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CORK Bibliography: African-Americans

105 citations. January 2010 to present

Prepared: September 2011

Ade JN; Rohrer J; Rea NK. Immigration, income, drinking and obesity in African American adults. Journal of Immigrant and Minority Health 13(4): 659-663, 2011. (9 refs.)

The objective of this study was to investigate the relationship between immigration status, income, drinking and overweight and obesity in African American adults residing in the United States using an internet web based survey. Data on 303 adult African American immigrants and non-immigrants was collected using a self-administered web based survey. Respondents were recruited using a snowball sampling technique to obtain a convenience sample. Multiple logistic regression analysis were used to test the independent effects of the immigration status while controlling for confounding effects of demographic, social and behavioral variables. The results of the study showed no significant difference between obesity and immigration status in black adults residing in the US (adjusted odds ration = 1.1095, P = 0.7489). Significance at the P < 0.05 level was demonstrated for obesity and two independent variables: age (OR = 1.0332, P = 0.0298) and days per month consumed more than 5 alcoholic beverages (OR = 1.7735, P = 0.0001). Adult African American immigrants in this study sample were not at risk of being obese due to their immigration status. However, age and days in a month in which more than 5 alcoholic beverages are consumed were significant risk factors for obesity. Primary care providers should be alert for obesity and alcohol consumption in this population.

Akins S; Smith CL; Mosher C. Pathways to adult alcohol abuse across racial/ethnic groups: An application of general strain and social learning theories. Journal of Drug Issues 40(2): 321-351, 2010. (90 refs.)

There is considerable variation in the prevalence, etiology and consequences of alcohol and other drug use across racial/ethnic groups, but studies examining these issues among adult populations remain scarce. This is an important oversight as exposure to many of the risk factors associated with substance use and abuse has been shown to vary by race/ethnicity as well as age. This study examines the causes and correlates of adult alcohol abuse across the three largest racial/ethnic groups in the United States Whites, Blacks and Hispanics and provides a theoretically grounded examination of substance abuse by applying two general theories of deviance, Agnew's general strain theory and Akers' social learning theory. Results indicate unconditional support for both theories when applied to White alcohol abuse but more conditional support when applied to patterns of adult alcohol abuse among Hispanics and Blacks. These results suggest that these three racial/ethnic groups experience somewhat different pathways to alcohol disorder.

Allen B; Cruz TB; Leonard E; Unger JB. Development and validation of a scale to assess attitudes and beliefs about menthol cigarettes among African American smokers. Evaluation & the Health Professions 33(4): 414-436, 2010. (28 refs.)

To develop more effective smoking cessation interventions for the 70% of African American smokers who smoke menthol cigarettes, it is important to understand smokers' reasons for choosing menthols verses nonmenthols. This study conducted a focus group of African American smokers about their attitudes and beliefs about menthol cigarettes. These attitudes and beliefs, along with others from the literature, were included in a survey of 720 African American smokers in Los Angeles County, California. Five common factors emerged-Medicinal Effects, Image, Less Harmful, Tradition, and Taste/Sensation. Menthol smokers had significantly higher scores on the Taste/Sensation, Medicinal Effects, and Less Harmful scales than nonmenthol smokers did. Men were significantly more likely than women to endorse Medicinal Effects, Image, and Tradition, whereas women were significantly more likely to endorse Taste/Sensation. Education was inversely associated with endorsement of Medicinal Effects, Image, Less Harmful, and Tradition. Respondents aged 40 years or older had significantly higher scores on Medicinal Effects, Image, and Less Harmful, compared with younger respondents. Smoking cessation interventions for African American menthol smokers should address commonly held myths that menthols have medicinal effects and are less harmful than nonmenthols, especially among smokers who are older, male, and/or have low levels of education. The new measures presented in this article could be useful for tailoring cessation interventions to individual smokers' attitudes and beliefs about menthol cigarettes.

Balls JE; Price JH; Dake JA; Jordan TR; Khuder S. African American primary care physicians' perceptions and practices regarding smoking cessation therapy. Journal of The National Medical Association 102(7): 579-589, 2010. (39 refs.)

African American smokers (34% of males and 23% of females) need formal interventions to assist them in quitting smoking, a major method of preventing premature mortality from smoking-related illnesses. The purpose of this study was to examine African American primary care physicians' perceptions and practices regarding smoking cessation counseling. A national random sample (n = 202) of primary care physicians was asked about their perceptions and practices regarding smoking cessation therapy. Most (89%) placed themselves in the maintenance stage for asking their patients about their smoking status and regularly documented the smoking status of their patients (70%). Most physicians did not comply with all of the components of the US Public Health Services' smoking cessation guidelines (eg, 5 A's and 5 R's). The component most often implemented of the 5 A's was to "advise" patients to quit (89%), and "arrange" follow-up was the least frequently (60%) used component. Perceived barriers to engaging in smoking cessation interventions were time (38%) and patients not interested in quitting (19%). Although physicians used many of the steps in the 5 A's and 5 R's, they were far less compliant in recommending, nicotine replacement therapy, prescribing pharmacotherapy, and providing support and/or follow-up for patients who were willing to quit smoking. Physicians need more academic preparation in providing smoking cessation counseling since few received such training in medical school (31%) or during their residency programs (18%).

Barnes GM; Welte JW; Hoffman JH; Tidwell MCO. Comparisons of gambling and alcohol use among college students and noncollege young people in the United States. Journal of American College Health 58(5): 443-452, 2010. (25 refs.)

Objective: Gambling and alcohol use were compared for college and noncollege young adults in the US population. Participants: Participants were 1,000 respondents aged 18 to 21. Methods: Data were analyzed from a representative household sample of US young people aged 14 to 21 years old. Telephone interviews were conducted between August 2005 and January 2007. Results: After taking into account gender, age, race/ethnicity, and socioeconomic status, college student status did not predict gambling, frequent gambling, or problem gambling. In contrast, being a college student was associated with higher levels of alcohol use and problem drinking. Being male was the strongest predictor of both problem gambling and problem drinking. Blacks were less likely than whites to drink heavily; yet they were more likely than whites to gamble heavily. Conclusion: Young males should be targeted for prevention and intervention efforts for both problem gambling and problem drinking regardless of college student status.

Behnken MP; Le YCL; Temple JR; Berenson AB. Forced sexual intercourse, suicidality, and binge drinking among adolescent girls. Addictive Behaviors 35(5): 507-509, 2010. (17 refs.)

Although sexual assault victimization has been shown to predict suicidality. little is known about the mechanisms linking these two factors. Using cross-sectional data (N = 6364) from the 2007 Youth Risk Behavior Survey, binge drinking significantly mediated the relationship between forced sexual intercourse and suicide for Hispanic (n = 1915) and Caucasian (it = 2928) adolescent females. but not for African American adolescent females (n = 1521). Results suggest the need for closer monitoring of adolescent victims of sexual assault who also abuse alcohol to intervene in early suicide behaviors. Treatment and intervention programs should also be culturally sensitive to account for differences in reaction to sexual trauma among race/ethnicity. Implications for suicide prevention and alcohol intervention strategies as well as suggestions to clinical providers are discussed.

Belgrave FZ; Johnson J; Nguyen A; Hood K; Tademy R; Clark T et al. Stress and tobacco use among African-American adolescents: The buffering effect of cultural factors. Journal of Drug Education 40(2): 173-188, 2010. (51 refs.)

Tobacco is a leading contributor to morbidity and mortality and a primary reason for health disparities among African Americans. In this study we explore the role of stress in smoking and cultural factors that protect against stress among African-American adolescents. Our sample consisted of 239 youth who were recruited into the study while enrolled in 8th and 12th grade. Measures of risk factors (stress, school transition stress, and community disorganization), moderator or protective factors (religious support and intergenerational connections), and 30-day tobacco use were collected. Hierarchical multiple regression analyses were conducted. Intergenerational connections moderated the effect of stress on past 30-day tobacco use. Religious support moderated the effect of neighborhood disorganization on past 30-day tobacco use. Religious support also moderated the effect of stress on past 30-day tobacco use. The findings have implications for prevention efforts to consider religious beliefs and practices and also to link youth with supportive adults in their community.

Berg CJ; Thomas JL; Guo HF; An LC; Okuyemi KS; Collins TC et al. Predictors of smoking reduction among Blacks. Nicotine & Tobacco Research 12(4): 423-431, 2010. (68 refs.)

Blacks who smoke have increased tobacco-related health risks. Cessation decreases the likelihood of many health problems. Smoking reduction may be important in the cessation process and potentially reduce health risks. Because little is known about specific predictors of smoking reduction, we investigated factors predicting reduction among Black light smokers enrolled in a 26-week cessation trial. Specifically, we compared (a) reducers (reduced cigarettes per day [cpd] >= 50%) with nonreducers and (b) reducers with quitters. Baseline demographic, smoking-related, and psychosocial variables were collected, and Week 26 smoking status was assessed. Among 539 participants, 41.0% (n = 221) reduced their smoking, 17.6% (n = 95) quit, and 41.4% (n = 223) did not reduce their smoking by >= 50%. In comparison with reducers, nonreducers were more likely to have their first cigarette within 30 min of waking (odds ratio [OR] = 2.4, 95% CI = 1.47-3.93), lower baseline cpd (OR = 0.84, 95% CI = 0.77-0.93), higher baseline cotinine levels (OR = 1.002, 95% CI = 1.000-1.003), lower perceived stress (OR = 0.86, 95% CI = 0.78-0.95), and higher Smoking Consequences Questionnaire (SCQ) negative social impression scores (OR = 1.04, 95% CI = 1.01-1.06), after controlling for treatment arm, gender, and age. Significant predictors of smoking cessation versus reduction included lower baseline cpd (OR = 0.85, 95% CI = 0.75-0.95), higher nicotine dependence (OR = 1.47, 95% CI = 1.09-1.98), lower baseline cotinine levels (OR = 0.996, 95% CI = 0.994-0.998), higher body mass index (OR = 1.05, 95% CI = 1.01-1.08), lower perceived stress (OR = 0.82, 95% CI = 0.72-0.95), and higher SCQ negative social impression scores (OR = 1.05, 95% CI = 1.01-1.08). Distinct predictors are associated with different trajectories of smoking behavior change (i.e., reduction vs. cessation vs. no change).

Biksey T; Zickmund S; Wu F. Disparities in risk communication: A pilot study of asthmatic children, their parents, and home environments. Journal of the National Medical Association 103(5): 388-391, 2011. (28 refs.)

Parents' knowledge and control of asthma triggers in home environments can help reduce risks associated with asthmatic children's respiratory health. This pilot study used both qualitative and quantitative methods to determine parental knowledge of their children's asthma triggers in home environments, control of those triggers, and information received and trusted. Twelve parents of asthmatic children in the greater Pittsburgh area-8 white and 4 African American participated in one-on-one interviews about home exposures to asthma triggers. All parents described the link between asthma symptoms and both environmental tobacco smoke (ETS) and pet dander exposures. House dust mites and mold were also commonly identified asthma triggers. All 8 white parents reported receiving information from physicians about controlling home environmental triggers of asthma, but the 4 African American parents reported having received no such information. However, all 12 parents reported having greater trust in information received from physicians than from other sources. White parents were significantly more aware of potential asthma triggers and performed significantly more actions to control the triggers in their homes. African American parents noted stressful experiences with primary and secondary care, less recall of information sharing about asthma triggers, and a focus on symptom management vs trigger avoidance.

Boardman JD; Alexander KB. Stress trajectories, health behaviors, and the mental health of black and white young adults. Social Science & Medicine 72(10): 1659-1666, 2011. (39 refs.)

This paper uses data from the National Longitudinal Study of Adolescent Health to examine the mental health of non-Hispanic black and white young adults in the US. We use latent growth curve modeling to characterize the typical stress trajectories experienced by black and white young adults spanning the bulk of their lives. We identify the following four stress trajectories: 1) relatively stress free; 2) stress peak at age 15 and a subsequent decline; 3) stress peak at age 17 and a subsequent decline; and 4) a moderately high chronic stress. Results. indicate that black adolescents have significantly higher risk of being in all three of the stressful classes compared to white adolescents. Stress exposure is strongly associated with depression and the race differences in stress profiles account for a modest amount of the observed race differences in mental health. We do not observe any race differences in behavioral responses to stressors; black youth are no more likely than white youth to engage in poor health behaviors (e.g., smoking, drinking, or obesity) in response to stress. We provide tentative support for the notion that poor health behaviors partially reduce the association between stress and depression for blacks but not whites. These findings contribute to unresolved issues regarding mental and physical health disparities among blacks and whites.

Boggs DA; Palmer JR; Stampfer MJ; Spiegelman D; Adams-Campbell LL; Rosenberg L. Tea and coffee intake in relation to risk of breast cancer in the Black Women's Health Study. Cancer Causes & Control 21(11): 1941-1948, 2010. (41 refs.)

Prospective studies of tea and coffee intake and breast cancer risk have yielded inconsistent results. None of these studies has reported separately on African-American women. We prospectively examined the relation of tea and coffee consumption to risk of breast cancer among 52,062 women aged 21-69 at enrollment in 1995 in the Black Women's Health Study. Dietary intake was assessed in 1995 and 2001 using a validated food frequency questionnaire. Cox proportional hazards models were used to estimate incidence rate ratios (IRR) and 95% confidence intervals (CI), adjusted for breast cancer risk factors. During 12 years of follow-up through 2007, there were 1,268 incident cases of breast cancer. Intakes of tea, coffee, and caffeine were not significantly associated with the risk of breast cancer overall. The IRRs for consumption of a parts per thousand yen4 cups/day compared with none were 1.13 (95% CI 0.78-1.63) for tea and 1.03 (95% CI 0.77-1.39) for caffeinated coffee, and the IRR for the top quintile relative to the bottom quintile of caffeine intake was 1.04 (95% CI 0.87-1.24). Consumption of tea, coffee, and caffeine was not significantly associated with breast cancer risk according to menopausal status or hormone receptor status. Our findings suggest that intakes of tea, coffee, and caffeine are not associated with the risk of breast cancer among African-American women.

Boggs DA; Rosenberg L; Ruiz-Narvaez EA; Palmer JR. Coffee, tea, and alcohol intake in relation to risk of type 2 diabetes in African American women. American Journal of Clinical Nutrition 92(4): 960-966, 2010. (46 refs.)

Background: Numerous studies have reported inverse associations of coffee, tea, and alcohol intake with risk of type 2 diabetes, but none has reported results separately among African American women. Objective: We prospectively examined the relation of coffee, tea, and alcohol consumption to diabetes risk in African American women. Design: The study included 46,906 Black Women's Health Study participants aged 30-69 y at baseline in 1995. Dietary intake was assessed in 1995 and 2001 by using a validated food-frequency questionnaire. During 12 y of follow-up, there were 3671 incident eases of type 2 diabetes. Relative risks (RRs) and 95% CIs were estimated by using Cox proportional hazards models adjusted for diabetes risk factors. Results: Multivariable RRs for intakes of 0-1, 1, 2-3, and >= 4 cups of caffeinated coffee/d relative to no coffee intake were 0.94 (95% CI: 0.86, 1.04), 0.90 (95% CI: 0.81, 1.01), 0.82 (95% CI: 0.72, 0.93), and 0.83 (95% CI: 0.69, 1.01), respectively (P for trend =0.003). Multivariable RRs for intakes of 1-3, 4-6, 7-13, and >= 14 alcoholic drinks/wk relative to never consumption were 0.90 (95% CI: 0.82, 1.00), 0.68 (95% CI: 0.57, 0.81), 0.78 (95% CI: 0.63, 0.96), and 0.72 (95% CI: 0.53, 0.98), respectively (P for trend < 0.0001). Intakes of decaffeinated coffee and tea were not associated with risk of diabetes. Conclusion: Our results suggest that African American women who drink moderate amounts of caffeinated coffee or alcohol have a reduced risk of type 2 diabetes.

Brook JS; Lee JY; Brown EN; Finch SJ; Brook DW. Developmental trajectories of marijuana use from adolescence to adulthood: Personality and social role outcomes. Psychological Reports 108(2): 339-357, 2011. (42 refs.)

Longitudinal trajectories of marijuana use from adolescence into adulthood were examined for adverse life-course outcomes among African-Americans and Puerto Ricans. Data for marijuana use were analyzed at four points in time and on participants' personality attributes, work functioning, and partner relations in adulthood using growth mixture modeling. Each of the three marijuana-use trajectory groups (maturing-out, late-onset, and chronic marijuana-users) had greater adverse life-course outcomes than a nonuse or low-use trajectory group. The chronic marijuana-use trajectory group was highly associated with criminal behavior and partners' marijuana use in adulthood. Treatment programs for marijuana use should also directly address common adverse life-course outcomes users may already be experiencing.

Brook JS; Saar NS; Brook DW. Developmental pathways from parental substance use to childhood academic achievement. American Journal on Addictions 19(3): 270-276, 2010. (58 refs.)

This cross-sectional study examined the pathways to childhood academic achievement in 209 African American and Puerto Rican children and their mothers. There were three pathways to childhood academic achievement: (a) the mother-child relationship and the child's personality mediated between low parental substance use and childhood academic achievement; (b) the child's personality mediated between high parental education and childhood academic achievement; and (c) there was a direct relationship between the child's gender and childhood academic achievement. Policy and clinical implications suggest the importance of increasing educational opportunities for all parents by providing substance use treatment and self-esteem workshops.

Brook JS; Zhang CS; Finch SJ; Brook DW. Adolescent pathways to adult smoking: Ethnic identity, peer substance use, and antisocial behavior. American Journal on Addictions 19(2): 178-186, 2010. (58 refs.)

African-Americans and Puerto Ricans were interviewed during adolescence, in their early twenties, and then again in their mid-twenties. Results indicated that earlier adolescent smoking, family conflict, and weak ethnic identity were significantly related to antisocial behavior, which in turn was related to associating with friends who smoked and/or used illegal drugs, and ultimately, to their own smoking. Results further indicate that early interventions in the development of tobacco use should focus on decreasing parental and adolescent smoking and parent-child conflict. If intervention occurs at a later time point, the emphasis should be on increasing ethnic identity and decreasing antisocial behavior.

Bryant-Davis T; Ullman SE; Tsong Y; Tillman S; Smith K. Struggling to survive: Sexual assault, poverty, and mental health outcomes of African American women. American Journal of Orthopsychiatry 80(1): 61-70, 2010. (90 refs.)

A substantial body of research documents the mental health consequences of sexual assault including, but not limited to, depression, posttraumatic stress disorder, substance use, and suicidality. Far less attention has been given to the mental health effects of sexual assault for ethnic minority women or women living in poverty. Given African American women's increased risk for sexual assault and increased risk for persistent poverty, the current study explores the relationship between income and mental health effects within a sample of 413 African American sexual assault survivors. Hierarchical regression analyses revealed that after controlling for childhood sexual abuse there were positive relationships between poverty and mental health outcomes of depression, posttraumatic stress disorder, and illicit drug use. There was no significant relationship between poverty and suicidal ideation. Counseling and research implications are discussed.

Caetano R; Baruah J; Ramisetty-Mikler S; Ebama MS. Sociodemographic predictors of pattern and volume of alcohol consumption across Hispanics, Blacks, and whites: 10-Year Trend (1992-2002). Alcoholism: Clinical and Experimental Research 34(10): 1782-1792, 2010. (40 refs.)

Background: There have been limited trend studies examining variations on the patterns of alcohol consumption among Whites, Blacks, and Hispanics in the United States. The current paper reports national trends in drinking patterns, volume of drinking (number of drinks per month), binge drinking, and drinking to intoxication among Blacks, Whites, and Hispanics over a period of 10 years and identifies sociodemographic predictors of these behaviors across the 3 ethnic groups. Methods: Data are from the 1991 to 1992 National Longitudinal Alcohol Epidemiologyogic Survey (NLAES; n = 42,862) and the 2001 to 2002 National Epidemiologyogic Study on Alcohol and Related Conditions (NESARC; n = 43,093). Both surveys used multistage cluster sample procedures to select respondents 18 years of age and older from the U.S. household population. Results: Trends varied across different dimensions of drinking and ethnic groups. There were no statistically significant differences in the mean number of drinks consumed per month among men and women in any of the 3 ethnic groups between 1992 and 2002, but there was a significant rise in the proportion of current drinkers in both genders and in all 3 ethnic groups. Multivariate analysis indicated that, compared to Whites in 1992, Blacks and Hispanics did not increase their volume of drinking, but Whites did. Drinking 5 or more drinks in day at all did not increase between 1992 and 2002, but drinking 5 or more drinks at least once a month was more likely for all groups in 2002 compared to Whites in 1992. Drinking to intoxication at all was more likely among Whites in 2002 than 1992, but drinking to intoxication at least once a month was more likely among Whites and Blacks in 2002 than 1992. Conclusion: The only common trend between 1992 and 2002 across both genders and 3 ethnic groups was a rise in the proportion of drinkers. There was also a rise in drinking 5 or more drinks in a day (Whites, Blacks, and Hispanics) and drinking to intoxication (Whites and Blacks), but this was limited to those reporting such drinking at least once a month. The reasons for these changes are many and may involve complex sociodemographic changes in the population. It is important for the field to closely monitor these cross-ethnic trends in alcohol consumption.

Caraballo RS; Holiday DB; Stellman SD; Mowery PD; Giovino GA; Muscat JE et al. Comparison of serum cotinine concentration within and across smokers of menthol and nonmenthol cigarette brands among Non-Hispanic Black and Non-Hispanic White US adult smokers, 2001-2006. Cancer Epidemiology, Biomarkers & Prevention 20(7): 1329-1340, 2011. (36 refs.)

Background: The Food and Drug Administration (FDA) is examining options for regulating menthol content in cigarettes. There are many pharmacologic properties of menthol that may facilitate exposure to tobacco smoke, and it has been suggested that the preference for menthol cigarettes in black smokers accounts for their higher cotinine levels. Objective: To assess cigarettes smoked per day-adjusted cotinine levels in relation to smoking a menthol or nonmenthol cigarette brand among non-Hispanic black and white U. S. adult smokers under natural smoking conditions. Method: Serum cotinine concentrations were measured in 1,943 smokers participating in the 2001 to 2006 National Health and Nutrition Examination Surveys (NHANES). The effect of smoking a menthol brand on cigarettes smoked per day-adjusted serum cotinine levels in these two populations was modeled by adjusting for sex, age, number of smokers living in the home, body weight, time since last smoked, and FTC (Federal Trade Commission)-measured nicotine levels. The 8- or 12-digit Universal Product Code (UPC) on the cigarette label was used to determine the cigarette brand and whether it was menthol. Results: Smoking a menthol cigarette brand versus smoking a nonmenthol cigarette brand was not associated (P >= 0.05) with mean serum cotinine concentration in either black or white smokers. Conclusions: The higher levels of cotinine observed in black smokers compared with white smokers are not explained by their higher preference for menthol cigarette brands. Impact: Further studies like ours are needed to improve our ability to understand health consequences of future changes in tobacco product design.

Carter BL; Paris MM; Lam CY; Robinson JD; Traylor AC; Waters AJ et al. Real-time craving differences between black and white smokers. American Journal on Addictions 19(2): 136-140, 2010. (30 refs.)

Black and White smokers may experience aspects of nicotine dependence, including craving, differently. This study used a naturalistic technique, ecological momentary assessment (EMA), to explore differences in craving, mood, expectancy, and smoking enjoyment between Black and White smokers. Participants carried personal digital assistants (PDAs) programmed to obtain multiple daily assessments. Black smokers reported higher craving after smoking and at random assessment times and higher cigarette enjoyment. No differences were found in mood or expectancy. Racial differences in psychological factors related to smoking are explored in the contexts of genetic, sociological, and psychophysiological distinctions. Implications for practice and research are discussed.

Castro Y; Kendzor DE; Businelle MS; Mazas CA; Cofta-Woerpel L; Cinciripini PM et al. Structural and predictive equivalency of the Wisconsin Smoking Withdrawal Scale across three racial/ethnic groups. Nicotine & Tobacco Research 13(7): 548-555, 2011. (37 refs.)

The Wisconsin Smoking Withdrawal Scale (WSWS) is a valid and reliable scale among non-Latino Whites but has not been validated for use among other racial/ethnic groups despite increasing use with these populations. The current study examined the structural invariance and predictive equivalency of the WSWS across three racial/ethnic groups. The WSWS scores of 424 African American, Latino, and White smokers receiving smoking cessation treatment were analyzed in a series of factor analyses and multiple-group analyses. Additionally, hierarchical logistic regression analyses were conducted to determine whether WSWS scores differentially predicted smoking relapse across racial/ethnic groups. These analyses were consistent with a step-down hierarchical regression procedure for examination of test bias. The 7-factor structure of the WSWS was largely confirmed in the current study, with the exception of the removal of two offending items. Evidence of full invariance across race/ethnicity was found in multiple-group analyses. The WSWS total score and subscales measuring anger, anxiety, concentration, and sadness predicted relapse, whereas the hunger, craving, and sleep subscales did not. None of these scales displayed differential predictive ability across race/ethnicity. The WSWS sleep subscale showed a significant interaction with race/ethnicity such that it was a significant predictor of relapse among Whites but not African Americans or Latinos. Overall, the WSWS is similar in structure and predictive of relapse across racial/ethnic groups. Caution should be exercised when using the WSWS sleep subscale with African Americans and Latinos.

Champion JD. Context of sexual risk behaviour among abused ethnic minority adolescent women. International Nursing Review 58(1): 61-67, 2011. (37 refs.)

Background: Evidence suggests that multiple influences on sexual behaviour of adolescents exist, ranging from relationships with significant others including sexual or physical abuse and childhood molestation to substances used prior to sex and environmental circumstances such as sex work. Purpose: This study aims to describe associations between childhood molestation and sexual risk behaviour. Method: African American and Mexican American adolescent women aged 14-18 years (n = 562) with sexually transmitted infection (STI) or abuse histories and enrolled in a randomized controlled trial of behavioural interventions were interviewed via self-report concerning sexual risk behaviour, abuse and childhood molestation at study entry. Results: Sexual (59%), physical (77%) and psychological (82%) abuse and childhood molestation (25%) were self-reported without differences by ethnicity. Adolescents reporting childhood molestation experienced more forms of sexual, physical and psychological abuse than others and higher incidences of STI. Fewer attended school; however, more had arrests, convictions, incarcerations and probations. Stressors including depression, running away, thoughts of death and suicide were highest for those reporting childhood molestation. Those reporting childhood molestation engaged in higher sexual risk behaviours than adolescents experiencing other forms of sexual or physical abuse (lifetime partners, bisexual relationships, anal and group sex, sex with friends with benefits, sex for money, concurrent partners, drug use including multiple substances, alcohol use and alcohol problems). These adolescents reported 'getting high' and having sex when out of control as reasons for sex with multiple partners. Conclusion: Interventions for abused adolescent women necessitate a focus on associations between childhood molestation and a multiplicity of sexual risk behaviours for prevention of abuse, substance use and sex work, STI/human immunodeficiency virus (HIV) and sequelae.

Chiocco MJ; Zhu XG; Walther D; Pletnikova O; Troncoso JC; Uhl GR et al. Fine mapping of calcineurin (PPP3CA) gene reveals novel alternative splicing patterns, association of 5 ' UTR trinucleotide repeat with addiction vulnerability, and differential isoform expression in Alzheimer's Disease. Substance Use & Misuse 45(11): 1809-1826, 2010. (25 refs.)

Fine mapping of calcineurin (PPP3CA) gene identified single nucleotide polymorphisms (SNPs) and simple sequence repeat polymorphisms that are associated with addiction vulnerability. A trinucleotide repeat marker, located in the 5'untranslated region (5'UTR) of the PPP3CA mRNA, exhibited significantly different genotype and allele frequencies between abusers and controls in the NIDA African-American sample. The polymorphism showed allelic-specific expression in mRNA extracted from postmortem brain specimens. Novel alternatively spliced isoforms of PPP3CA were identified and their expressions were found altered in brain regions of postmortem Alzheimer's disease patients. These data underscore the importance of calcineurin gene in the molecular mechanism of addiction and Alzheimer's diseases.

Chung T; White HR; Hipwell AE; Stepp SD; Loeber R. A parallel process model of the development of positive smoking expectancies and smoking behavior during early adolescence in Caucasian and African American girls. Addictive Behaviors 35(6): 647-650, 2010. (17 refs.)

This study examined the development of positive smoking expectancies and smoking behavior in an urban cohort of girls followed annually over ages 11-14. Longitudinal data from the oldest cohort of the Pittsburgh Girls Study (N=566, 56% African American, 44% Caucasian) were used to estimate a parallel process growth model of positive smoking expectancies and smoking behavior. Average level of positive smoking expectancies was relatively stable over ages 11-14, although there was significant variability in initial level and rate of change in positive smoking expectancies. Ethnicity was associated with expectancy intercept and slope, such that African American, relative to Caucasian, girls initially had more positive expectancies, and less rapid change in positive expectancies. Ethnic differences in past year smoking prevalence emerged at age 14, with greater smoking prevalence among Caucasian (17%), compared to African American (8%), girls. Initial level of positive smoking expectancies and initial smoking behavior were positively associated, but positive expectancies did not predict growth in smoking behavior. Depression at age 11 was concurrently and positively associated with both positive expectancies and smoking. Study results suggest the potential utility of culturally tailored smoking prevention efforts, and the potential secondary benefit of depression treatment to prevent smoking among at-risk girls.

Copeland-Linder N; Lambert SF; Chen YF; Ialongo NS. Contextual stress and health risk behaviors among African American adolescents. Journal of Youth and Adolescence 40(2): 158-173, 2011. (111 refs.)

This study examined the longitudinal association between contextual stress and health risk behaviors and the role of protective factors in a community epidemiologically-defined sample of urban African American adolescents (N = 500; 46.4% female). Structural equation modeling was used to create a latent variable measuring contextual stress (community violence, neighborhood disorder, and experiences with racial discrimination). Contextual stress in 8th grade was associated with aggressive behavior and substance use 2 years later for boys. For girls, contextual stress predicted later substance use, but not aggressive behavior. High academic competence and self-worth reduced the impact of contextual stress on substance use for boys. Implications for intervention and directions for future research on health risk behaviors among African American adolescents are discussed.

Daley CM; Greiner KA; Nazir N; Daley SM; Solomon CL; Braiuca SL et al. All nations breath of life: Using community-based participatory research to address health disparities in cigarette smoking among American Indians. Ethnicity & Disease 20(4): 334-338, 2010. (21 refs.)

Using a community-based participatory research (CBPR) approach, we developed the All Nations Breath of Life smoking cessation program and pilot-tested it in urban and reservation communities. The program combines weekly in-person group support sessions with individual telephone calls using motivational interviewing. All sessions include discussion of sacred tobacco and information about quitting and health. We have assessed the scientific validity, cultural-appropriateness, and readability of our program materials and found them to be adequate; participant satisfaction is high. The program shows promise for improving quit rates among American Indians, who have the highest smoking rates and lowest quit rates of any ethnic group. Our preliminary self-report data show quit rates of 65% at program completion and 25% at six months post-baseline.

Dalton WT; Klesges LM; Henderson L; Somes G; Robinson L; Johnson KC. Gender, smoking status, and risk behavior attitudes explain adolescents' patterns of nicotine replacement therapy use. Addictive Behaviors 35(2): 147-151, 2010. (20 refs.)

Treatment studies provide minimal support for nicotine replacement therapy (NRT) with youth; however, survey studies suggest that adolescents use NRT, and may engage in inappropriate use. The current study sought to examine patterns of NRT use and risk factors for use to further aid smoking cessation efforts including prevention of potential misuse. In-school surveys assessing socio-demographic and behavioral factors associated with NRT use, gum or patch were completed by 4078, predominantly African American, high school students. Approximately 5% of students reported former or current use of NRT products: 42% gum, 29% patch, and 29% both gum and patch. Among smokers, 5.4% reported use of both NRT gum and patch, with exclusive use of gum twice as likely as exclusive use of the patch. Those with high-risk-taking attitudes were more likely than low-risk takers (3% vs. 1%) to report use of both products, with exclusive gum use more prevalent than patch use. A cumulative logit model revealed males, risk takers, and/or smokers were at greatest odds for NRT use. Among this adolescent sample, NRT gum was used more often than the patch. Adolescent males, risk takers, and/or smokers appear more likely to use NRT (gum and/or patch) compared to their counterparts, despite limited empirical support for effective use of these products as cessation aids among adolescents. Smoking cessation and prevention programs may emphasize appropriate NRT use, specifically within these populations.

Edens EL; Glowinski AL; Pergadia ML; Lessov-Schlaggar CN; Bucholz KK. Nicotine addiction in light smoking African American mothers. Journal of Addiction Medicine 4(1): 55-60, 2010. (41 refs.)

Background: Although African Americans (AAs) smoke fewer average cigarettes per day (CPD) than European Americans (EAs), they carry a disproportionate tobacco-related morbidity and mortality burden. The objective of this study was to evaluate the ethnic differences in markers of nicotine addiction, including rates of lifetime nicotine dependence (ND) symptoms, current smoking, and smoking during pregnancy across different levels of peak lifetime cigarette consumption. Methods: Data from 237 EA (N = 118) and AA (N = 119) mothers participating in the Missouri Family Study (2003-2005), an ethnically diverse family study of offspring outcomes in high and low risk families, were used to contrast prevalence of ND symptoms and other smoking behaviors between EA and AA women at low (1-10 CPD), moderate (11-19 CPD), and high (>= 20 CPD) levels of lifetime peak daily cigarette consumption. Results: Compared with EA smokers, AAs had lower lifetime prevalence of DSM-IV ND (68% vs 54%, P < 0.05), consumed fewer CPD during their heaviest lifetime consumption (18% EA vs 58% AA smoked <= 10 CPD, P < 0.0001), but did not differ in overall rates of smoking during pregnancy or current smoking. However, stratifying by categories of peak lifetime daily cigarette use, AA mothers who smoked <= 10 CPD reported greater lifetime ND symptoms and current smoking than their EA counterparts. In addition, nearly two thirds of AA mothers in this smoking category smoked during pregnancy, and 30% smoked throughout an entire pregnancy. The respective prevalence estimates in EA mothers were 38% and 0%. Conclusions: Stratifying the sample into categories of lifetime peak daily cigarette use revealed significant ethnic or racial differences in smoking prevalence during pregnancy, which were obscured in overall analysis. Substantial public health risks warranting clinical attention exist among light smokers, particularly AA women.

Faseru B; Daley CM; Gajewski B; Pacheco CM; Choi WS. A longitudinal study of tobacco use among American Indian and Alaska Native tribal college students. BMC Public Health 10: 617, 2010. (36 refs.)

Background: American Indians (AI) have the highest smoking rates of any ethnic group in the US (40.8%), followed most closely by African Americans (24.3%) and European Americans (23.6%). AI smokers also have more difficulty quitting smoking compared to other ethnic groups, evidenced by their significantly lower quit ratios, and are among the least successful in maintaining long term abstinence. While health disparities like these have existed for years among AI, the epidemiology of smoking and nicotine dependence has not been optimally described among this underserved population. Our overarching hypothesis is that the susceptibility of AI to cigarette smoking and nicotine dependence and its consequences has both an underlying nicotine metabolism component as well as psychosocial, cultural, and environment causes. We are well-positioned to explore this issue for the first time in this population. Our objective is to establish a cohort of AI tribal college/university students to determine the predictors of smoking initiation (non-use to experimentation), progression (experimentation to established use), and cessation (established use to cessation). Much of what is known about the process of smoking initiation and progression comes from quantitative studies with non-Native populations. Information related to smoking use among AI tribal college/university (TCU) students is entirely unknown and critically needs further investigation. This study will be the first of its kind among AI college students who are at the highest risk among all ethnic groups for tobacco dependence. Methods/design: First year students at Haskell Indian Nations University in Kansas will be recruited over four consecutive years and will be surveyed annually and repeatedly through year 5 of the study. We will use both longitudinal quantitative surveys and qualitative focus group methods to examine key measures and determinants of initiation and use among this high risk group.

Field CA; Caetano R; Harris TR; Frankowski R; Roudsari B. Ethnic differences in drinking outcomes following a brief alcohol intervention in the trauma care setting. Addiction 105(1): 62-73, 2010. (54 refs.)

Background: Evidence suggests that brief interventions in the trauma care setting reduce drinking, subsequent injury and driving under the influence (DUI) arrest. However, evidence on the effectiveness of these interventions in ethnic minority groups is lacking. The current study evaluates the efficacy of brief intervention among whites, blacks and Hispanics in the United States. Methods: We conducted a two-group parallel randomized trial comparing brief motivational intervention (BMI) and treatment as usual with assessment (TAU+) to evaluate treatment differences in drinking patterns by ethnicity. Patients were recruited from a level 1 urban trauma center over a 2-year period. The study included 1493 trauma patients, including 668 whites, 288 blacks and 537 Hispanics. Hierarchical linear modeling was used to evaluate ethnic differences in drinking outcomes including volume per week, maximum amount consumed in 1 day, percentage days abstinent and percentage days heavy drinking at 6- and 12-month follow-up. Analyses controlled for age, gender, employment status, marital status, prior alcohol treatment, type of injury and injury severity. Special emphasis was given to potential ethnic differences by testing the interaction between ethnicity and BMI. Results: At 6- and 12-month follow-up, BMI significantly reduced maximum amount consumed in 1 day (P < 0.001; P < 0.001, respectively) and percentage days heavy drinking (P < 0.05; P < 0.05, respectively) among Hispanics. Hispanics in the BMI group also reduced average volume per week at 12-month follow-up (KH2 = 6.8, df = 1, P < 0.01). In addition, Hispanics in TAU+ reduced maximum amount consumed at 6- and 12-month follow-up (P < 0.001; P < 0.001) and volume per week at 12-month follow-up (P < 0.001). Whites and blacks in both BMI and TAU+ reduced volume per week and percentage days heavy drinking at 12-month follow-up (P < 0.001; P < 0.01, respectively) and decreased maximum amount at 6- (P < 0.001) and 12-month follow-up (P < 0.001). All three ethnic groups In both BMI and TAU+ reduced volume per week at 6-month follow-up (P < 0.001) and percentage days abstinent at 6- (P < 0.001) and 12-month follow-up (P < 0.001). Conclusions: All three ethnic groups evidenced reductions in drinking at 6- and 12-month follow-up independent of treatment assignment. Among Hispanics, BMI reduced alcohol intake significantly as measured by average volume per week, percentage days heavy drinking and maximum amount consumed in 1 day.

Fisher JC; Cook PA; Kapiga SH. Alcohol use before sex and HIV risk: Situational characteristics of protected and unprotected encounters among high-risk African Women. Sexually Transmitted Diseases 37(9): 571-578, 2010. (39 refs.)

Objectives: To compare the situational characteristics of protected and unprotected sexual encounters that involved alcohol use 2 hours prior with ones that did not. Methods: Data were collected between December 2002 and December 2005 as part of enrollment in a prospective cohort study designed to identify HIV seroconversion risk factors among women bar and hotel workers in Northern Tanzania. A total of 608 (37.3%) of the women who were inconsistent condom users were asked a set-matched questions concerning situational characteristics surrounding their last protected and unprotected sexual encounter including whether they had been drinking within 2 hours of sex. The associations between drinking 2 hours before sex (yes/no), condom use (protected/unprotected), and their interaction with the situational descriptors were examined with a 2 x 2 model for paired categorical data after controlling for time since the last type of encounter. Results: Condom failure was 5 times more likely if someone (woman, man, or both partners) had been drinking in advance of the encounter (OR, 5.19; 95% CI, 2.05-15.46) and was especially likely to occur if only the woman had been drinking before sex (OR, 14.05; 95% CI, 4.03-50.41). Alcohol use before sex was associated with sexual contacts where the woman was having sex with her partner for the first time, their relationship was casual or transitory or sex was transactional, the location was unfamiliar and less under her control, and the partner had been drinking or using drugs before having sex. Condom use was more frequent in precisely the same types of encounters. Interestingly, there were no significant interactions between alcohol use before sex and condom use, suggesting that drinking before sex and use of condom are distinct and not contingent risk factors. Conclusions: Alcohol use before sex is associated with an increased likelihood of condom failures and with high-risk sexual encounters, ones that have consistent situational characteristics regardless of whether condoms are used or not.

Floyd LJ; Alexandre PK; Hedden SL; Lawson AL; Latimer WW; Giles N. Adolescent drug dealing and race/ethnicity: A population-based study of the differential impact of substance use on involvement in drug trade. American Journal of Drug and Alcohol Abuse 36(2): 87-91, 2010. (26 refs.)

Background: Among adolescents, peers are an important source of drug procurement. However, little is known about factors associated with youths' involvement in drug trade. Objectives: The aim of the study is to identify substance use behaviors and contextual factors related to drug dealing among Black and White adolescents. Methods: The sample consisted of 13,706 White and Black youths who completed the National Survey on Drug Use and Health. Separate backward logistic regression was used to identify substance use behaviors and contextual factors associated with drug dealing among Black and White youths. Results: Among White youths, drug dealing was associated with use of marijuana, hallucinogens, cocaine, prescription drug misuse, availability of cocaine, and socioeconomic status (SES). Among Black youths, marijuana use and availability of crack and marijuana were associated with drug dealing. Conclusions and Scientific Significance: For White youths, substance use seems to be more relevant to drug dealing. Consequently, preventing and treating substance abuse may reduce involvement in the illegal distribution of drugs among White youths. More research is needed to identify risk and protective factors for drug dealing among Black adolescents.

Francis SA; Thorpe RJ. Using the primary socialization theory to predict substance use and sexual risk behaviors between black and white adolescents. Substance Use & Misuse 45(13): 2113-2129, 2010. (34 refs.)

Using the Primary Socialization Theory (PST), we examined substance use and sexual risk-taking behaviors between Black (N = 1,464) and White (N = 3,946) adolescents in the National Longitudinal Study of Adolescent Health, Wave 1, public use (Add Health). Self-reported substance use and sexual risk-taking behaviors, PST constructs, and covariates were assessed using regression modeling techniques. Black youth were more likely to initiate sex, while White youth were more likely to report lifetime alcohol use. The PST predicted risk for White but not Black youth. The study's limitations are noted, and implications for future research are discussed.

Green KM; Doherty EE; Stuart EA; Ensminger ME. Does heavy adolescent marijuana use lead to criminal involvement in adulthood? Evidence from a multiwave longitudinal study of urban African Americans. Drug and Alcohol Dependence 112(1-2): 117-125, 2010. (58 refs.)

While marijuana use is common during adolescence, it can have adverse long-term consequences, with serious criminal involvement being one of them. In this study, we utilize longitudinal data from the Woodlawn Study of a community cohort of urban African Americans (N = 702) to examine the effects of heavy adolescent marijuana use (20 or more times) on adult criminal involvement, including perpetration of drug, property and violent crime, as well as being arrested and incarcerated. Utilizing propensity score matching to take into account the shared risk factors between drug use and crime, regression analyses on the matched samples show that heavy adolescent marijuana use may lead to drug and property crime and criminal justice system interactions, but not violent crime. The significant associations of early heavy marijuana use with school dropout and the progression to cocaine and/or heroin use only partially account for these findings. Results suggest that the prevention of heavy marijuana use among adolescents could potentially reduce the perpetration of drug and property crime in adulthood, as well as the burden on the criminal justice system, but would have little effect on violent crime.

Green KM; Doherty EE; Reisinger HS; Chilcoat HD; Ensminger M. Social integration in young adulthood and the subsequent onset of substance use and disorders among a community population of urban African Americans. Addiction 105(3): 484-493, 2010. (56 refs.)

Aims: This paper examines the association between social integration in young adulthood and the later onset of substance use and disorders through mid-adulthood. Design: Data come from a community cohort of African Americans followed longitudinally from age 6-42 years with four assessment periods. Setting: The cohort all lived in the Woodlawn neighborhood of Chicago in 1966, an urban disadvantaged setting. Participants: All Woodlawn first graders in 1966 were asked to participate; 13 families declined (n = 1242). Measurement Substance use was measured via interview at age 42 and includes the onset of alcohol and drug use disorders and the onset of cocaine/heroin use between ages 32 and 42 years. Social integration measures were assessed via interview at age 32 and include social roles (employee, spouse, parent), participation in religious and social organizations and a measure of overall social integration. Control variables were measured in childhood and later in the life course. Findings: Multivariate regression analyses suggest that unemployment, being unmarried, infrequent religious service attendance and lower overall social integration in young adulthood predict later adult-onset drug use disorders, but not alcohol use disorders once confounders are taken into consideration. Unemployment and lower overall social integration predict onset of cocaine/heroin use later in adulthood. Conclusions: Results show meaningful onset of drug use and substance use disorders during mid-adulthood and that social integration in young adulthood seems to play a role in later onset of drug use and drug disorders, but not alcohol disorders.

Guilamo-Ramos V; Jaccard J; Dittus P; Gonzalez B; Bouris A; Banspach S. The Linking Lives Health Education Program: A randomized clinical trial of a parent-based tobacco use prevention program for African American and Latino youths. American Journal of Public Health 100(9): 1641-1647, 2010. (29 refs.)

Objectives. We evaluated the effectiveness of a parent-based add-on component to a school-based intervention to prevent cigarette smoking among African American and Latino middle school youths. Methods. Mother-adolescent dyads (n=1386) were randomly assigned to 2 groups: (1) a school-based smoking-prevention intervention or (2) the same intervention with a parent-based add-on component called Raising Smoke-Free Kids. Mothers in the experimental condition received the parent add-on component. Mothers in the control condition received information on selecting a high school. All adolescents received a version of Project Towards No Tobacco Use (TNT). The primary outcome was a reduction in adolescent cigarette smoking. Follow-up data were obtained from 1096 mother-adolescent dyads at 15 months postintervention. Results. At follow-up, the odds of smoking cigarettes were reduced by 42% for adolescents in the parent add-on condition versus the TNT-only condition. Mothers in the parent add-on condition were more likely than were mothers in the TNT-only condition to set rules about risk-sensitive social activities and to be perceived as trustworthy by their child. Group differences also were found in the frequency and quality of mother-adolescent communication. Conclusions. Including parent add-on components in school-based smoking prevention programs can reduce smoking behavior on the part of inner-city middle school youths.

Guydish J; Chan M; Bostrom A; Jessup MA; Davis TB; Marsh C. A randomized trial of probation case management for drug-involved women offenders. Crime & Delinquency 57(2): 167-198, 2011. (100 refs.)

This article reports findings from a clinical trial of a probation case management (PCM) intervention for drug-involved women offenders. Participants were randomly assigned to PCM (n = 92) or standard probation (n = 91) and followed for 12 months using measures of substance abuse, psychiatric symptoms, social support, and service utilization. Arrest data were collected from administrative data sets. The sample included mostly African American and White women (age M = 34.7, education M = 11.6 years). Cocaine and heroin were the most frequently reported drugs of abuse, 86% reported history of incarceration, and 74% had children. Women assigned to both PCM and standard probation showed clinical improvement change over time on 7 of 10 measured outcomes. However, PCM group changes were no different than those observed for the standard probation group. Higher levels of case management, drug abuse treatment, and probationary supervision may be required to achieve improved outcomes in this population.

Hall J. Childhood perceptions of family, social support, parental alcoholism, and later alcohol use among African American college students. Journal of Substance Use 15(3): 157-165, 2010. (29 refs.)

This study investigated differences in alcohol use, family of origin, and social support between a sample of adult children of alcoholics (ACOAs, 25 males and 25 females), and a sample of adult children of non-alcoholics (non-ACOAs, 25 males and 25 females). Participants completed a battery of tests: a demographic questionnaire, the Children of Alcoholics Screening Test, the Michigan Alcoholism Screening Test, the Family of Origin Scale, and the Dimension of Social Support Scale. Analysis of variance revealed that the two groups differed on alcohol consumption and family of origin, with ACOAs reporting significantly less alcohol use, and non-ACOAs reporting healthier families of origin. The findings indicate that not all ACOAs abuse alcohol or struggle with social or behavioural problems.

Hamidovic A; Kasberger JL; Young TR; Goodloe RJ; Redline S; Buxbaum SG et al. Genetic variability of smoking persistence in African-Americans. Cancer Prevention Research 4(5): 729- 734, 2011. (30 refs.)

To date, most genetic association analyses of smoking behaviors have been conducted in populations of European ancestry and many of these studies focused on the phenotype that measures smoking quantity, that is, cigarettes per day. Additional association studies in diverse populations with different linkage disequilibrium patterns and an alternate phenotype, such as total tobacco exposure which accounts for intermittent periods of smoking cessation within a larger smoking period as measured in large cardiovascular risk studies, can aid the search for variants relevant to smoking behavior. For these reasons, we undertook an association analysis by using a genotyping array that includes 2,100 genes to analyze smoking persistence in unrelated African American participants from the Atherosclerosis Risk in Communities study, A locus located approximately 4 kb downstream from the 3'-UTR of the brain-derived neurotrophic factor (BDNF) significantly influenced smoking persistence. In addition, independent variants rs12915366 and rs12914385 in the cluster of genes encoding nicotinic acetylcholine receptor subunits (CHRNA5-CHRNA3-CHRNB4) on 15q25.1 were also associated with the phenotype in this sample of African American subjects. To our knowledge, this is the first study to more extensively evaluate the genome in the African American population, as a limited number of previous studies of smoking behavior in this population included evaluations of only single genomic regions.

Harris KM; Lee H; DeLeone FY. Marriage and health in the transition to adulthood: Evidence for African Americans in the Add Health Study. Journal of Family Issues 31(8): 1106-1143, 2010. (75 refs.)

This article explores the relationships among early marriage (before age 26 years), cohabitation, and health for African Americans and Whites during the transition to adulthood using the National Longitudinal Study of Adolescent Health (Add Health). The study examines three categories of health outcomes relevant to young adulthood: physical health, mental health, and health risk behaviors. Lagged dependent variable models are used to examine the health effects of early marriage and cohabitation accounting for potential health selection into unions. The results indicate that early marriage by young adults does not have protective effects for African Americans; the authors also find more negative effects for African American men than for women. There are mixed results for Whites with some protective effects of marriage for binge drinking. Early marriage for African Americans and Whites is associated with increased body mass index. Cohabitation is uniformly associated with negative health outcomes for all racial and gender groups.

Hartz SM; Johnson EO; Saccone NL; Hatsukami D; Breslau N; Bierut LJ. Inclusion of African Americans in genetic studies: What is the barrier? American Journal of Epidemiology 174(3): 336-344, 2011. (25 refs.)

To facilitate an increase in the amount of data on minority subjects collected for genetic databases, the authors attempted to clarify barriers to African-American participation in genetic studies. They randomly sampled 78,072 subjects from the community (Missouri Family Registry, 2002-2007). Of these, 28,658 participated in a telephone screening interview, 3,179 were eligible to participate in the genetic study, and 1,919 participated in the genetic study. Response rates were examined in relation to the proportion of subjects in the area who were African-American according to US Census 2000 zip code demographic data. Compared with zip codes with fewer than 5% African Americans (average = 2% African-American), zip codes with at least 60% African Americans (average 87% African-American) had higher proportions of subjects with an incorrect address or telephone number but lower proportions of subjects who did not answer the telephone and subjects who refused the telephone interview (P < 0.0001). Based on reported race from the telephone screening, 71% of eligible African Americans and 57% of eligible European Americans participated in the genetic study (P < 0.0001). The results of this study suggest that increasing the number of African Americans in genetic databases may be achieved by increasing efforts to locate and contact them.

Hedden SL; Whitaker DE; von Thomsen S; Severtson SG; Latimer WW. Latent patterns of risk behavior in urban African-American middle school students in Baltimore City. Journal of Child & Adolescent Substance Abuse 20(1): 34-47, 2011. (47 refs.)

Students who engage in high-risk behaviors, including early initiation of sexual intercourse, alcohol use, marijuana use, tobacco use, and externalizing behavior are vulnerable to a broad range of adverse outcomes as adults. Latent class analysis was used to determine whether varying patterns of risk behavior existed for 212 urban African-American students from Baltimore public schools who were recruited as part of a study for the prevention of drug use. A two-class model was estimated. The proportion of the sample bearing a high probability of each of the five risk behaviors was 10.7%; in comparison, the proportion of students with a low probability of the risk behaviors was 89.3%. Controlling for other variables, older age and parental drug or alcohol use was associated with being in the high-risk class, whereas neighborhood was not predictive of latent class. Results from this study may be used to target early adolescents with co-occurring risk behaviors for prevention and treatment.

Hickman NJ; Delucchi KL; Prochaska JJ. A population-based examination of cigarette smoking and mental illness in black Americans. Nicotine & Tobacco Research 12(11): 1125-1132, 2010. (48 refs.)

This study examines the relation between tobacco use and cessation with lifetime and past year mental illness in a nationally representative sample of Blacks. This cross-sectional study analyzed nationally representative data from 3,411 adult Blacks participating in the 2001-2003 National Survey of American Life. Smoking prevalence and quit rates according to lifetime and past year Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition mental disorders were assessed by a modified version of the Composite International Diagnostic Interview. Compared with those without mental illness, respondents with a lifetime, past year, or past month mental illness had a higher smoking prevalence (20.6%, 35.6%, 36.0%, and 45.4%, respectively) and lower quit rate (40.5%, 31.2%, and 26.2%, respectively). The odds of being a current smoker among Blacks with mental illness in their lifetime, past year, and past month, after adjusting for age, gender, education, poverty, and marital status were 1.76 (95% CI = 1.39-2.22), 1.57 (95% CI = 1.22-2.03), and 2.20 (95% CI = 1.56-3.12), respectively. Mental illness also was associated with heavier smoking. Blacks with past year mental illness represented 18.1% of the sample, yet consumed 23.9% of cigarettes smoked by Black smokers. Past year (odds ratio [OR] = 0.72, 95% CI = 0.53-0.97) and past month (OR = 0.54, 95% CI = 0.29-0.98) mental illness were associated with a lower odds of quitting for at least 1 year. Findings indicate that mental illness is significantly associated with tobacco use in Blacks. Tobacco cessation interventions that address mental illness as a barrier to cessation are needed.

Highland KB; McChargue DE. Stress-induced cardiovascular reactivity among African American smokers. American Journal of Health Behavior 35(1): 51-59, 2011. (59 refs.)

Objectives: To test for differences in stress-induced cardiovascular functioning among hypertensive and normotensive African American (AA) smokers. Methods: Participants (n=35) were exposed to both stress and neutral mood inductions. Results: Repeated measures analyses of covariance produced a significant group x mood condition interaction for systolic blood pressure (P=.048), but not for diastolic blood pressure (P>.05). The most notable finding was that AA hypertensive smokers showed selectively greater elevations in their systolic responses compared with normotensive controls following the laboratory-induced stressor. Conclusions: Implications to an elevated risk of future cardiovascular disease among AA hypertensive smokers are discussed.

Hum AM; Robinson LA; Jackson AA; Ali KS. Physician communication regarding smoking and adolescent tobacco use. Pediatrics 127(6): E1368-E1374, 2011. (27 refs.)

BACKGROUND: Physician advice increases quit rates 1% to 3% above unassisted quit rates among adults, an increase sufficient to be ranked as a high-priority, evidence-based preventive service. However, there is little research on the potential impact of physician advice on adolescent smoking. OBJECTIVE: The purpose of this study was to examine the association between recalled physician communication and adolescents' attitudes toward smoking, knowledge about smoking, intentions to smoke, tobacco use, and quitting behaviors. METHODS: This study was a retrospective observational study of 5154 students (82.9% black, 17.1% white) from an urban, mid-South school system. Outcome variables included adolescents' self-rated attitudes toward smoking, knowledge about smoking, intentions to smoke, tobacco use, and quitting behaviors. RESULTS: Physician advice and the combination of screening and advice were associated with healthier attitudes about smoking. Physician screening and advice were also associated with a more accurate knowledge regarding tobacco-related damage. Among current smokers, recalled physician advice was also associated with reduced intentions to smoke in 5 years. Importantly, advised teens were more likely to plan to quit smoking in 6 months. Furthermore, teens who were screened by their physician reported significantly more quit attempts than those who were neither screened nor advised (P = .007). CONCLUSIONS: Physician's tobacco-related interactions with adolescents seemed to positively impact their attitudes, knowledge, intentions to smoke, and quitting behaviors. Brief physician interventions have the potential to be a key intervention on a public health level through the prevention, cessation, and reduction of smoking and smoking-related disease.

Kendzor DE; Businelle MS; Costello TJ; Castro Y; Reitzel LR; Cofta-Woerpel LM et al. Financial strain and smoking cessation among racially/ethnically diverse smokers. American Journal of Public Health 100(4): 702-706, 2010. (27 refs.)

Objectives. We evaluated the influence of financial strain on smoking cessation among Latino, African American, and Caucasian smokers of predominantly low socioeconomic status. Methods. Smokers enrolled in a smoking cessation study (N = 424) were followed from 1 week prequit through 26 weeks postquit. We conducted a logistic regression analysis to evaluate the association between baseline financial strain and smoking abstinence at 26 weeks postcluit after control for age, gender, race/ethnicity, educational level, annual household income, marital status, number of cigarettes smoked per day, and time to first cigarette of the day. Results. Greater financial strain at baseline was significantly associated with reduced odds of abstinence at 26 weeks postquit among those who completed the study (odds ratio [OR] = 0.77; 95% confidence interval [CII = 0.62, 0.94; P = .01). There was a significant association as well in analyses that included those who completed the study in addition to those lost to follow-up who were categorized as smokers (OR = 0.78; 95% CI = 0.64, 0.96; P = .02). Conclusions. Greater financial strain predicted lower cessation rates among racially/ethnically diverse smokers. Our findings highlight the impact of economic concerns on smoking cessation and the need to address financial strain in smoking cessation interventions.

Kidney CA; Alvarez J; Jason LA; Ferrari JR; Minich L. Residents of mutual help recovery homes, characteristics and outcomes: Comparison of four US ethnic subgroups. Drugs: Education, Prevention and Policy 18(1): 32-39, 2011. (40 refs.)

This study compared the characteristics and outcomes of four ethnic groups living in mutual help recovery homes. The sample consisted of 524 Caucasian, 305 African American, 31 Latino/a and 17 American Indian (AI) participants. This article includes a short review of relevant literature on AIs and substance use, provides an analysis of characteristics and outcomes of four ethnic groups and includes a discussion of the implications of the findings for knowledge of patterns of use among AIs. The AIs were more likely to report being on parole or probation and being referred for aftercare by the legal system. Additionally, AIs reported greater disharmony within their recovery residences than Caucasians, but there were no significant ethnic differences in baseline length of stay in Oxford House, length of alcohol or drug sobriety or substance use outcomes 4 months after the baseline assessment.

Kiviniemi MT; Orom H; Giovino GA. Psychological distress and smoking behavior: The nature of the relation differs by race/ethnicity. Nicotine & Tobacco Research 13(2): 113-119, 2011. (56 refs.)

We explored how the relation between psychological distress and smoking behavior differed as a function of race/ethnicity of respondents to a representative national survey. Data from the 2007 Health Information National Trends Survey were analyzed. Participants reported experiences of psychological distress in the past 30 days, race/ethnicity, current smoking status (smoker/nonsmoker), and number of cigarettes smoked per day. Logistic regression and linear regression analyses were used to examine the influence of race, distress, and their interaction on smoking behavior using survey weighting techniques to account for sampling strategy and nonresponse. For current smoking status, there was a significant interaction between race and psychological distress. Follow-up analyses indicated that psychological distress was related to smoking status for White but not for Black or Hispanic respondents. Similar results were found for number of cigarettes smoked per day among current smokers. The results suggest that the often-reported association between psychological distress and smoking is relatively specific to White individuals. The relation does not appear to characterize either Black or Hispanic individuals.

Komro KA; Tobler AL; Maldonado-Molina MM; Perry CL. Effects of alcohol use initiation patterns on high-risk behaviors among urban, low-income, young adolescents. Prevention Science 11(1): 14-23, 2010. (32 refs.)

This study examined associations between patterns of alcohol use initiation and progression from age 12 to 14 years and recent cigarette and marijuana use, and violent and delinquent behavior at age 14. The study sample (n = 2,193) was predominantly African American or Hispanic (43% and 37%, respectively) and low-income (68% receiving free, or reduced price, lunch). They completed classroom-based surveys when in 6th-8th grades. Multilevel latent class analyses were used to identify the heterogeneous alcohol use trajectories. Linear and logistic mixed-effects regression was then used to examine the association between these patterns and high-risk behaviors in 8th grade. Five alcohol use trajectories were identified: (1) No Use (63.3%), (2) Onset of Consistently Infrequent Use at Age < 12 (13.3%), (3) Onset of Monthly Use at Age 14 (9.9%), (4) Onset of Monthly Use at Age 13 to Heavy Use at Age 14 (6.6%), and (5) Onset of Consistently Heavy Use at Age 12 (6.9%). Relative to non-users, membership in any of the alcohol use trajectory classes was significantly associated with greater past month cigarette and marijuana use, as well as violent behaviors in 8th grade. Higher levels of delinquent behaviors were significantly associated with membership in all but one of the alcohol use trajectory classes relative to the "no use" class. Results suggest that any use of alcohol in early adolescence is associated with other high-risk behaviors and support the critical need for efforts to prevent early initiation and progression of alcohol use among youth as a key component to prevent future high-risk behaviors.

Kramer TL; Booth BM; Han XT. Two-year trajectory of stimulant use in 18-to 21-year-old rural African Americans. Substance Abuse 31(1): 12-23, 2010. (57 refs.)

Little is known about stimulant use trajectories of rural African American youth. The purpose of the present study is to explore substance use over 24 months in 98 African Americans, ages 18 to 21, who used cocaine or methamphetamine 30 days prior to baseline. The majority was male, unemployed, and had not graduated from high school. At baseline, almost half of the participants met criteria for abuse/dependence of cocaine-the primary stimulant used-which decreased to 25% by the final follow-up. Similar decreases were noted in rates of alcohol and marijuana abuse/dependence, although monthly use remained high. Participants reported minimal utilization of mental health or substance abuse services, but demonstrated significant improvements on physical and mental health measures. In summary, cocaine use declined, but other substances were used at high rates, suggesting a significant need for intervention services that address multisubstance use in rural areas.

Kwate NOA; Meyer IH; Eniola F; Dennis N. Individual and group racism and problem drinking among African American women. Journal of Black Psychology 36(4): 446-457, 2010. (34 refs.)

This study investigated whether perceived individual and group racism were associated with problematic drinking patterns among urban African American women. In this cross-sectional survey, 139 African American women aged 21 to 49 years who consumed alcohol at least once per month were recruited from and interviewed at varied community sites in Central Harlem, New York City. Drinking patterns were assessed with the CAGE, a commonly used four-item screening measure. Frequent heavy drinking was measured with a single item used in the Centers for Disease Control Behavioral Risk Factor Surveillance System. The results showed that, controlling for household income and education level, individual racism was associated with drinking patterns suggestive of alcohol dependence but not frequent heavy drinking. Group racism was not associated with either outcome. The results replicate and extend findings in previous studies and contribute to building literature on the effects of racism on health-damaging behaviors.

Lee CB; Schulenberg JL. The impact of race and youth cohort size: An analysis of juvenile drug possession arrest rates. Journal of Drug Issues 40(3): 653-679, 2010. (88 refs.)

Statistics indicate that blacks are overrepresented in the Juvenile drug-related arrest rates. Based on Easterlin s (1978) youth cohort size theory, this study examines whether there is a positive relationship between the black youth cohort size and Juvenile drug possession arrest rates controlling for the influence of social disorganization. Using cluster regression analyzing city-level Juvenile arrest rates (N = 525), the current study found that the black youth cohort size had a negative relationship with Juvenile arrest rates for drug possession and social disorganization theory provided only a partial explanation. Findings are discussed in the context of theoretical and practical implications and areas for future research

Lillie-Blanton M; Stone VE; Jones AS; Levi J; Golub ET; Cohen MH et al. Association of race, substance abuse, and health insurance coverage with use of highly active antiretroviral therapy among HIV-Infected women, 200518. American Journal of Public Health 100(8): 1493-1499, 2010. (18 refs.)

Objectives. We examined racial/ethnic disparities in highly active antiretroviral therapy (HAART) use and whether differences are moderated by substance use or insurance status, using data from the Women's Interagency HIV Study (WIHS). Methods. Logistic regression examined HAART use in a longitudinal cohort of women for whom HAART was clinically indicated in 2005 (N=1354). Results. Approximately 3 of every 10 eligible women reported not taking HAART. African American and Hispanic women were less likely than were White women to use HAART. After we adjusted for potential confounders, the higher likelihood of not using HAART persisted for African American but not for Hispanic women. Uninsured and privately insured women, regardless of race/ethnicity, were less likely than were Medicaid enrollees to use HAART. Although alcohol use was related to HAART nonuse, illicit drug use was not. Conclusions. These findings suggest that expanding and improving insurance coverage should increase access to antiretroviral therapy across racial/ethnic groups, but it is not likely to eliminate the disparity in use of HAART between African American and White women with HIV/AIDS.

Lopez V; Kopak A; Robillard A; Gillmore MR; Holliday RC; Braithwaite RL. Pathways to sexual risk taking among female adolescent detainees. Journal of Youth and Adolescence 40(8): 945-957, 2011. (63 refs.)

Sexual risk taking among female delinquents represents a significant public health problem. Research is needed to understand the pathways leading to sexual risk taking among this population. This study sought to address this issue by identifying and testing two pathways from child maltreatment to non-condom use among 329 White and 484 African American female adolescent detainees: a relational pathway and a substance use coping pathway. The relational pathway indicated that child maltreatment would be related to non-condom use via depressive self-concept and condom use self-efficacy. The substance use coping pathway suggested that depressive self-concept and alcohol-based expectancies for sexual enhancement would mediate the relationship between child maltreatment and non-condom use. As hypothesized, the relational pathway variables were associated with one another in the expected directions; however, evidence of mediation was not found. Support for mediation was found for the substance use coping pathway. Exploratory across group comparison analysis indicated that the relational pathway was significant for White girls whereas the substance use coping pathway was significant for African American girls. Limitations and implications for future research are discussed.

Mandara J; Rogers SY; Zinbarg RE. The effects of family structure on African American adolescents' marijuana use. Journal of Marriage and Family 73(3): 557-569, 2011. (39 refs.)

The relationship between family structure and marijuana use throughout adolescence was assessed among 1,069 African Americans from the NLSY. A model was also tested suggesting that the effects of family structure on marijuana use would be mediated by poverty, neighborhood quality, and adolescents' self-control. As most prior studies have found, family structure was not related to female adolescents' marijuana use. For young men, being raised with both biological parents was associated with less marijuana use throughout adolescence compared to those whose mothers never married, divorced early and never remarried, or divorced and remarried. Some support for the model was also found. We concluded that being raised without the presence of a biological father is a risk factor for marijuana use among young men, but African American young women from single-parent households have unique resources that protect them from marijuana use. Understanding those resources may offer insight into prevention programs for other youth.

Max W; Sung HY; Tucker LY; Stark B. The disproportionate cost of smoking for African Americans in California. American Journal of Public Health 100(1): 152-158, 2010. (46 refs.)

Objectives. We estimated the economic impact of smoking on African Americans in California in 2002, including smoking-attributable health care expenditures and productivity losses from smoking-caused mortality. Methods. We estimated econometric models of smoking-attributable ambulatory care, prescription drugs, inpatient care, and home health care using national and state survey data. We assessed smoking-attributable mortality using epidemiological models. Results. Adult smoking prevalence for African Americans was 19.3% compared with 15.4% for all Californians. The health care cost of smoking was $626 million for the African American community. A total of 3013 African American Californians died of smoking-attributable illness in 2002, representing a loss of over 49000 years of life and $784 million in productivity. The total cost of smoking for this community amounted to $1.4 billion, or $1.8 billion expressed in 2008 dollars. Conclusions. Although African Americans account for 6% of the California adult population, they account for over 8% of smoking-attributable expenditures and fully 13% of smoking-attributable mortality costs. Our findings confirm the need to tailor tobacco control programs to African Americans to mitigate the disproportionate burden of smoking for this community.

Mickens L; Ameringer K; Brightman M; Leventhal AM. Epidemiology, determinants, and consequences of cigarette smoking in African American women: An integrative review. (review). Addictive Behaviors 35(5): 383-391, 2010. (118 refs.)

Tobacco smoking is a national public health problem that has been associated with numerous adverse health effects, including increased disease and cancer rates. Previous review articles on smoking in specific demographic populations have focused on smoking in women and on smoking in African Americans, but have not considered the dual roles of ethnicity and gender in smoking behavior. African American women (AAW) are an important subgroup to study because they are distinct from non-AAW and their male African American counterparts on biopsychosocial factors that are relevant to smoking behavior. The purpose of the present review paper is to integrate and summarize the current literature on the epidemiology, determinants, and consequences of cigarette smoking among AAW, by contrasting them to relevant comparison groups (non-AAW and African American men). Evidence suggests that MW are generally more likely to be light smokers and initiate smoking later. The prevalence rates of AAW smokers have decreased over the past 25 years, yet AAW are disproportionately affected by several smoking-related illnesses when compared to their ethnic and gender comparison groups. AAW smokers are distinct from relevant comparison groups in metabolic sensitivity to nicotine, aspects of smoking topography, and several psychosocial factors that influence smoking. Although a small literature on smoking in AAW is emerging, further empirical research of AAW smokers could inform the development of tailored interventions for MW.

Mieczkowski T. Assessing the potential for racial bias in hair analysis for cocaine: Examining the relative risk of positive outcomes when comparing urine samples to hair samples. Forensic Science International 206(1-3): 29-34, 2011. (36 refs.)

This article examines the conjecture that hair analysis, performed to detect cocaine use or exposure, is biased against African Americans. It does so by comparing the outcomes of 33,928 hair and 105,792 urine samples collected from both African American and white subjects. In making this comparison the analysis seeks to determine if there is a departure in rates of positive and negative outcomes when comparing the results of hair analysis for cocaine to the results from urinalysis for cocaine by racial group. It treats urine as an unbiased test. It compares both the relative ratios of positive outcomes when comparing the two groups and it calculates the relative risk of outcomes for each group for having positive or negative outcomes. The findings show that the ratios of each racial group are effectively same for hair and urine assays, and they also show that the relative risk and risk estimates for positive and negative outcomes are the same for both racial groups. Considering all samples, the cocaine positive risk estimate for the hair samples comparing the two racial groups is 3.28 and for urinalysis the risk estimate is 3.10 (Breslow-Day chi(2).250, 1 df, p = 0.617) a non-significant difference in risk. For pre-employment samples, the cocaine positive risk estimate for the hair samples comparing the two racial groups is 3.10 and for urinalysis the risk estimate is 2.90 (Breslow-Day chi(2).281, df = 1, p = 0.595), also a non-significant difference in risk.

Mikuls TR; Sayles H; Yu F; LeVan T; Gould KA; Thiele GM et al. Associations of cigarette smoking with rheumatoid arthritis in African Americans. Arthritis and Rheumatism 62(12): 3560-3568, 2010. (32 refs.)

Objective. To examine the associations of cigarette smoking with rheumatoid arthritis (RA) in African Americans, and to determine whether this association is impacted by the HLA-DRB1 shared epitope (SE). Methods. Smoking status, cumulative smoking exposure, and SE status were determined in African American patients with RA and African American healthy controls. Associations of smoking with RA were examined using age-and sex-adjusted logistic regression analyses. Additive and multiplicative SE-smoking interactions were examined. Results. After adjustment for age and sex, ever smoking (odds ratio [OR] 1.45, 95% confidence interval [95% CI] 1.07, 1.97) and current smoking (OR 1.56, 95% CI 1.07, 2.26), relative to never smoking, were more common in African American patients with RA (n = 605) than in controls (n = 255). The association of smoking with RA was limited to those with a cumulative exposure exceeding 10 pack-years, associations that were evident both in autoantibody-positive and in autoantibody-negative disease. There was evidence of a significant additive interaction between SE status and heavy smoking (>= 10 pack-years) in relation to RA risk (attributable proportion [AP] due to interaction 0.58, P = 0.007), with similar results for the additive interaction between SE status and ever smoking (AP 0.47, P = 0.006). There was no evidence of multiplicative interactions. Conclusion. Among African Americans, cigarette smoking is associated not only with the risk of autoantibody-positive RA but also with the risk of autoantibody-negative disease. The risk of RA attributable to smoking is limited to African Americans with more than 10 pack-years of exposure and is more pronounced among individuals positive for the HLA-DRB1 SE.

Murphy DA; Shetty V; Herbeck DM; Der-Martirosian C; Urata M; Yamashita DD. Adolescent orofacial injury: Association with psychological symptoms. Psychology, Health & Medicine 15(5): 574-583, 2010. (25 refs.)

Ethnic minority youth living in urban areas experience disproportionately high rates of violent intentional injuries. This study investigates the association of violent intentional injuries with psychological distress and alcohol use among adolescents treated in trauma centers for facial injuries. Interviews were conducted with 67 adolescents treated at two urban trauma centers (predominantly males [86%], and minority [Latino, 72%; African American, 19%]). Adolescents reported experiencing several different types of accidental and assault-related injuries that required medical attention in the past six months. About half (53%) reported experiencing only unintentional injuries (e. g. car accidents, falls, sports injury); 23% experienced one type of intentional injury resulting from either fighting or being attacked; and 24% experienced two types of intentional injuries resulting from both fighting and being attacked. Measures of alcohol use and psychological distress were examined in relation to these three types of injuries. Overall, 30% of study participants reported they had been drinking alcohol at the time of injury. Compared to adolescents without intentional injuries, those who experienced a physical fight and/ or attack had higher levels of alcohol problems, depression, paranoia and somatic symptoms, and were more likely to have family members with alcohol problems. There is a considerable need for adolescents with intentional assault-related injuries to be screened for alcohol and mental health problems, and to be referred for appropriate treatment interventions if they score at problem levels.

Negriff S; Dorn LD; Huang B. Pubertal timing and smoking initiation in adolescent females: Differences by race. Nicotine & Tobacco Research 12(7): 748-755, 2010. (49 refs.)

The purpose of this study was to examine whether (a) early pubertal timing effects on smoking onset existed for both White and Black girls and (b) whether the association between pubertal timing and smoking onset was moderated by race. Participants included 264 girls (14.9 +/- 2.2 years, 164 White, and 100 Black) at the baseline report of a longitudinal study of whom 153 reported smoking and age at first cigarette. Kaplan-Meier analysis stratified by racial group showed a significant difference between the pubertal timing groups for Black girls only. After accounting for covariates using Cox regression, there was no significant interaction between pubertal timing and racial group. There was a main effect of pubertal timing indicating that late maturers were at significantly lower risk for smoking initiation compared with the early and on-time groups, but the early and on-time groups were not significantly different from each other. Results point to equal risk of early smoking onset for early and on-time maturers of both racial groups, indicating the need for smoking prevention in early adolescence for both White and Black females.

Nejtek VA; Kaiser K; Vo H; Hilburn C; Lea J; Vishwanatha J. Are there racial/ethnic differences in indigent inner-city clients with dual diagnoses? Journal of Dual Diagnosis 7(1-2): 26- 38, 2011. (12 refs.)

Objective: This is an exploratory, cross-sectional study that examined personal, clinical, and treatment characteristics among non-Hispanic Caucasian, non-Hispanic African American, and Hispanic indigent inner-city clients with co-occurring disorders. Methods: Men and women aged 20 to 50 years who met DSM-IV criteria for concurrent mood and substance use disorders were eligible. Inpatients, persons in detoxification programs, and incarcerated inmates were excluded. Assessments covered sociodemographic characteristics, clinical diagnoses, substance use, psychosocial variables, health care utilization and treatment history. Results: Two hundred volunteers were screened, and 145 were eligible to enroll. Racial/ethnic group differences in the distribution of mood and substance use disorders and medical diseases were evident. Receiving psychiatric treatment and psychiatric medications significantly differed among racial/ethnic groups, with Caucasians more likely to receive these services than African Americans or Hispanics. African Americans and Hispanics were also more likely than Caucasians to have positive screening results for their drug of choice and for other drugs as well. Serious medical illnesses were evident in about half of the sample, and the distributions of these illnesses significantly differed among racial/ethnic groups. There were no significant differences in hospitalization or emergency department visits among racial/ethnic groups. Conclusions: Indigent inner-city clients have multiple psychiatric and medical problems that warrant continuity of care. However, few doctor's visits for medical illnesses, lack of psychotropic medications, staggering unemployment, and homelessness were common in our sample. These results present health care and social service professionals with potentially serious treatment challenges. Better recognition and understanding of racial/ethnic needs in those with co-occurring disorders are needed.

Noel NE; Maisto SA; Ogle RL; Johnson JD; Jackson LA; Sims CM. A comparison of African-American versus Caucasian men screened for an alcohol administration laboratory study: Recruitment and representation implications. Addictive Behaviors 36(5): 536-538, 2011. (11 refs.)

African-Americans are under-represented in alcohol research, especially alcohol administration laboratory studies. Specific recruitment of African-Americans into laboratory studies, however, may also inadvertently affect the generalizability of the findings. In the current study, we compared all African-American young adult men (n = 53) who volunteered and met criteria for an alcohol administration study to a sample (n = 50) of Caucasian men recruited for the same study. Groups were compared on variables including demographics, quantity and frequency of alcohol consumption and other substance use, consequences of use and psychopathology. Compared to their Caucasian counterparts, African-American men reported less drinking frequency and quantity, less use of other substances and fewer negative consequences, but their alcohol and drug use was more likely to be associated with various measures of psychopathology. Results suggest that even when recruiting participants using criteria that should minimize differences (i.e. all participants were "social drinkers"), differences on key variables were evident. These differences may have important implications for alcohol research.

Okuyemi KS; Zheng H; Guo HF; Ahluwalia JS. Predictors of adherence to nicotine gum and counseling among African-American light smokers. Journal of General Internal Medicine 25(9): 969-976, 2010. (47 refs.)

A high proportion of African-American smokers are light smokers, and they experience low smoking cessation rates and disproportionately high tobacco-related morbidity; yet no studies have examined tobacco treatment adherence in this group. To determine the predictors of adherence to nicotine gum and counseling among African-American light smokers (defined as smoking a parts per thousand currency sign10 cigarettes/day), and the effects of adherence on smoking cessation. Data were from a 2 x 2 randomized, placebo-controlled smoking cessation trial of nicotine gum (2 mg versus placebo) and counseling (motivational interviewing versus health education). Seven hundred fifty-five African-American light smokers at a community-based clinic. Demographic and health-related information, smoking behaviors, psychosocial variables, adherence to nicotine gum and counseling, and cotinine-verified 7-day abstinence from smoking at week-26 follow-up. A logistic regression model showed that having a higher body mass index (OR = 1.03, 95% CI = 1.01 to 1.05), more quit attempts in the past year (OR = 1.04, 95% CI = 1.01 to 1.07), higher baseline exhaled carbon monoxide (OR = 1.22, 95% CI = 1.01 to 1.48), and higher perceived stress (OR = 1.12, 95% CI = 1.03 to 1.22) increased the likelihood of adherence to nicotine gum. Being a high school graduate was a predictor of adherence to counseling (OR = 1.58, 95% CI = 1.02 to 2.44). Surprisingly, being adherent to nicotine gum significantly reduced the odds of smoking cessation (OR = 0.50, CI = 0.28 to 0.87). On the other hand, adherence to counseling dramatically increased the likelihood of smoking cessation (OR = 3.32, CI = 1.36 to 8.08). Individual risk factors may influence adherence to nicotine gum and counseling. Improving psychological interventions and promoting adherence to counseling may increase overall smoking cessation success among African-American light smokers.

Pahl K; Brook JS; Koppel J. Trajectories of marijuana use and psychological adjustment among urban African American and Puerto Rican women. Psychological Medicine 41(8): 1775-1783, 2011. (55 refs.)

Background. The current longitudinal study examined the developmental patterns of marijuana use and their relationship with subsequent psychological adjustment in a community-based sample of urban African American and Puerto Rican women. Method. Participants were interviewed five times over a period ranging from adolescence (mean age 14.0 years) to adulthood (mean age 32.5 years). Outcome measures included depressive symptoms, anger/hostility and the presence of a substance use disorder (abuse/dependence). Results. Three distinct trajectories of marijuana use were identified : non-users, increasers and quitters. Increasers reported higher levels of depressive symptoms and anger/hostility than did non-users and were more likely to meet criteria for a substance use disorder at age 32.5 years. Conclusions. Our findings indicate that early-starting long-term use of marijuana is associated with psychological maladjustment among women. Prevention efforts should emphasize the long-term cost associated with marijuana use, and that the best psychological health is reported by those who abstain from the drug.

Pahl K; Brook JS; Koppel J; Lee JY. Unexpected benefits: Pathways from smoking restrictions in the home to psychological well-being and distress among urban Black and Puerto Rican Americans. Nicotine & Tobacco Research 13(8): 706-713, 2011. (59 refs.)

Introduction: This study examined the pathways from smoking policies in the home (no ban, partial ban, and total ban on smoking) to psychological well-being (e.g., self-esteem) and psychological symptoms (e.g., depressive symptoms) as mediated by a healthy lifestyle (engaging in exercise, eating healthful foods, and sleeping enough) and cigarette smoking among a sample of urban Black and Puerto Rican Americans. Methods: Questionnaire data were collected from 816 participants (mean age = 32 years). Structural equation modeling (SEM) was employed to examine the pathways of restrictions on smoking in the home to a healthy lifestyle, cigarette smoking, psychological well-being, and psychological distress. Results: The SEM showed mediational pathways linking higher levels of restrictions on smoking in the home with a healthy lifestyle, which in turn was related negatively to psychological distress and positively to psychological well-being. Higher levels of restrictions on smoking in the home were also related inversely to cigarette smoking, which was related positively to psychological distress and negatively to psychological well-being. Conclusions: Findings show that higher levels of restrictions on smoking in the home are associated with a healthier lifestyle and less cigarette smoking, which in turn are associated with better psychological functioning. Greater restrictions on smoking in the home may thus support positive lifestyle choices, including exercise and nutrition, as well as psychological functioning.

Park ER; Kleimann S; Youatt EJ; Lockhart A; Campbell EG; Levy DE et al. Black and White adults' perspectives on the genetics of nicotine addiction susceptibility. Addictive Behaviors 36(7): 769-772, 2011. (49 refs.)

Aims: Emerging research may soon lead to improved quit rates via genetically-tailored smoking cessation treatment. The purpose of this study was to explore individuals' beliefs and attitudes about genetic testing in this context, and how these may differ across racial groups. Design: Two site qualitative study. Methods: Eleven focus groups were conducted in 2007 with 51 Black and 55 White adult participants in Montgomery, AL and Baltimore, MD. Measurements: Questions were asked about smoking as an addiction, the role of genetics in nicotine addiction susceptibility, and undergoing genetic testing to receive tailored smoking cessation treatment. Data were analyzed using content analysis. Findings: Most participants believed that smoking was an addiction yet were unwilling to endorse the notion that genetics played a role in nicotine addiction susceptibility. However, 91% of White participants and 62% of Black participants indicated that they would likely take a genetic test that would match them to their optimal smoking cessation treatment. The primary potential benefit was a vague sense that additional knowledge about oneself would be of value. Primary barriers included disinterest and skepticism about the test, unwillingness to believe that genetics played a role in nicotine addiction or treatment response, and concerns about psychological consequences. Conclusions: The majority of participants, particularly Black participants, did not believe that genetics played a significant role in nicotine addiction susceptibility but were willing to undergo genetic testing. Participants identified some benefit to tailoring smoking treatment by genotype. However, participants also expressed skepticism about the test and concerns about its consequences; these issues would need to be addressed in the clinical encounter.

Pedersen SL; Treloar HR; Burton CM; McCarthy DM. Differences in implicit associations about alcohol between blacks and whites following alcohol administration. Journal of Studies on Alcohol and Drugs 72(2): 270-278, 2011. (40 refs.)

Objective: Implicit cognitions about alcohol have been shown to be an important predictor of alcohol use. Relatively little research has been conducted on racial/ethnic differences in implicit cognitions or changes in implicit cognitions while intoxicated. This study examined differences between Blacks and Whites in positive and negative implicit associations about alcohol, as measured by the Implicit Association Test (IAT) and tested differences in IAT scores when participants were sober and intoxicated. Method: One hundred thirty-five young adults (46% of Black descent) participated in an alcohol-administration study, receiving a moderate dose of alcohol (0.72 g/kg alcohol for men, 0.65 g/kg for women). The IAT was administered in two sessions, one in which alcohol was administered (30 minutes after alcohol consumption) and one in which it was not, approximately 1 week apart. Results: Repeated-measures mixed-factorial analyses of variance were conducted separately for positive and negative IAT scores. Blacks held lower positive and negative implicit cognitions about alcohol compared with Whites. Positive and negative IAT scores did not change as a function of intoxication. Positive explicit expectancies and self-reported past-month drinking behavior were related to positive IAT scores. Positive and negative IAT scores were also related to acute subjective response to alcohol, and this association differed by race. Conclusions: Results extend previous studies by providing evidence for racial differences in implicit cognitions about alcohol and by showing the stability of the IAT while participants are intoxicated. Future studies are needed to determine what factors contribute to racial differences in implicit cognitions.

Peralta RL; Tuttle LA; Steele JL. At the intersection of interpersonal violence, masculinity, and alcohol use: The experiences of heterosexual male perpetrators of intimate partner violence. Violence Against Women 16(4): 387-409, 2010. (54 refs.)

This article examines the relationship between violence, masculinity, and alcohol use among heterosexual, economically disadvantaged, and primarily Black men officially identified as batterers. Violence occurred against intimates and strangers. Alcohol use coupled with violence against intimates and violence against others (e.g., strangers) appeared to be used for masculinity construction. The use of alcohol before and during assaultive behavior combined with the use of violence symbolized dominance and control. This occurred in situations where markers of masculinity were largely absent (e.g., steady employment) in instances of both intimate partner violence and stranger violence.

Perron BE; Mowbray OP; Glass JE; DelvaJ; Vaughn MG; Howard MO. Differences in service utilization and barriers among Blacks, Hispanics, and Whites with drug use disorders. Substance Abuse Treatment, Prevention and Policy 5(e-journal 3), 2010. (33 refs.)

Background: Treatment for drug use disorders (DUD) can be effective, but only a small proportion of people with DUD seek or receive treatment. Research on racial and ethnic treatment differences and disparities remains unclear. Understanding racial and ethnic differences and disparities in drug treatment is necessary in order to develop a more effective referral system and to improve the accessibility of treatment. The purpose of the current study was to explore the role of race and ethnicity in service utilization. Methods: Using data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), this study examined racial and ethnic differences in use of 14 types of treatment services for DUD and 27 different treatment barriers among persons who met lifetime criteria for a DUD. Multivariate logistic regression analyses were used to examine service utilization and barriers among the racial and ethnic groups, while adjusting for other sociodemographic and clinical variables. Results and discussion: Among Blacks, Hispanics and Whites in the overall NESARC sample, approximately 10.5% met criteria for at least one lifetime drug use disorder. Approximately 16.2% of persons with a lifetime DUD received at least one type of service. Overall, this study indicated that Whites were less likely to report receiving help for drug-related problems than Blacks, Blacks used a greater number of different types of services, and no racial and ethnic differences were observed with respect to perceived barriers to drug treatment. However, by examining types of services separately, a complex picture of racial and ethnic differences emerges. Most notably, Whites were most likely to use professional services, whereas Blacks were most likely to use 12-step and clergy. The service use pattern of Hispanics most resembled that of Whites. Conclusion: While structural barriers to accessing treatment were observed, broad-based educational programs and interventions that are appropriately targeted to racial and ethnic groups remains an important area for prevention and treatment.

Peterson NA; Yu DL; Morton CM; Reid RJ; Sheffer MA; Schneider JE. Tobacco outlet density and demographics at the tract level of analysis in New Jersey: A statewide analysis. Drugs: Education, Prevention and Policy 18(1): 47-52, 2011. (28 refs.)

Aim: Geographic relationships between tobacco outlet density and demographics were examined at the tract level in New Jersey, a Northeastern US state. Method: Data for 1938 residential census tracts were analyzed. The 2000 TIGER/Line files were used to geocode addresses of licensed tobacco-selling retail outlets. Median income, percent African-American residents, and percent Hispanic residents were based on year 2000 census data. Address matching with ArcGIS (R) resulted in successful geocoding of 13,984 (93.1%) outlets. Findings: Results showed that outlet density was significantly related with demographics. Tracts with greater density of tobacco outlets tended to have lower median household income and higher percentages of African-American or Hispanic residents. Cluster analysis of tracts resulted in a three-cluster solution, identifying high, medium and low areas of disparity. The high disparity area was characterized by tracts with the highest tobacco outlet density, the highest percentages of African-American and Hispanic residents, the lowest percentage of white residents, and the lowest median income. Further analysis showed that while there were significant associations between tobacco outlet density and all three demographic variables across the state, such associations varied in each of the three clusters. Conclusions: Results may be used to inform strategic planning and policy decisions on a statewide basis.

Plebani JG; Oslin DW; Lynch KG. Examining naltrexone and alcohol effects in a minority population: Results. from an initial human laboratory study. American Journal on Addictions 20(4): 330-336, 2011. (32 refs.)

Prior clinical findings have indicated a potential lack of naltrexone efficacy among African Americans with alcohol dependence. However, no definitive conclusions have been drawn due to the relatively small numbers of African Americans in most alcohol treatment trials. The purpose of this study was to examine alcohol and naltrexone effects on healthy African-American individuals in a laboratory environment. Nonalcohol-dependent social drinking adults of African descent (n = 43) were recruited for participation. After consenting and completing the baseline assessment, they participated in four separate alcohol challenge sessions each separated by at least 10 days. During each of the sessions, subjects were administered alcohol or sham drinks, after pretreatment with either naltrexone (50 mg/day) or placebo in a double-blind fashion. The order of the four sessions was randomly assigned. During each session, breath alcohol levels and subjective responses were measured. Results indicate an alcohol effect among these subjects for subjective responses, but no naltrexone effect. Similar to the apparent lack of clinical efficacy findings, naltrexone does not appear to impact alcohol effects in African-American social drinkers. Future studies should investigate African-American populations with heavy drinking as well as alcohol-dependent subjects in order to strengthen the parallels to clinical findings.

Pope RC; Wallhagen M; Davis H. The social determinants of substance abuse in African American baby boomers: Effects of family, media images, and environment. Journal of Transcultural Nursing 21(3): 246-256, 2010. (68 refs.)

Grounded theory methodology was used to explore the social processes involved in the use of illicit drugs in older African Americans as an underpinning to the development of approaches to nursing care and treatment. Interviews were conducted with six older African American substance users who were currently in drug treatment programs. Responses to the questions were recorded, transcribed, and analyzed using constant comparative methods. Three core themes emerged: (a) family, (b) media images, and (c) environment. The core issues of substance abuse, such as the environment and larger societal forces, cannot be addressed by one discipline and mandate that clinicians move to an interdisciplinary approach to achieve a plan of care for this growing population.

Reimer RA; Gerrard M; Gibbons FX. Racial disparities in smoking knowledge among current smokers: Data from the health information national trends surveys. Psychology & Health 25(8): 943-959, 2010. (37 refs.)

Although African-Americans (Blacks) smoke fewer cigarettes per day than European-Americans (Whites), there is ample evidence that Blacks are more susceptible to smoking-related health consequences. A variety of behavioural, social and biological factors have been linked to this increased risk. There has been little research, however, on racial differences in smoking-related knowledge and perceived risk of lung cancer. The primary goal of the current study was to evaluate beliefs and knowledge that contribute to race disparities in lung cancer risk among current smokers. Data from two separate nationally representative surveys (the Health Information National Trends surveys 2003 and 2005) were analysed. Logistic and hierarchical regressions were conducted; gender, age, education level, annual household income and amount of smoking were included as covariates. In both studies, Black smokers were significantly more likely to endorse inaccurate statements than were White smokers, and did not estimate their lung cancer risk to be significantly higher than Whites. Results highlight an important racial disparity in public health knowledge among current smokers.

Ryan KK; Garrett-Mayer E; Alberg AJ; Cartmell KB; Carpenter MJ. Predictors of cessation pharmacotherapy use among Black and Non-Hispanic white smokers. Nicotine & Tobacco Research 13(8): 646-652, 2011. (36 refs.)

Introduction: Use of pharmacotherapy for smoking cessation improves quit rates, but these treatments are underutilized, particularly among Black smokers. Attitudes toward pharmacotherapy may differ between racial/ethnic minorities and Caucasian smokers. It was hypothesized that Black and non-Hispanic White smokers would differ in their attitudes toward pharmacotherapy and that the association between attitudes toward and actual use of pharmacotherapy would differ by race. Methods: The study consisted of a single, cross-sectional telephone-based survey of current smokers (N = 697), which examined the relationship between race, attitudes toward pharmacotherapy, and pharmacotherapy usage in a representative bi-racial sample (39% Black). Results: Black smokers were significantly less likely to report ever use of pharmacotherapy (23%) than Caucasians (39%; odds ratio [OR] = 0.46; 95% CI: 0.33-0.66). Compared with Caucasians, Blacks had significantly less favorable attitudes toward pharmacotherapy, including disbelief about efficacy (p = .03), addiction concerns (p = .03), harmfulness of pharmacotherapy (p = .008), and need for treatment of any kind to quit smoking (p = .004). In a multiple logistic regression, racial group (Caucasian is referent: OR = 0.55, p = .003), addiction concerns (OR = 0.80, p < .01), and need for treatment of any kind to quit smoking (OR = 1.52, p < .001) were predictive of pharmacotherapy use. Conclusions: These findings replicate and build upon previous research demonstrating underutilization of pharmacotherapy and enduring misconceptions about pharmacotherapy, particularly among Black smokers. Regardless of racial group, misconceptions about pharmacotherapy are related to lower rates of use. Efforts to improve understanding about the efficacy and safety of these products are needed to boost utilization and impact cessation rates.

Scott MC; Easton CJ. Racial differences in treatment effect among men in a substance abuse and domestic violence program. American Journal of Drug and Alcohol Abuse 36(6): 357-362, 2010. (26 refs.)

Background: It is unclear whether racial differences in treatment effect exist for individuals in substance abuse and domestic violence programs. Objectives: This study examined racial differences in treatment effect among substance dependent Caucasian and African-American male intimate partner violence (IPV) offenders court mandated to an integrated substance abuse and domestic violence treatment. Methods: From baseline to completion of treatment (week 12), 75 participants (39 Caucasian; 36 African-American) were assessed on demographics, substance use, legal characteristics, and use of violence (physical, verbal, and psychological). Results: African-American men served more months incarcerated in their life than Caucasian men. Both groups showed decreases in their use of physical violence and alcohol abuse over treatment. Caucasian men also showed a decrease in their use of verbal abuse. Conclusions and Scientific Significance: At treatment completion, both groups showed a reduction in physical abuse and alcohol abuse. Caucasian men showed a reduction in their use of verbal abuse, but African-American men did not. Substance dependent African-American male IPV offenders may benefit from interventions that thoroughly target communication skills in addition to issues of substance abuse and IPV to reduce use of verbal abuse and improve treatment outcomes among African American men.

Scott MC; Edwards L; Lussier LR; Devine S; Easton CJ. Differences in legal characteristics between Caucasian and African-American women diverted into substance abuse treatment. Journal of the American Academy of Psychiatry and the Law 39(1): 65-71, 2011. (29 refs.)

In this exploratory study. we examined differences in the legal characteristics of Caucasian and African-American female offenders (n = 122) who were diverted into substance abuse treatment, to identify any racial disparities. We also examined the differences between groups in demographics and in substance abuse, family, and violence histories. In terms of legal characteristics, the results showed that African-American female offenders were significantly more likely to have been incarcerated at the time of their substance dependency evaluation than were Caucasian female offenders. Also, African-American women were more likely to have served 13 months for the current legal charge in comparison to the 4 months served by Caucasian women, although no differences were found between groups in the severity of the current legal charge. Comparison of demographics and substance abuse, family, and violence histories indicated that African-American women were more likely to be undereducated, crack cocaine dependent, and overly exposed to violence. Overall, the sample of female offenders evidenced severe substance dependency problems, a strong need for inpatient substance abuse treatment, and chronic legal and social difficulties. Implications of these findings are discussed in relation to unbalanced sentencing policies and increasing awareness of the treatment needs of this unique population.

Scott-Sheldon LAJ; Carey MP; Senn TE; Vanable PA. Smoking behavior among low-income black adults: Patterns and correlates of smoking trajectories. Nicotine & Tobacco Research 12(10): 1019-1028, 2010. (71 refs.)

Limited research has focused on identifying smoking patterns and correlates of cigarette use among low-income Blacks. Identifying smoking patterns and correlates of use would assist health providers to develop more culturally sensitive interventions. A semiparametric group-based trajectory modeling strategy was used to empirically identify patterns of cigarette use among 947 low-income Black adults (47% women) enrolled in a sexual risk reduction intervention at a sexually transmitted disease clinic. Patients' cigarette use was assessed 4 times over a 12-month period; correlates of cigarette use were examined. Six smoking trajectories were empirically identified: none/rare smokers (n = 536), decreasing light smokers (n = 69), increasing light smokers (n = 51), low light smokers (n = 112), upper light smokers (n = 142), and moderate smokers (n = 33). Smoking trajectories were predicted by alcohol use, prior substance use treatment, marijuana use, and other illegal drug use, but the patterns varied by trajectory. Results from this study show that Blacks' smoking patterns are associated with several risk factors. These findings suggest that development of prevention and cessation programs should be targeted to the specific needs of Blacks' smoking trajectories.

Seth P; Wingood GM; DiClemente RJ; Robinson LS. Alcohol use as a marker for risky sexual behaviors and biologically confirmed sexually transmitted infections among young adult African-American women. Women's Health Issues 21(2): 130-135, 2011. (42 refs.)

Introduction: Previous research has primarily focused on the relationship between illicit drug use and HIV/sexually transmitted infection (STI) risk behavior among African-American women. Very few studies have solely reviewed the role of alcohol use on risky sexual behavior. The present study examined the relationship between alcohol use at non-abuse levels and risky sexual behaviors and STIs among young adult African-American women. Methods: Eight hundred forty-eight African American women, ages 18 to 29, participated at baseline, with 669 and 673 women at 6 and 12 months follow-up, respectively. Participants completed an Audio Computer Assisted Survey Interview assessing sociodemographics, alcohol use, and risky sexual behaviors. Subsequently, participants provided two vaginal swab specimens for STIs. Results: Multivariate logistic regression analyses were conducted for cross-sectional analyses, with illicit drug use as a covariate. Women who consumed alcohol were more likely to have multiple partners and risky partners. Binary generalized estimating equation models assessed the impact of alcohol use at baseline on risky sexual behavior and STIs over a 12-month period. Illicit drug use, intervention group, and baseline outcome measures were entered as covariates. Alcohol consumption predicted positive results for chlamydia, positive results for any STI, and never using a condom with a casual partner over a 12-month follow-up period. Discussion: Frequency of alcohol use at non-abuse levels was correlated with and predicted risky sexual behaviors and STIs. Prevention programs for African-American women should incorporate education regarding the link between alcohol and HIV/STI risk behaviors and the potential negative health consequences

Shah LM; King AC; Basu A; Krishnan JA; Borden WB; Meltzer D. Effect of clinician advice and patient preparedness to quit on subsequent quit attempts in hospitalized smokers. Journal of Hospital Medicine 5(1): 26-32, 2010. (22 refs.)

BACKGROUND: Although smoking cessation counseling for cardiac inpatients is a quality measure, little data exist regarding postdischarge quit attempts in a primarily urban, African American, underserved population. This study aimed to assess preparedness to quit smoking and quit behaviors. METHODS: Smokers on the cardiology service were asked to rate preparedness using the 10-step Contemplation Ladder. During phone surveys given 30-days postdischarge, patients reported whether they made quit attempts, method and success of attempts, and recall of receiving advice to quit. RESULTS: From February 2006 through July 2007, 2906 of 3364 of inpatients were interviewed. Fifteen percent (436/2906) were current smokers and 415/436 completed the inpatient assessment. Of these, 75% (310/415) indicated they were prepared to quit. At the 1-month follow-up, 67% (276/415) were interviewed and 71% of those patients (195/276) reported making a quit attempt, with most (76%) reporting quitting "cold turkey" (without aid). Compared with less prepared patients, prepared patients were more likely to report making a quit attempt after discharge (77% [163/212] vs. 50% [32/64], P < 0.001) and were successful in that attempt (43% [90/212] vs. 25% [16/64], P = 0.010). CONCLUSIONS: The majority of smokers hospitalized with cardiac disease reported being prepared to quit smoking. Those prepared, and who received advice to quit, were more likely to make a quit attempt and report abstinence than those less prepared. However, most quit attempts were made using the least effective methods. Future studies in a population of primarily African American patients should assess preparedness to quit and target prepared patients with more effective interventions.

Shaw RJ; Pickett KE; Wilkinson RG. Ethnic density effects on birth outcomes and maternal smoking during pregnancy in the US linked birth and infant death data set. American Journal of Public Health 100(4): 707-713, 2010. (41 refs.)

Objectives. We investigated whether mothers from ethnic minority groups have better pregnancy outcomes when they live in counties with higher densities of people from the same ethnic group-despite such areas tending to be more socioeconomically deprived. Methods. In a population-based US study, we used multilevel logistic regression analysis to test whether same-ethnic density was associated with maternal smoking in pregnancy, low birthweight, preterm delivery, and infant mortality among 581,151 Black and 763,201 Hispanic mothers and their infants, with adjustment for maternal and area-level characteristics. Results. Higher levels of same-ethnic density were associated with reduced odds of infant mortality among Hispanic mothers, and reduced odds of smoking during pregnancy for US-born Hispanic and Black mothers. For Black mothers, moderate levels of same-ethnic density were associated with increased risk of low birthweight and preterm delivery; high levels of same ethnic density had no additional effect. Conclusions. Our results suggest that for Hispanic mothers, in contrast to Black mothers, the advantages of shared culture, social networks, and social capital protect maternal and infant health.

Shetgiri R; Kataoka S; Ponce N; Flores G; Chung PJ. Adolescent fighting: Racial/ethnic disparities and the importance of families and schools. Academic Pediatrics 10(5): 323-329, 2010. (35 refs.)

OBJECTIVE: To identify factors associated with fighting among African American, Asian/Pacific Islander, Latino, and white youth, with a focus on family and school connectedness. METHODS: Subjects were 4010 adolescents (12-17 years old) from the 2003 California Health Interview Survey. Stratified logistic regression examined whether fighting in the past year was associated with various risk and protective factors among African American, Asian/Pacific Islander, Latino, and white youth subsamples. RESULTS: Fighting was reported by 27% of African American, 24% of Latino, 16% of white, and 6% of Asian/Pacific Islander youth. Male gender, alcohol use, and smoking were associated with higher odds of fighting among whites and Latinos. Poverty was associated with higher odds of fighting among whites and African Americans, as was depression among Latinos. Higher family support was associated with decreased odds of fighting for white youth. Higher school support was associated with decreased odds of fighting for Latino youth. CONCLUSIONS: A higher proportion of African American and Latino youth report fighting than do whites and Asians/Pacific Islanders. There is, however, important variation in racial/ethnic disparities in risk and protective factors associated with fighting. Family and school factors may be protective against fighting. Prevention and intervention efforts to decrease youth violence might benefit from tailoring to communities' racial/ethnic composition and paying greater attention to family and community influences on adolescent fighting.

Shih RA; Miles JNV; Tucker JS; Zhou AJ; D'Amico EJ. Racial/ethnic differences in adolescent substance use: Mediation by individual, family, and school factors. Journal of Studies on Alcohol and Drugs 71(5): 640-651, 2010. (117 refs.)

Objective: This study examined racial/ethnic differences in alcohol, cigarette, and marijuana use among a diverse sample of approximately 5,500 seventh and eighth graders. We also evaluated the extent to which individual, family, and school factors mediated racial/ethnic disparities in use. Method: Students (49% male) from 16 participating middle schools in southern California reported on lifetime and past-month substance use, individual factors (expectancies and resistance self-efficacy), family factors (familism, parental respect, and adult and older sibling use), and school factors (school-grade use and perceived peer use). We used generalized estimating equations to examine the odds of consumption for each racial/ethnic group adjusting for sex, grade, and family structure. Path analysis models tested mediation of racial/ethnic differences through individual, family, and school factors. Results: After adjusting for sex, grade, and family structure, Hispanics reported higher and Asians reported lower lifetime and past-month substance use, compared with non-Hispanic Caucasians. Rates of substance use did not differ between non-Hispanic African Americans and Caucasians. Several individual factors mediated the relationship between Hispanic ethnicity and substance use, including negative expectancies and resistance self-efficacy. Higher use among Hispanics was generally not explained by family or school factors. By contrast, several factors mediated the relationship between Asian race and lower alcohol use, including individual, family (parental respect, adult and older sibling use), and school (perceived peer use, school-grade use) factors. Conclusions: Results highlight the importance of targeting specific individual, family, and school factors in tailored intervention efforts to reduce substance use among young minority adolescents.

Stahre M; Okuyemi KS; Joseph AM; Fu SS. Racial/ethnic differences in menthol cigarette smoking, population quit ratios and utilization of evidence-based tobacco cessation treatments. Addiction 105(Supplement 1): 75-83, 2010. (28 refs.)

Aims: This study examines the relationship between menthol cigarette smoking and the population quit ratio and whether menthol smokers differ in utilization of evidence-based smoking cessation aids among a nationally representative sample of US adult smokers. Design, setting and particiants Secondary data analysis of cross-sectional data from the 2005 National Health Interview Survey (NHIS) Cancer Control Supplement. The NHIS is a nationally representative survey of US households conducted annually. Measurements: The main outcome variables of interest were (1) the population quit ratio and (2) use of smoking quit aids. All analyses were conducted using SAS version 9.2 with SUDAAN, which corrects for the complex sampling design of the study. Univariate analyses were used to determine variables that differed significantly by menthol status and utilization of types of quit aids. Multiple logistic regression analysis modeled the relationship between menthol smoking status, demographic characteristics and smoking-related characteristics on the population quit ratio and utilization of quit aids. Findings: We observed significant differences in the population quit ratio for menthol versus non-menthol among African American smokers (34% versus 49%, P < 0.001), but not among whites (52% versus 50%). In multiple logistic regression analysis, there was a significant interaction between race and menthol smoking status. African American menthol smokers were significantly less likely than white non-menthol smokers to have quit smoking (adjusted odds ratio: 0.72, 95% confidence interval: 0.53, 0.97) after controlling for age group, sex, marital status, region and average number of cigarettes smoked per day. Menthol smoking status was not associated with differences in utilization of quit aids. Conclusions: African Americans have the highest rates of menthol cigarette smoking of all racial and ethnic groups in the United States. Menthol cigarette smoking is associated negatively with successful smoking cessation among African Americans.

Stanley LR; Henry KL; Swaim RC. Physical, social, and perceived availabilities of alcohol and last month alcohol use in rural and small urban communities. Journal of Youth and Adolescence 40(9): 1203-1214, 2011. (43 refs.)

This study seeks to provide a greater understanding of the factors that determine the perceived availability of alcohol and its role in predicting adolescents' alcohol use. Participants were 151,703 7th-12th grade students (50% female) from a sample of 219 rural communities across the United States, with oversampling for predominantly Mexican-American and African-American communities. Multilevel analysis was used to estimate the perceived availability of alcohol as a function of physical and social availability measures and individual and community-level control variables. Physical availability was measured as the number of alcohol outlets in the community and whether beer and wine were sold in non-liquor stores. Social availability measured the availability of alcohol from social or family groups. Last month alcohol use was then estimated as a function of physical, social and perceived availabilities and control variables. Physical availability had little relationship to perceived availability or recent alcohol use while social availability was a strong predictor of both. Perceived availabilities at the individual and community levels were significant in predicting last month alcohol use. The findings suggest that altering both perceived and actual availability of alcohol can potentially have strong effects on the levels of adolescent alcohol use.

Stevens-Watkins D; Rostosky S. Binge drinking in African American males from adolescence to young adulthood: The protective influence of religiosity, family connectedness, and close friends' substance use. Substance Use & Misuse 45(10): 1435-1451, 2010. (72 refs.)

We examined the contribution of culturally relevant protective factors (i.e., adolescent religiosity, family connectedness, and perceived close friends' substance use) to the probability of young adult binge drinking among African American males. Participants (n = 1,599) drawn from the National Longitudinal Study of Adolescent Health were high school age adolescents (14-18 years, M=16) at Wave 1 and young adults (18-26, M = 22) at Wave 3. Adolescent binge drinking was associated with all three protective factors. Perceived close friends' substance use in adolescence was a protective factor in later binge drinking during young adulthood, and was moderated by age such that the effect was stronger for younger adolescents. Implications for culturally relevant research and prevention are discussed.

Sutherland ME; Ericson R. Alcohol use, abuse, and treatment in people of African descent. Journal of Black Studies 41(1): 71-88, 2010. (71 refs.)

The use and abuse of alcohol is prevalent in many nations across the globe, but few studies have examined within-group differences found in people of African descent in the United States, in Africa, and in the Caribbean. A review of current research about alcohol use, abuse, and treatment in people of African descent is presented, including information about risk factors and contributors to alcohol use. Examples of education and prevention interventions are also described. Finally, conclusions based on the review of the research literature as well as recommendations for future research are explained.

Thomas JL; Scherber RM; Stewart DW; Lynam IM; Daley CM; Ahluwalia JS. Targeting African American nonsmokers to motivate smokers to quit: A qualitative inquiry. Health Education & Behavior 37(5): 680-693, 2010. (42 refs.)

African Americans bear a disproportionate health burden from smoking but are less likely than other populations to engage in cessation treatment. Intervening on adult nonsmokers residing with a smoker might represent an innovative approach to motivate smokers to engage in smoking behavior change. Twelve focus groups were conducted with African American smokers (four groups, n = 27), nonsmokers (four groups, n = 26) and pairs of cohabitating smokers and nonsmokers (four groups, n = 22) to assess attitudes and/or beliefs regarding engaging a nonsmoker in the home in smoking behavior change efforts. Participants (N = 75) were middle-aged (45.1 +/- 3.7 years) females (68.0%) with 11.8 +/- 1.5 years of education. Smokers smoked 14.9 +/- 11.3 cigarettes per day, made 3.0 +/- 4.4 quit attempts in the past year, and are interested in receiving cessation assistance from a nonsmoker in their home. African American nonsmokers living with a smoker may be an appropriate target group to motivate smoking behavior change in the smoker. Suggestions for future research considerations are provided.

Thompson AB; Moon-Howard J; Messeri PA. Smoking cessation advantage among adult initiators: Does It apply to black women? Nicotine & Tobacco Research 13(1): 22-28, 2011. (36 refs.)

Smokers who initiate as adults are more likely to quit than those who initiate as adolescents. Black women are more likely than White women to initiate smoking in adulthood and are less likely to quit. There is a paucity of research examining whether the smoking cessation advantage among adult initiators applies to Black women. The study objective is to examine race differences in the effect of developmental stage of smoking initiation on number of years until cessation among Black and White women. Data were extracted from the National Longitudinal Survey of Young Women, a national cohort of women between the ages of 49 and 61 years in 2003. The analytic sample comprised 1,008 White women and 271 Black women with a history of smoking. Survival analysis procedures were utilized to address the study objective. Racial disparities in smoking cessation were most evident among women who initiated smoking as adults. White young adult initiators had a 31% increased hazard of smoking cessation advantage (adjusted hazards ratio [HR]: 1.31, 95% CI: 1.04-1.65) over adolescent initiators, whereas Black young adult initiators had no smoking cessation advantage (adjusted HR: 0.85, CI: 95% 0.55-1.30) over adolescent initiators. Prior observations that smoking initiation in adulthood is associated with high rates of cessation do not apply to black women. To contribute to the reduction of disparities in women's cessation efforts to prevent initiation should target young adult women, particularly Black young adult women.

Timpson SC; Williams ML; Bowen AM; Atkinson JS; Ross MW. Sexual activity in HIV-positive African American crack cocaine smokers. Archives of Sexual Behavior 39(6): 1353-1358, 2010. (30 refs.)

The AIDS epidemic in the United States continues to disproportionately affect minorities of color, especially African Americans. The purpose of this study was to explore the sexual behaviors of a sample of African American HIV positive crack smokers aware of their serostatus. Participants (100 men, 37 women) were included in this study based on the following criteria: a minimum age of 18 years, HIV positive serostatus, treatment with HIV antiretroviral medications for a minimum of 3 months prior to interview, crack cocaine use at least once in the 7 days prior to being interviewed, willingness to provide a urine sample to confirm recent drug use, and vaginal or anal sex at least once in the past 7 days. The questionnaire was a compilation of other reliable surveys and was designed to collect sociodemographic data, drug use, sexual behavior, condom use intentions and motivators, STD and HIV infection history, HIV medications, and adherence requirements. Participants reported having 1,266 different partners in the 30 days prior to the interview and had traded sex for money or drugs with 68%. A total of 79 participants had multiple partners and accounted for 1,247 partnerships. Rates of consistent condom use across partnerships were low, indicating that more interventions in this at-risk population are needed.

Topitzes J; Mersky JP; Reynolds AJ. Child maltreatment and adult cigarette smoking: A long-term developmental model. Journal of Pediatric Psychology 35(5): 484-498, 2010. (71 refs.)

Objective: To examine: (a) child maltreatment's association with young adult daily cigarette smoking, (b) variations in this association by gender, and (c) mediators of this association. Methods: For all study participants (N = 1,125, 94% African American), data from multiple sources (e.g., child welfare records) were collected prospectively at child, adolescent, and young adult time points. Authors enlisted multivariate probit regression for objectives a and b versus exploratory and confirmatory mediation strategies for objective c. Results: Maltreatment was significantly associated with daily cigarette smoking. Although not moderated by gender, this relation was fully mediated by adolescent indicators of family support/stability, social adjustment, and cognitive/school performance along with young adult indicators of educational attainment, life satisfaction, substance abuse, and criminality. Conclusions: Maltreatment places low-income, minority children at risk for daily cigarette smoking and other deleterious young adult health outcomes. Recommended treatment targets include family support/stability, emotion regulation, social skills, and cognitive/academic functioning.

Turner AK; Latkin C; Sonenstein F; Tandon SD. Psychiatric disorder symptoms, substance use, and sexual risk behavior among African-American out of school youth. Drug and Alcohol Dependence 115(1-2): 67-73, 2011. (65 refs.)

Purpose: To examine the association between symptoms of psychiatric disorder (i.e. depression, anxiety, and substance use) and sexual risk behavior in a sample of African-American adolescents and young adults in an employment training program. Methods: Baseline data were used from a pilot study of an intervention to reduce depressive symptoms among youth disconnected from school and the workforce. Participants were recruited from two employment training programs in East and West Baltimore (N = 617; age 16-23 years). Data were collected through audio computer-assisted self-interview (ACAS. Mental health indicators were measured using the Center for Epidemiology Studies Depression Scale and Beck Anxiety Inventory. Multivariate logistic regression was used to determine the odds of sexual risk behavior for each mental health condition and combinations of conditions. Results: Lack of condom use at last sex was significantly associated with elevated anxiety symptoms. Number of sexual partners was associated with elevated depression symptoms and substance use. Early sexual debut was associated with substance use in the past 30 days. Also, there were differences in the likelihood of engaging in sexual risk behavior comparing groups with different combinations of mental health problems to those with no symptoms of disorder or substance use. Conclusions: The results demonstrate the need for HIV prevention programs that target out-of-school youth, as they are likely to engage in risky sexual behavior. Our findings highlight the need to develop behavioral interventions that address disorder symptoms, substance use, and risky sexual behavior among youth in employment training programs.

Unger JB; Allen B; Leonard E; Wenten M; Cruz TB. Menthol and non-menthol cigarette use among Black smokers in Southern California. Nicotine & Tobacco Research 12(4): 398-407, 2010. (42 refs.)

Menthol cigarette smoking is more prevalent among Blacks than among other groups in the United States. This study examined associations between demographic, psychological, attitudinal, social, and cultural factors and menthol smoking among Black adults. This study recruited 720 Black smokers from community intercept locations throughout Los Angeles County, California, and surveyed them by telephone. Fifty-seven percent of respondents were menthol-only smokers, 15% were regular-only smokers, and 28% smoked both menthols and regular cigarettes (combined smokers). In bivariate models, menthol-only and combined smokers had stronger beliefs in the medicinal effects of menthols relative to regular-only smokers. Menthol-only smokers held stronger beliefs, relative to regular-only smokers, that menthols were less harmful than regular cigarettes. Menthol-only smokers preferred the menthol taste/sensation more than combined smokers, who preferred the menthol taste/sensation more than regular-only smokers. Menthol-only and combined smokers had more menthol smokers in their current social networks compared with regular-only smokers. In multivariate analyses, preference for menthol taste/sensation, belief in medicinal effects of menthols, and menthol smokers in current social network differentiated menthol-only and combined smokers from regular-only smokers, controlling for confounding variables. Correlates of menthol smoking varied across genders and age groups. Health education efforts are needed to dispel the myth that menthol cigarettes are more medicinal and less harmful than regular cigarettes. Prevention and cessation efforts in Black communities can be tailored to reflect predictors of menthol smoking to reduce tobacco-related morbidity and mortality. In the era of Food and Drug Administration regulation of cigarettes, research is needed to prevent health disparities associated with menthol cigarette smoking.

Vidourek RA; King KA. Risk and protective factors for recent alcohol use among African-American youth. Journal of Drug Education 40(4): 411-425, 2010. (47 refs.)

A total of 7488 7th-12th grade African-American students completed a survey assessing factors associated with recent alcohol use. Results: indicated that 13.6% used alcohol in the past month. A series of odds ratios revealed that making good grades, participating in school activities, attending church, and having parents/teachers talk about the dangers of alcohol and set/enforce rules regarding alcohol were associated with decreased recent use. Participating in risky behaviors such as getting into trouble, skipping school, and having friends who use alcohol and other drugs was directly related to recent use. Prevention specialists should encourage parents/teachers to engage youth in family, school, and community activities to deter alcohol use. Results may assist youth health professionals in developing prevention programs aimed at African-American youth.

Walsemann KM; Bell BA. Integrated schools, segregated curriculum: effects of within-school segregation on adolescent health behaviors and educational aspirations. American Journal of Public Health 100(9): 1687-1695, 2010. (63 refs.)

Objectives. We examined the extent to which within-school segregation, as measured by unevenness in the distribution of Black and White adolescents across levels of the English curriculum (advanced placement-international baccalaureate-honors, general, remedial, or no English), was associated with smoking, drinking, and educational aspirations, which previous studies found are related to school racial/ethnic composition. Methods. We analyzed data from wave 1 of the National Longitudinal Study of Adolescent Health, restricting our sample to non-Hispanic Blacks (n=2731) and Whites (n=4158) who from 1994 to 1995 attended high schools that enrolled Black and White students. Results. White female students had higher predicted probabilities of smoking or drinking than did Black female students; the largest differences were in schools with high levels of within-school segregation. Black male students had higher predicted probabilities of high educational aspirations than did White male students in schools with low levels of within-school segregation; this association was attenuated for Black males attending schools with moderate or high levels of within-school segregation. Conclusions. Our results provide evidence that within-school segregation may influence both students' aspirations and their behaviors.

Wang Y; Storr C; Browne DC; Wagner FA. Early sexual experience and later onset of illegal drug use among African American students on HBCU Campuses. Substance Use & Misuse 46(4): 543-551, 2011. (36 refs.)

Few studies examine whether early sexual experience is associated with subsequent illegal drug use among adolescents. A sample of 7,372 African American students who had not used illegal drugs before the age of 14 were identified in the dataset of the 2001 Historically Black Colleges and Universities (HBCU) Substance Use Survey. Using self-reported ages of onset, discrete-time survival models estimated the hazard of illegal drug use onset after age 13 subsequent to first sexual intercourse. Early sex was modestly associated with subsequent illegal drug initiation, particularly among females. Drug use prevention services should be provided to youth engaged in early sexual activity.

Warren JR; Okuyemi KS; Guo HF; Thomas JL; Ahluwalia JS. Predicting home smoking restrictions among African American light smokers. American Journal of Health Behavior 34(1): 110-118, 2010. (41 refs.)

Objective: To determine home smoking restrictions (HSR) predictors among African American light smokers (smoke <= 10 cigarettes per day). Methods: Data were obtained from a clinical trial testing the efficacy of nicotine gum and counseling among 755 African American light smokers. Results: Forty percent reported adopting HSR at week 26. Implementing HSR increased with higher baseline confidence to quit (P<0.0001) and female gender (P=0.019) and decreased with older age (P=0.016) and reduced confidence to quit between baseline and week 26 (P<0.0001). Conclusions: Confidence to quit, gender, and age are important factors to incorporate into interventions enhancing the adoption of HSR.

Warren JR; Thomas JL; Okuyemi KS; Lindgren B; Ahluwalia JS. Development and validation of a multidimensional measure of stress among African American light smokers. Journal of the National Medical Association 102(10): 890-897, 2010. (48 refs.)

The complete Multidimensional Measure of Stress (MMOS) measure may be made available to interested persons by contacting the corresponding author. Context: Smoking rates are higher among inner-city and lower-income African Americans, perhaps due to psychosocial barriers to cessation efforts, including stress. Objective: To describe the development of the MMOS and examine the psychometric Properties of the MMOS among African American light smokers. Design: Secondary analysis of data generated from a 2x2 randomized clinical trial, designed to examine the efficacy of nicotine replacement and cessation counseling among 755 African American light smokers. Results: Fourteen items were included in the final MMOS (alpha = 83). An exploratory factor analysis identified 3 factors: interpersonal (alpha = .80), safety (alpha = .70), and financial (alpha = .75). The MMOS was significantly correlated with the Perceived Stress scale (r = 0.49, p < .001) and was associated with several demographic, psychosocial, and tobacco-related variables. Conclusions: The MMOS appears to be a valid measure of stress among African American light smokers enrolled in a cessation trial.

Webb MS; de Ybarra DR; Baker EA; Reis IM; Carey MP. Cognitive-behavioral therapy to promote smoking cessation among African American smokers: A randomized clinical trial. Journal of Consulting and Clinical Psychology 78(1): 24-33, 2010. (46 refs.)

Objective: The health consequences of tobacco smoking disproportionately affect African Americans, but research on whether efficacious interventions can be generalized to this population is limited. This study examined the efficacy of group-based cognitive-behavioral therapy (CBT) for smoking cessation among African Americans. Method: Participants (N = 154; 65% female, M = 44 years old, mean cigarettes/day = 13) were randomly assigned to either (a) group CBT or (b) group general health education (GHE). Participants in both conditions received 6 sessions of counseling and 8 weeks of transdermal nicotine patches. The primary outcome variable was 7-day point prevalence abstinence (ppa), assessed at the end of counseling (2 weeks) and at 3- and 6-month follow-ups. Secondary outcomes included 24-hr ppa and 28-day continuous abstinence (assessed at 3 and 6 months). Results: Intent-to-treat analyses demonstrated the hypothesized effects, such that 7-day ppa was significantly greater in the CBT than the GHE condition at the end of counseling (51% vs. 27%), at 3 months (34% vs. 20%), and at 6 months (31% vs. 14%). Results of a generalized linear mixed model demonstrated a significant effect of CBT versus GHE on 7-day ppa (odds ratio = 2.57, 95% Cl [1.40, 4.71] and also an effect of time (p < .002). The Condition x Time interaction was not significant. Similar patterns of results emerged for 24-hour ppa and 28-day continuous abstinence. Results from per protocol analyses (i.e., participants who completed all aspects of the study) corroborate the intent-to-treat findings. Conclusions: These results demonstrate that intensive, group CBT smoking cessation interventions are efficacious among African American smokers.

Wiehe SE; Aalsma MC; Liu GC; Fortenberry JD. Gender differences in the association between perceived discrimination and adolescent smoking. American Journal of Public Health 100(3): 510-516, 2010. (33 refs.)

Objectives. We examined associations between perceived racial/ethnic discrimination, gender, and cigarette smoking among adolescents. Methods. We examined data on Black and Latino adolescents aged 12 to 19 years who participated in the Moving to Opportunity study (N=2561). Perceived discrimination was assessed using survey items asking about unfair treatment because of race/ethnicity in the prior 6 months. We used logistic regression to investigate associations between discrimination and smoking, stratified by gender and controlling for covariates. Results. One fourth of adolescents reported that discrimination had occurred in at least 1 location. Discrimination was associated with increased odds of smoking among boys (odds ratio [OR]=1.9; 95% confidence interval [CI]=1.2, 3.0) and decreased odds among girls (OR=0.6; 95% CI=0.3, 1.1). Discrimination at school or work contributed to associations for girls (OR=0.3; 95% CI=0.1, 0.9), and discrimination at shops (OR=2.0; 95% Cl=1.1, 3.8) and by police (OR=2.0; 95% CI=11.2, 3.4) contributed to associations for boys. Conclusions. Associations between discrimination and smoking differ by gender. Girls' decreased smoking in higher-discrimination settings may be a result of protective factors associated with where they spend time. Boys' increased smoking in higher-discrimination settings may reflect increased stress from gender-specific targeting by police and businesses.

Windsor LC; Benoit E; Dunlap E. Dimensions of oppression in the lives of impoverished black women who use drugs. Journal of Black Studies 41(1): 21-39, 2010. (32 refs.)

Oppression against Black women continues to be a significant problem in the United States. The purpose of this study is to use grounded theory to identify multiple dimensions of oppression experienced by impoverished Black women who use drugs by examining several settings in which participants experience oppression. Three case studies of drug using, impoverished Black women were randomly selected from two large scale consecutive ethnographic studies conducted in New York City from 1998 to 2005. Analysis revealed five dimensions of oppression occurring within eight distinct settings. While dimensions constitute different manifestations of oppression, settings represented areas within participants' lives or institutions with which participants interact. Dimensions of oppression included classism, sexism, familism, racism, and drugism. Settings included the school system, correction system, welfare system, housing and neighborhood, relationship with men, family, experiences with drug use, and employment. Findings have important implications for social justice, welfare, drug, and justice system policy.

Witkiewitz K; Villarroel NA; Hartzler B; Donovan DM. Drinking outcomes following drink refusal skills training: Differential effects for African American and Non-Hispanic white clients. Psychology of Addictive Behaviors 25(1): 162-167, 2011. (27 refs.)

Determining whether a particular treatment works for specific groups of people can help tailor dissemination of evidence-based alcohol treatments. It has been proposed that individuals from different racial groups might have better outcomes in treatments that are sensitive to sociocultural issues that impact alcohol use among these groups. The current study was a secondary analysis of data from the combined behavioral intervention (CBI) condition of the COMBINE study. Those randomly assigned to CBI (n = 776) had the opportunity to receive up to 9 skills training modules, which were chosen by the therapist. The goal of the current study was to determine whether receiving I of the CBI modules, drink refusal and social pressure skills training, predicted differential outcomes among African American clients. Results indicated that African American clients who received the drink refusal skills training module (n = 25) had significantly fewer heavy drinking days (d = 0.79) 1 year following treatment than African Americans clients who did not receive the module (n = 35). African American clients who received the module also had significantly fewer heavy drinking days (d = 0.86) than non-Hispanic White clients who received the module (n = 241). Good clinical outcomes at 1 year posttreatment were observed among 80% of African Americans who received the module, compared with 54% of African Americans who did not receive the module and 52% of non-Hispanic White clients who did receive the module. Although small sample size limits interpretation, findings provide preliminary evidence supporting the inclusion of drink refusal skills training as part of alcohol interventions for African American clients.

Wu ZH; Temple JR; Shokar NK; Nguyen-Oghalai TU; Graduatey JJ. Differential racial/ethnic patterns in substance use initiation among young, low-income women. American Journal of Drug and Alcohol Abuse 36(2): 123-129, 2010. (27 refs.)

Background: Accumulating research suggests that the gateway hypothesis of substance use may not apply equally across different race/ethnicity groups. Objectives: The current study examines racial and ethnic differences in patterns of initiation of licit and illicit substance use. Methods: A cross-sectional survey was conducted among 696 low-income women between the ages of 18 and 31 who sought gynecological care between December, 2001 and May, 2003 in southeast Texas. Results: Overall, White women fit the classic profile of drug use initiation patterns, with those initiating tobacco and beer/wine at earlier ages being more likely to use illicit drugs. Conversely, African-American and Hispanic women initiated tobacco and beer/wine at much later ages than White women, but they were as likely to use illicit drugs. Conclusions: To be optimally effective, prevention efforts may need to be tailored to fit the race/ethnicity of the audience. Further studies are suggested to investigate specific risk factors related to substance use initiation by race/ethnicity.

Xu J; Kochanek KD; Murphy SL; Tejada-Vera B. QuickStats: Rates of Drug-Induced Deaths, by Race/Ethnicity --- United States, 1999--2007. MMWR. Morbidity and Mortality Weekly Review 59(42): 1376, 2010. (1 refs.)

Drug-induced deaths include deaths from poisoning, drug dependence, and conditions resulting from acute or chronic exposure to drugs. Drug-induced deaths exclude deaths from adverse events caused by drugs in therapeutic use (ICD-10 codes Y40--59), deaths indirectly related to drug use (e.g., motor vehicle crashes), and newborn deaths associated with the mother's drug use. During 1999--2007, age-adjusted rates for drug-induced deaths generally increased for each race group. The rate increased by 80.0% for the total population, 97.1% for the white population, 15.8% for the black population, 65.8% for American Indians/Alaska Natives, and 42.9% for Asians/Pacific Islanders. However, for the Hispanic population the rate was more stable, with a decline of 5.8%. During this period, Asians/Pacific Islanders had substantially lower rates than all other groups.

Public Domain

Yuan ASV. Black-white differences in aging out of substance use and abuse. Sociological Spectrum 31(1): 3-31, 2011. (62 refs.)

Blacks have lower rates of substance use and abuse than whites in early adolescence and young adulthood but similar or higher rates by middle adulthood, which could be due to blacks being less likely to age (i.e., mature) out of deviance than whites by transitioning into high-quality conventional social roles. Using the National Comorbidity Survey (1990-1992), this study finds that work, economic conditions, and family roles explain the race-by-age crossover for drug abuse and explain most of this relationship for alcohol use and abuse. There is no race-by-age crossover for drug use. Thus, even though blacks have lower substance use and abuse than whites at younger ages, this advantage is eliminated and even reversed due to the disadvantages blacks face over the life course.

Zhu SH; Gardiner P; Cummins S; Anderson C; Wong S; Cowling D et al. Quitline utilization rates of African-American and white smokers: The California experience. American Journal of Health Promotion 25(5, Supplement S): S51-S58, 2011. (42 refs.)

Purpose. To compare the utilization rate of a statewide tobacco quitline by African-American smokers to that of white smokers. Design, Setting, and Subjects. Observational study of 18 years of state quitline operation in California. Subjects were 61,096 African-American and 279,042 white smokers who called the quitline from August 1992 to December 2009. Data from six California Tobacco Surveys, 1993, 1996, 1999, 2002, 2005, and 2008 were also used. Measure. Callers' answers' to the question how they heard about the quitline were grouped into four categories: media, health care providers, friends/family, and others. Analysis. The averaged annual quitline call volume fir each ethnic group was divided by the total number of smokers in that group, based on California Tobacco Surveys, to produce the annual quitline utilization rate. Results. In five out of six periods of comparison, African-American smokers had a higher annual utilization rate than white smokers. The odds ratios [ORs] ranged from 1.44 to 2.40 (all p < .05). In the 1996 comparison, the OR was .90 (p < .05). The difference in utilization rates that is attributed to media, accounts for most of the difference in total utilization rates between the two ethnic groups. Conclusions. Within the context of California's comprehensive tobacco control program, which includes a strong media campaign, African-American smokers were significantly more likely to call the state quitline than white smokers were. Promoting the quitline as part of antismoking media campaigns can help reduce disparity in cessation service utilization.