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Interaction between ethnicity and smoker type: a comparison of daily and intermittent African-American and Caucasian smokers

Cheng, Jessica (2017) Interaction between ethnicity and smoker type: a comparison of daily and intermittent African-American and Caucasian smokers. Master Essay, University of Pittsburgh.

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Ethnic differences in smoking patterns and dependence have been observed between Caucasian (CA) and African American (AA) smokers: AA who smoke are more likely to be intermittent smokers and, among daily smokers, consume fewer cigarettes, yet report more dependence.
We enrolled adults aged ≥21 who had been smoking for ≥3 years, oversampling AA smokers. Participants (N=482, 67% CA) were either daily smokers (DS, 5-30 cigarettes per day) or intermittent smokers (ITS, 4-27 days per month). They reported their smoking behavior and dependence, as measured by the Primary and Secondary Dependence subscales of the Wisconsin Inventory of Smoking Dependence Motives (WISDM), the Nicotine Dependence Syndrome Scale, the Hooked on Nicotine Checklist (HONC), the Fagerstrom Test of Nicotine Dependence (FTND), and a singular time to first cigarette after waking item (TTFC). We tested associations between ethnicity, smoker type, and dependence using multivariable linear regression with a cross-product interaction term for ethnicity and smoker type.
Adjusting for age, sex, and education, there was a significant interaction between ethnicity and smoker type for all measures of dependence except the WISDM Secondary Dependence Motives: AA were more dependent than CA among ITS, but not among DS. After further controlling for cigarettes per day, the interaction was attenuated and remained significant for only the WISDM Primary Dependence subscale (p=.04): among ITS, AA (least square mean=3.31) were more dependent than CA (2.87), but not among DS (AA and CA both= 3.75).

Ethnic differences in tobacco dependence may be explained by an interaction between ethnicity and smoker type whereby AA are more dependent than CA among ITS only, and most of this difference may be explained by cigarette consumption. Such an interaction suggests a need to develop cessation strategies specific to AA intermittent smokers especially as it pertains to differences in cigarette consumption. A detailed understanding of dependence across ethnic groups is vital to public health efforts to increase cessation in subpopulations and subsequently decrease smoking-related disease morbidity and mortality.


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Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Cheng, Jessicajec150@pitt.edujec150
ContributionContributors NameEmailPitt UsernameORCID
Committee Chairking, wendywck1@pitt.eduUNSPECIFIEDUNSPECIFIED
Committee Membershiffman, saulshiffman@pinneyassociates,comUNSPECIFIEDUNSPECIFIED
Committee Memberprimack, brianbprimack@pitt.eduUNSPECIFIEDUNSPECIFIED
Date: 24 June 2017
Date Type: Submission
Number of Pages: 29
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Epidemiology
Degree: MPH - Master of Public Health
Thesis Type: Master Essay
Refereed: Yes
Date Deposited: 02 Oct 2017 17:42
Last Modified: 01 Jul 2021 05:15


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