Perceived Stress and Cotinine among African American smokers: Variation by skin color

In the United States, skin color has played an important role in race relations and racial stratification. This has consequences in the daily lives of African Americans, one of which is stress. Numerous studies have looked at the consequences of stress in African American communities. However, there is no empirical evidence that links skin color and perceived stress to cotinine. This study (n=147) performed in Harrisburg (PA) tested 1) whether African American smokers with higher perceived stress levels had higher cotinine levels; 2) whether self-perception of skin color (subjective measurement) was a better predictor of perceived stress than either facultative or constitutive melanin (objective measure) among African Americans; and 3) whether skin color-based discrimination questions was a better predictor of perceived stress than more objective measures. The results of this study indicated that perceived stress among African American smokers was not significantly associated with cotinine levels. Facultative melanin was found to be significantly and positively associated with cotinine level. This relationship was found to be partially mediated by years of smoking, as smoking duration was significantly associated with higher cotinine levels. Constitutive melanin was not found to be significantly associated with cotinine levels. Self-perception of skin color was found to be a stronger predictor of perceived stress levels than either facultative melanin or constitutive melanin. A composite discrimination measure based on skin color was found to be a stronger predictor of perceived stress among African Americans than the use of an objective measurement or reflectometer.