Regional variation in smoking among African Americans

Background. The impact of geographic region and metropolitan residence on smoking prevalence among African Americans has not been adequately examined. Methods. This study analyzed 5 years of data from the National Health Interview Survey (1990-1994) on current smoking and regional variation among 16,738 African Americans. Results. Respondents in the West had the lowest unadjusted smoking prevalence rates and Midwest residents had the highest. Current smoking was lower among African Americans living in noncentral cities than in central cities even after adjusting for several sociodemographic covariates. Multivariate logistic regression analysis revealed that black women in the South were significantly less likely to be smokers compared with any other gender/region group. Conclusions. These findings suggest the significance of gender and regional factors such as the social history of migration, social stress and racism, exposure to tobacco advertisement, variations in cultural influences, community structures, and coping strategies in understanding African American smoking behavior. (C) 1999 American Health Foundation and Academic Press.