Black-white differences in cigarette smoking uptake: Progression from adolescent experimentation to regular use

Background. More U.S. adolescents and young adults have initiated cigarette smoking in recent years. Blacks have been less likely than whites to start smoking, and the gap has widened recently. Reasons accounting for this large black-white difference remain unclear. Methods. A multiple logistic regression analysis was performed using a cohort of 2,467 adolescent smoking experimenters ages 11-18, within the 1989-1993 Teenage Attitudes and Practices Survey, a nationally representative survey. Results. Among experimenters (1989), 25.7% of whites and 10.3% of blacks had progressed to current smoking (1993). The unadjusted odds ratio (OR) of progression for blacks (vs whites) was 0.33 [95% confidence interval (CI) 0.23, 0.48]. Adjustment for factors significantly predictive of progression (most parsimonious model) modified the black-white OR to 0.36 (CI 0.24, 0.55), while the full model yielded a black-white OR of 0.39 (CI 0.24, 0.66). Conclusions. The observed black-white difference in smoking progression was only partly explained by the factors evaluated, and some additional factor(s) must be important. Understanding the black-white difference in the progression from experimentation to current smoking may help prevent uptake among all adolescents. (C) 1998 American Health Foundation and Academic Press.