Effects of tobacco use among rural African American young adult males

Tobacco related disease is a primary source of mortality for African American men. Recent studies suggest that "alternative" tobacco products may have supplanted cigarettes as the most common products used by young African Americans, according to new research published in the August 2011 issue of Otolaryngology – Head and Neck Surgery.

While the tobacco-related disease burden is higher in African American adults, prevalence rates of tobacco use among young African American teens are surprisingly lower than those reported for whites. This picture changes in early adulthood. According to the National Survey on Drug Use and Health conducted between 2002-2005, 29.7% of white males 18 years of age and older reported smoking cigarettes in the past 30 days as compared to 33.6%% of African American men.

Study results show cigarettes were the most common product ever (54%) and currently (39.9%) used. Participants who attended school for 12 years or attended religious services were less likely to use cigarettes. Marijuana and blunts, mini-cigars, were used next most commonly. Only 35 respondents (8.9%) currently used mini-cigars. Other products, bidis/kreteks, smokeless tobacco, and pipes were used uncommonly in this sample.

"Tobacco-related disease disparities are magnified in the rural counties of the Black Belt region in rural Alabama," said study author William Carroll, MD. "The Black Belt counties are named for the rich dark soil that supported the agricultural industry of an earlier era. These counties are predominantly African American, among the poorest counties in the US, and are characterized by striking health disparities when compared to the remainder of the state and the nation as a whole."

The study included interviewer administered surveys that were completed among African American males, aged 19 to 30, in five of the Black Belt counties of rural Alabama. Participants were stratified by income (above and below poverty level) and educational level (12th grade above/below) with target representation in the stratification table informed by U.S. census data for the Black Belt counties. Distribution of survey participants within the stratification table was monitored to ensure representative sampling of the Black Belt counties.

Cigarette use prevalence in rural Alabama far exceeds that measured statewide for African American men of the same age. Effective community based intervention must target cigarette initiation and cessation in this vulnerable population.