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
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.
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.
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.
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.
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.
Davis RM. Current trends in cigarette advertising and
marketing. N
Engl J Med 1987;316: 725-32.
Blum A. Selling cigarettes: the blue-collar, black target.
Washington Post 1986 May 18:F1,F4.
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