Regional variation in smoking among African Americans

Background. The impact of geographic region and metropolitan residence on s moking prevalence among African Americans has not been adequately examined. Methods. This study analyzed 5 years of data from the National Health Inter view Survey (1990-1994) on current smoking and regional variation among 16, 738 African Americans. Results. Respondents in the West had the lowest unadjusted smoking prevalen ce rates and Midwest residents had the highest. Current smoking was lower a mong African Americans living in noncentral cities than in central cities e ven after adjusting for several sociodemographic covariates. Multivariate l ogistic regression analysis revealed that black women in the South were sig nificantly less likely to be smokers compared with any other gender/region group. Conclusions. These findings suggest the significance of gender and regional factors such as the social history of migration, social stress and racism, exposure to tobacco advertisement, variations in cultural influences, comm unity structures, and coping strategies in understanding African American s moking behavior. (C) 1999 American Health Foundation and Academic Press.