CORRESPONDENCE

Race, Grade Level, and Cigarette Smoking: The 1999 National Youth Tobacco Survey

Dorothy L. Faulkner, Matthew C. Farrelly, James C. Hersey

Affiliation of authors: Research Triangle Institute, Research Triangle Park, NC.

Correspondence to: Dorothy L. Faulkner, Ph.D., Research Triangle Institute, 2951 Flowers Rd. South, Suite 119, Atlanta, GA 30341 (e-mail: dfaulkner{at}rti.org).

In the United States, the prevalence of cigarette smoking has remained consistently lower among African-American adolescents than among their white counterparts (1), and previous studies (24) have not been able to explain the race differential. One fruitful area of research is the examination of how the race gap varies by grade level. This information could provide direction for additional research on the topic. Therefore, a cross-sectional analysis of the 1999 National Youth Tobacco Survey (NYTS) was performed to answer the question, "At which grade level do race differences in adolescent cigarette smoking first become apparent?"

The NYTS was designed to provide nationally representative data about tobacco use among students in grades 6–12. The 1999 NYTS was administered in the fall of 1999. More than 15 000 students completed anonymous, self-administered questionnaires in 131 schools across the country. The school response rate was 90%, and the student response rate was 93%, for an overall response rate of 84%. A weighting factor was applied to each student record to adjust for nonresponse and the various probabilities of selection, including those resulting from the oversampling of African-Americans and Hispanics (5).

To determine the racial category, respondents were asked, "Which one of these groups best describes you?" The response options were "American Indian or Alaska Native," "Asian," "Black or African-American," "Hispanic or Latino," "Native Hawaiian or Other Pacific Islander," and "White." To determine smoking status, respondents were asked, "During the past 30 days, on how many days did you smoke cigarettes?" Respondents who had not smoked in the last month were considered nonsmokers, and those who had smoked on 1 or more days were classified as current smokers. STATA (6) was used to calculate weighted percentages and their 95% confidence intervals.

Table 1Go reveals that among 6th, 7th, and 8th graders, there were no statistically significant race differences in the prevalence of current smoking (overlapping confidence intervals). However, among 9th graders, race differences became apparent. Whites were 1.6 times more likely to smoke than African-Americans. The race differential increased steadily with age, so that by grade 12, whites were 2.5 times more likely to smoke.


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Table 1. Prevalence of cigarette smoking by race and grade level from the 1999 National Youth Tobacco Survey (n = 15 058)
 
Two considerations must be kept in mind when interpreting these results. First, the data are cross-sectional. Thus, when the younger adolescents grow older, they may not show the same race differences in smoking that are currently observed among older youth. Second, information on socioeconomic status (SES) was not available. However, it is unlikely that race differences in SES would have explained away the race gap in teen smoking. Investigators (24) have found that the race gap persists, even after adjustment for SES. It is anticipated that future NYTSs will capture SES information.

These findings are consistent with those of previous studies (24) that report a race gap in teen smoking among household populations (students and non-students). The advantage of the current investigation is that it describes race differences in teen smoking across multiple grade levels. Analyses revealed that the race gap in teen smoking first appears in the 9th grade (14–15 year olds), suggesting that the 9th grade is a critical period for whites (versus African-Americans).

Future studies should set out to identify those factors associated with being in the 9th grade that contribute to excess cigarette smoking among whites. Such research could advance theoretical understanding of the etiology of race differences in teen smoking and, eventually, lead to more effective smoking prevention programs for all youths.

NOTES

Supported by the American Legacy Foundation.

REFERENCES

1 University of Michigan. Monitoring the Future study. Available from URL: http://www.monitoringthefuture.org. Accessed January 25, 2000.

2 Faulkner DL, Escobedo LG, Zhu BP, Chrismon JH, Merritt RK. Race and the incidence of cigarette smoking among adolescents in the United States. J Natl Cancer Inst 1996;88:1158–60.[Free Full Text]

3 Faulkner DL, Merritt RK. Race and cigarette smoking among United States adolescents: the role of lifestyle behaviors and demographic factors. Pediatrics 1998;101:E4.[Medline]

4 Flint AJ, Yamada EG, Novotny TE. Black– white differences in cigarette smoking uptake: progression from adolescent experimentation to regular use. Prev Med 1998;27:358–64.[Medline]

5 Healton C, Messeri P, Reynolds J, Wolfe C, Stokes C, Ross J, et al. Tobacco use among middle and high school students—United States, 1999. MMWR Morb Mortal Wkly Rep 2000;49:49–53.[Medline]

6 STATA [computer program]. Reference manual. Release 6.0. College Station (TX): StataCorp; 1999.


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