The Effect of Race/Ethnicity and Adversities on Smoking Cessation among U.S. Adult Smokers.
Thursday, August 18, 2022
Posted by: Natalia Gromov
Avila JC, Sokolovsky AW,
Nollen NL, Lee J, Schmid CH, Ahluwalia JS.
The Effect of
Race/Ethnicity and Adversities on Smoking Cessation among U.S. Adult Smokers.
Addict Behav. 2022;131:107332. doi:10.1016/j.addbeh.2022.107332
Introduction. Black
and Hispanic individuals in the US experience more socioeconomic adversities
that are associated with disparities in tobacco use and cessation than White
individuals. This study examined if racial/ethnic differences in smoking
abstinence were mediated by socioeconomic (SES) adversities.
Methods. Data
from 7,101 established smokers were identified in Wave 1 (2013-2014) of the
Population Assessment of Tobacco and Health (PATH) and followed to Wave 4
(2016-2018). The study outcome was cigarette abstinence at Wave 4. The main
independent variable was race/ethnicity (Non-Hispanic White [White],
Non-Hispanic Black [Black] and Hispanic). The mediators were five measures of
SES adversities (unemployment, poverty, difficulty with money, lower education
level, lack of health insurance). A weighted Generalized Structural Equation
Model (GSEM) was used to estimate the total, direct, and indirect effect of
race/ethnicity on the odds of quitting mediated by the five SES adversities.
This model was adjusted by study covariates, including health and smoking
characteristics.
Results. The
indirect effect of race/ethnicity on cessation showed that differences in
quitting between Black and White individuals as well as Hispanic and White
individuals were mediated by SES adversities. However, the differences in
quitting between Hispanic and Black individuals were not mediated by SES
adversities. Black and Hispanic individuals were less likely to quit than White
individuals, but Hispanic individuals were more likely to quit than Black
individuals. There were no direct effects between Black or Hispanic individuals
compared to White individuals. Those with higher SES were more likely to quit
compared to those with lower SES.
Discussion. Smoking
abstinence is higher in White individuals compared to Black and Hispanic
individuals and is mediated by SES adversities. However, smoking abstinence is
higher among Hispanic individuals compared to Black individuals and it is not
mediated by SES adversities. Future studies should consider the role of other
factors, such as psychosocial support, racism, discrimination, and stress over
the life course in explaining differences in smoking abstinence between Black
and Hispanic individuals.
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