Age-related differences in cigarette smoking among whites and African-Americans: Evidence for the crossover hypothesis

• Published in: Drug and alcohol dependence Vol. 118; no. 2; pp. 280 - 287
• Main Authors: Kandel, Denise, Schaffran, Christine, Hu, Mei-Chen, Thomas, Yonette
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 01.11.2011; Elsevier
• Subjects: Addictive behaviors; Adolescent; Adolescents; Adult; Adult and adolescent clinical studies; African Americans - statistics & numerical data; Age crossover; Age differences; Age Factors; Age of Onset; Biological and medical sciences; Black American people; Child; Cross-Sectional Studies; Current cigarette smoking; Drug addiction; Education; Educational Status; European Continental Ancestry Group - statistics & numerical data; Female; Humans; Male; Medical sciences; Middle Aged; Multiple births; Non-Hispanic African-Americans; Non-Hispanic whites; Prevalence; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Smoking; Smoking - ethnology; Tobacco smoking; Tobacco, tobacco smoking; Toxicology; Current cigarette smoking; Non-Hispanic whites; Non-Hispanic African-Americans; Education; Age crossover; Human; Drug addiction; Tobacco smoking; Ethnic group; Hypothesis; Teaching; Addiction; Caucasoid; Age; Comparative study; African American
• ISSN: 0376-8716; 1879-0046
• DOI: 10.1016/j.drugalcdep.2011.04.008

Abstract Background Age crossover describes the age-related reversal in prevalence of current cigarette smoking among non-Hispanic whites and African-Americans, with prevalence higher among whites than African-Americans in adolescence but lower in adulthood. Prior studies have examined smoking patterns in separate adolescent and adult samples and have not sought to identify factors that could account for crossover. We conducted analyses using national samples to identify factors that account for crossover and estimate their impact on crossover age. Methods Analyses are based on national samples of lifetime smokers 12–49 years old in the 2006-2008 aggregated National Surveys on Drug Use and Health ( N = 61, 757) ( SAMHSA, 2007–2009 ) and on multiple birth cohorts followed over 21 cross-sectional surveys. Results We identified crossover for cigarette smoking in the US population at about age 29. Crossover is partially explained by differences between whites and African-Americans in education and marital status, and more weakly by the opposite impact of age of smoking onset on persistence of smoking in the two groups. Controlling for smoking history, education and social role participation would raise crossover in current smoking by more than 14 years. Rates of current smoking among lifetime smokers at four different age categories in multiple birth cohorts followed from ages 12–17 to 35 and over in 21 surveys spanning 24 years confirm the age-related patterns observed cross-sectionally. Conclusion Age crossover for current smoking appears among whites and African-Americans. Efforts targeted toward improving educational levels of young people would have the strongest impact in decreasing persistent smoking, especially among African-Americans.