Racial differences identified from 1991-2011 trends analysis in adolescent's current cigarette smoking

Background: Tobacco smoking is among the most preventable risk behaviors for cancers and chronic diseases. Tobacco prevention has been suggested to start from young ages. To date, most reports compared adolescent's current smoking prevalence trends by either sex, race/ethnicity, or grade separately. This study took a more holistic view and identified the disparity by sex-grade-race/ethnicity specific rate trends.

Methods: 1991 to 2011 Youth Risk Behavior Surveys with nationally representative participants each survey year were analyzed. The 20-year trends were plotted by the sex-grade-race/ethnicity-specific prevalence rates.

Results: The results showed that racial/ethnic differences in adolescents current smoking prevalence exist by grade progression. African Americans appeared to have the lowest current smoking prevalence rate without gender or grade distinction. Both White and Hispanic males from 9th to 11th grades and females in 9th grade had little trend distinction over 20 years. A distinct descending trend pattern of White's, Hispanic's and African American's exists among males in 12th grade and females from 10th to 12th grade. By grade progression, Whites had more current smokers in both males and females while African Americans and Hispanics showed no clear pattern.

Conclusions: Unlike other health risk behaviors, African Americans had the lowest current smoking prevalence rate in comparison with Whites and Hispanics. White boys and girls should be considered as the priority population for tobacco prevention. Priority for intervention using sex-grade-race/ethnicity-specific prevalence trends is suggested. Tailored intervention by adolescents gender, grade, and race/ethnicity is recommended.