Understanding race-based disparities: Which African American teen socio-cultural groups are at higher risk

Significance: African Americans have disproportionately high smoking rates, and have directly been targeted by tobacco industry advertising. Certain African American teens (AATs) are more likely to smoke than others because of their socio-cultural group identification. Strategies to identify these teens and understand their lifestyles, values, and attitudes can be used to develop more effective interventions. Objective: Describe the smoking prevalence among AAT socio-cultural groups, segment most-at risk group, and develop targeted intervention. Methods: AATs in Central and Southeast Virginia were interviewed to determine the most popular AAT radio stations. An online survey was advertised through these radio stations using a lottery incentive. Survey instrument used pictures of unknown teens to determine socio-cultural affiliation of survey respondents, in addition to tobacco use attitudes and behaviors. Results: 21.96% of all AAT respondents (N=582) smoked cigarettes and/or Black & Milds in the past 30-days. Three socio-cultural groups with varying tobacco use rates were prevalent: “mainstream” (15.33%), “preppy” (16.67%) and “hip hop” (27.23%). Logistic regression analysis results show that the odds that Hip-hop AATs use tobacco are more than twice that of other AATs (p<.01, controlling for age and gender). In bivariate analyses, reported tobacco use attitudes were also significantly associated with the different socio-cultural types of AATs. Discussion: Certain socio-cultural groups of AATs are at higher risk of smoking than others. Interventions tailored to reach all AATs may not reach those most at-risk. Tailored interventions should incorporate the unique attitudes, lifestyles and values of hip hop AATs. Possible interventions will be discussed.