Original reportsCigarette Smoking Among Native and Foreign-Born African Americans
Introduction
An important contemporary theme in the study of the health of African Americans is intra-group diversity or social heterogeneity 1, 2, 3. Socio-demographic variables such as age, gender, geographic region, and socio-economic status (SES) help to explain variations in health behavior and outcomes 4, 5, 6, 7, 8. Nativity or country of birth also has been shown to be associated with disease risks and health status among minority groups such as Hispanics and Asian Americans 9, 10, 11.
In the 1990 U.S. Census, it was estimated that 5.8% of African Americans were foreign-born (12) and more current data indicates that this figure may exceed 25% in some urban areas (e.g., New York City and Dade County, Florida) 13, 14. Studies of nativity can be useful in examining various social experiences and influences on the health of African Americans including acculturation, social mobility, cultural practices and social networks, and exposure to (or protective strategies against) racism. Moreover, this research could have important implications for health intervention programs and policies and may suggest multiple strategies for studying African American health.
Despite numerous studies on cigarette smoking among African Americans, differences in smoking behavior between foreign and native-born blacks have rarely been investigated (15). In a 1984 study of black pregnant women in Boston, foreign-born women were less likely than native-born women to be smokers at any time during pregnancy (16). In a study of New York high school students a lower smoking prevalence rate was found among Caribbean-born compared to native-born African-Americans (17). A study of adults living in New York City in 1992 revealed a lower rate of ever smoking among foreign-born relative to native-born African Americans (18). Despite the contributions of these studies, the results are based mostly on data from small select samples (i.e., Caribbeans, pregnant women, and students) 16, 17 and/or did not examine current smoking or consumption frequency (18).
Using data from the 1990–1994 National Health Interview Survey (NHIS), the major objectives of this paper were: 1) to determine whether differences in smoking status and the number of cigarettes consumed daily exist between foreign and native-born African Americans; and 2) to assess the relative importance of demographic and SES factors on smoking behavior between the two groups. This study of a large sample of African Americans is broadly representative of adults, 18–64 years old, and provides previously unreported information about tobacco addiction and nativity among blacks in the U.S.
Section snippets
Sample Design
The NHIS is a national cross-sectional household sample of non-institutionalized civilians. The survey is approximated by a three stage stratified cluster probability sample design. The response rates of African Americans to each of the NHIS surveys between 1990 and 1994 are not known but probably do not differ substantially from other groups (19). The overall annual response rates were about 95% and information about the NHIS has been previously published (20). The annual unweighted sample
Results
The age distribution differed slightly for the two subpopulations (Table 1) and the mean age was 36.8 years for native-born and 35.8 years for foreign-born blacks. A higher percentage of foreign-born than native-born blacks was found in the highest income and education categories. Most (55.2%) native-born blacks resided in the South compared to foreign-born blacks who mostly (56.5%) were located in the Northeast. A greater proportion of foreign-born (54%) than native-born blacks (44.2%) were
Discussion
This study shows large differences in the smoking behavior of native and foreign-born African Americans. Native-born African Americans were far more likely to be smokers than foreign-born blacks even after controlling for differences in sociodemographic indicators. Though women in both groups were less likely to be smokers, native-born women were 4 times more likely to be smokers than their foreign-born counterparts. Interestingly, among foreign-born blacks, income was inconsistently related to
References (40)
Race and healthBasic questions, emerging directions
Ann Epidemiol.
(1997)The “Race” Concept in smokingA review of the research on African Americans
Soc Sci Med.
(1997)- et al.
Youthful SmokingPatterns and relationships to alcohol and other drug use
J Adolesc.
(1987) - et al.
Mandelblatt JS. Ever -vs.- never smoking among an urban multiethnic sample of Haitian-, Caribbean-, and U
S.-born Blacks. Prev Med.
(1997) - et al.
Response error in self-reported current smoking frequency by black and white established smokers
Ann Epidemiol.
(1996) - et al.
Race and healthA multidimensional approach to African American health
Racial and Ethnic Differences in Disease
(1989)- et al.
Smoking by black and whitesSocioeconomic and demographic differences
Am J Public Health.
(1988) - et al.
Social heterogeneity in smoking among African Americans
Am J Public Health.
(1998) - et al.
Educational attainment and racial differences in cigarette smoking
J Natl Cancer Inst.
(1995)