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Topics in Minority Health Cigarette Smoking Among Blacks and Other Minority Populations

The Report of the Secretary's Task Force on Black and Minority Health documented that, compared with whites, blacks experience substantial excess mortality from cancer, cardiovascular disease, and infant death (1). All of these conditions are substantially affected by smoking; therefore, this excess mortality makes cigarette smoking a major health issue for blacks.

According to the 1985 National Health Interview Survey, 41% of black men smoke cigarettes, compared with 32% of white men. Similarly, the prevalence of smoking among black women (32%) exceeds that among white women (28%) (Table 1). Hispanic men smoke at about the same rate (31%) as white men, while Hispanic women have a much lower smoking rate (21%) than white and black women.

Higher death rates from heart disease and cancer, both of which are associated with tobacco use, parallel the increased prevalence of smoking among blacks. An estimated 30% of deaths from coronary heart disease and 30% of all deaths from cancer are attributable to cigarette smoking (3,4). Black men experience a 20% higher mortality rate from heart disease and a 58% higher incidence of lung cancer than white men. Black women have a 50% higher mortality rate from heart disease than white women (Table 2). Blacks also experience substantially higher rates of fetal death and low-birthweight babies (Table 3), both of which are associated with maternal smoking (5). Low birthweight is an important predictor of infant mortality, which also occurs at a much higher rate among blacks (Table 3). Reported by: Office on Smoking and Health, Center for Health Promotion and Education, CDC.

Editorial Note

Editorial Note: A joint committee with representatives from the Federal government and the private sector has called upon government, private health organizations, and social agencies to give higher priority to educating minority populations concerning the health hazards of tobacco use. The Interagency Committee on Smoking and Health, established by the Congress and chaired by the Surgeon General of the United States, met in Washington, D.C., on March 31, 1987, to hear testimony from experts and representatives of national organizations on the health effects of cigarette smoking among minority populations. The Committee considered such topics as the prevalence of smoking and the incidence of smoking-related diseases in minorities, possible interventions for reducing smoking in minority groups, and cigarette marketing and advertising campaigns that target minorities.

The cigarette industry is now aggressively promoting cigarettes to both blacks and Hispanics. These promotional efforts include advertisements in publications aimed at minority groups, sponsorship of entertainment and cultural events drawing large minority audiences, and extensive use of billboards in minority neighborhoods (6,7).

In his closing remarks to the Interagency Committee on Smoking and Health, the Surgeon General asked that the public health community and minority groups look upon cigarette smoking as an important health problem faced by minority individuals and communities. He stated, "We must place cigarette smoking in the total context of minority health, but in doing so we must give it its proper place in the hierarchy of risks. It ranks very high indeed. Two of the six leading causes of excess death observed among blacks and other minorities are cancer and cardiovascular disease, both of which are smoking-related, and a third is infant mortality, to which cigarette smoking contributes. I submit that no public or private effort aimed at improving the health of blacks and other minorities can omit the reduction of cigarette smoking as one of its major goals."

The reduction of cigarette smoking in the black population is one of the most important, immediately available options for reducing the wide disparities between the health status of minorities and that of whites.

References

  1. Office of Minority Health. Report of the Secretary's Task Force on Black and Minority Health. Washington, DC: US Department of Health and Human Services, Public Health Service, 1985-1986.

  2. National Center for Health Statistics. Health, United States, 1986. Hyattsville, Maryland: US Department of Health and Human Services, Public Health Service, 1986; DHHS publication no. (PHS)87-1232.

  3. Office on Smoking and Health. The health consequences of smoking: cancer--a report of the Surgeon General. Rockville, Maryland: US Department of Health and Human Services, Public Health Service, 1982:v; DHHS publication no. (PHS)82-50179.

  4. Office on Smoking and Health. The health consequences of smoking: cardiovascular disease--a report of the Surgeon General. Rockville, Maryland: US Department of Health and Human Services, Public Health Service, 1984:iv; DHHS publication no. (PHS)84-50204.

  5. Office on Smoking and Health. The health consequences of smoking for women: a report of the Surgeon General. Rockville, Maryland: US Department of Health and Human Services, Public Health Service, 1980.

  6. Davis RM. Current trends in cigarette advertising and marketing. N Engl J Med 1987;316: 725-32.

  7. Blum A. Selling cigarettes: the blue-collar, black target. Washington Post 1986 May 18:F1,F4.

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