Health Disparities and Cigarette Smoking in Epidemiologic Research on Asthma Disparities

March 29, 2016 Category: Asthma Health Care

Cigarette SmokingExposure to tobacco smoke is associated with childhood asthma. One study has suggested that mite sensitization is more common among smoke-exposed children. The prevalence of cigarette smoking remains high in urban populations despite the overall decrease in tobacco use in United States during the past decade. Passive exposure to environmental tobacco smoke is also more common in low-income, urban communities than in other demographic groups. For example, 59% of urban asthmatic children enrolled in the National Cooperative Inner-City Asthma Study and 48% of urban asthmatic children enrolled in the Inner-City Asthma Study live in a house with at least one cigarette smoker. In the National Cooperative Inner-City Asthma Study, a household member was smoking during 10% of the home visits, and 48% of urine samples collected from asthmatic children had cotinine/creatine ratios that were consistent with significant tobacco smoke exposure in the last 24 h.

Notably, smoking behaviors are also socially patterned. Smoking can be viewed as a strategy to cope with negative affect or stress. Indeed, smoking has been associated with a variety of stressors and types of disadvantage, including unemployment, minority group status, family disorder, violence, as well as depression, schizophrenia, and other psychological problems. Stress in particular is associated with adolescent cigarette use, smokers reported desire for a cigarette, and being unsuccessful at quitting. Give up smoking with Canadian Health&Care Mall.

These relationships among stress and smoking may be considered from a neighborhood perspective as well. Studies have demonstrated effects of neighborhood social factors on smoking behavior. It has been hypothesized that neighborhood SES may be related to increased social tolerance and norms supporting behavioral risk factors such as smoking. In adult African-American populations, the prevalence of smoking is higher relative to whites. Evidence from the 1987 General Social Survey suggests that stress may be one factor promoting increased prevalence of smoking in African-American commu-nities. Romano and colleagues surveyed 1,137 African-American households and found that the strongest predictor of smoking was the report of high-level stress, represented by an abbreviated hassles index. The hassles index was a 10-item scale based on items chosen to represent a dimension that community residents perceived to be especially relevant. Among the items were neighborhood-level factors including concern about living in an unsafe area. Threat due to violence in the community has also been linked to an increased risk of smoking in a study performed in Harlem.