Race and cigarette smoking among United States adolescents: the role of lifestyle behaviors and demographic factors.

OBJECTIVE Cigarette smoking is on the rise among adolescents in the United States. Although both African-American and white adolescents have experienced increases in cigarette smoking over time, the prevalence of smoking has remained consistently lower among African-American adolescents than their white counterparts. The purpose of this study was to determine whether the race differential in the prevalence of cigarette smoking is attributed to differences in selected lifestyle behaviors and demographic factors. DESIGN A cross-sectional study was conducted among African-American and white adolescents (aged 12 to 17 years) who participated in the Youth Risk Behavior Survey supplement to the 1992 National Health Interview Survey. Analyses were restricted to those who had complete data on all study variables (n = 5569). Logistic regression analysis was used to estimate the prevalence odds ratios (POR) of current smoking for white adolescents (versus African-American adolescents) before and after adjustment for confounding factors. RESULTS The crude POR of current smoking for white adolescents compared with African-American adolescents was 2.8 (95% confidence interval = 2.1 to 3.9). Simultaneous adjustment for confounding factors resulted in a POR of 2.6 (95% confidence interval = 1.8 to 3.7). CONCLUSIONS Selected lifestyle behaviors and demographic factors do not account for the race differential in the prevalence of adolescent cigarette smoking. This study underscores the need for more research on contributors to the race gap. Such research could advance theoretical understanding of the etiology of cigarette smoking among adolescents and lead to more effective smoking prevention programs for all youths.