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Cancer Control Research

Abstract

DESCRIPTION (provided by applicant): Cigarette smoking is a major cause of illness and death among African-American women. While smoking prevalence is generally similar for African-American women and white women, there are also important differences in smoking behavior. African-American women are more likely to be less successful in quitting, use menthol cigarettes, and smoke fewer cigarettes per day. However, little is known about factors that influence smoking behavior among African-American women. This study will diminish this knowledge gap by identifying factors that affect key aspects of smoking behavior-quitting, relapse, and menthol cigarette use among African-American women smokers. We will use data collected in the Black Women's Health Study (BWHS), a large national prospective study of U.S. black women. The BWHS had 9,350 current smokers at entry in 1995 and currently has eight years of follow-up through 2003. A prospective, longitudinal analysis of predictors of quitting and relapse over the follow-up period will be performed on 7,260 women who smoked at entry, returned a 2003 questionnaire, and returned at least two of the 1997, 1999, and 2001 questionnaires. Analysis of menthol cigarette use will be cross-sectional because information on whether the cigarette smoked was mentholated was obtained only in 2003. Both sets of analyses are guided by a social-contextual model which recognizes that smoking is influenced by a wide range of factors operating in a variety of domains (sociodemographic, personal, interpersonal, organizational, community, and societal). Analyses will both identify important predictors of cessation, relapse, and menthol cigarette use, and evaluate the relative importance of each domain. Measures considered in the study include group-level (i.e., Census neighborhood characteristics, strength of state-level tobacco control measures) as well as individual level factors. Multilevel models reflecting the hierarchical structure of the data will be used to assess the effect of neighborhood- and state-level variables, controlling for individual-level measures. This study dwarfs in size and scope any previous study of predictors of smoking behaviors in black women. The outcome of this project will be a better understanding of the dynamics of smoking among African-American women, which will inform further work and lay the basis for more effective interventions to reduce smoking in black women The cost is modest because all data collection has been supported by the parent grant.