinic, which was established to conduct research into adolescent nicotine addiction and to test promising therapies for helping teens to quit smoking. He and his colleagues assessed the smoking-related characteristics of African American and non-African American teenagers who applied to be participants in a smoking cessation trial. A total of 115 subjects responded by telephone to advertisements about the trial. The researchers used the Fagerström Test for Nicotine Dependence (FTND) as the basis for telephone interviews, and the self-reported data included sociodemographic information (such as age, sex, and ethnoracial affiliation); medical, psychiatric, and medications history; smoking history; previous cessation attempts; and motivation to quit.
The researchers found that the African American applicants tended to be significantly older and smoked less on the weekends and on average fewer cigarettes each day than their non-African American counterparts. Yet their smoking histories and motivation scores were similar, and both groups experienced asthma, allergies, and depression at similar rates.
The data support other research that indicates ethnoracial differences in the metabolism of nicotine among smoking adults. However, this is the first study to suggest similar findings in an adolescent population. According to Dr. Moolchan, "Given the potential differences in the metabolic profile of nicotine among ethnic groups, we suggest that use of an awareness-based instrument, in addition to other measures of dependence, might provide clinicians with clearer and more useful diagnoses of nicotine dependence."
The research team predicts that the currently observed tobacco-related health disparities seen in African Americans are likely to increase if proactive, culturally relevant prevention and treatment programs are not implemented.
Note to reporters: The full text of the article, "African-American Teen Smokers: Issues to Consider for Cessation Treatment," can be found in the December 2000 issue of the Journal of the National Medical Association: Vol. 92, number 12, pgs. 558-562.
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