TY - JOUR
T1 - With socioeconomic status controlled, cigarette use is lower among American Indians/Alaska Natives than whites
AU - Cunningham, James K.
AU - Ritchey, Jamie
AU - Arambula Solomon, Teshia G.
N1 - Funding Information:
The authors thank Margaret Thielemeir for helpful comments and the National Survey on Drug Use and Health for providing public use data sets. The authors are solely responsible for the analysis and conclusions presented here.
Publisher Copyright:
© 2020 Elsevier B.V.
PY - 2020/6/1
Y1 - 2020/6/1
N2 - Background: Higher crude prevalence of cigarette use among American Indians/Alaska Natives (AI/AN) than non-Hispanic whites (NHW) has helped engender an assumption that race/ethnicity explains the difference. This study examines whether being AI/AN versus NHW predicts greater use when socioeconomic status and demographics are controlled. Methods: Data came from the National Survey on Drug Use and Health (2013–2017). Using logistic regressions with socioeconomic (income, education) and demographic (gender, age, marital status) controls, differences between AI/AN (n = 4,305) and NHW (n = 166,348) regarding heavier cigarette use (past month daily use, past month use of 300+ cigarettes, and nicotine dependence) and current cigarette use (past month use plus 100+ cigarettes in lifetime) were assessed. Adjusted predicted probabilities were also constructed. Results: NHW, compared to AI/AN, had greater odds of daily use: adjusted odds ratio (AOR) = 1.23 (95% CI: 1.03–1.49); predicted probabilities—15.3% and 13.0%, respectively. NHW had greater odds of using 300+ cigarettes: AOR = 1.47 (CI: 1.19–1.83); predicted probabilities—13.6% and 9.9%. NHW had greater odds of being nicotine dependent: AOR = 1.57 (CI: 1.31–1.89); predicted probabilities—10.3% and 7.1%. A difference in current use was not found. As controls, income and education were especially impactful. Conclusions: With controls, particularly for socioeconomic status, heavier cigarette use was lower among AI/AN than NHW, and a current cigarette use difference was not indicated. This contradicts the idea that being AI/AN versus NHW independently predicts greater cigarette use, and it underscores the importance of socioeconomic status for understanding cigarette use among AI/AN.
AB - Background: Higher crude prevalence of cigarette use among American Indians/Alaska Natives (AI/AN) than non-Hispanic whites (NHW) has helped engender an assumption that race/ethnicity explains the difference. This study examines whether being AI/AN versus NHW predicts greater use when socioeconomic status and demographics are controlled. Methods: Data came from the National Survey on Drug Use and Health (2013–2017). Using logistic regressions with socioeconomic (income, education) and demographic (gender, age, marital status) controls, differences between AI/AN (n = 4,305) and NHW (n = 166,348) regarding heavier cigarette use (past month daily use, past month use of 300+ cigarettes, and nicotine dependence) and current cigarette use (past month use plus 100+ cigarettes in lifetime) were assessed. Adjusted predicted probabilities were also constructed. Results: NHW, compared to AI/AN, had greater odds of daily use: adjusted odds ratio (AOR) = 1.23 (95% CI: 1.03–1.49); predicted probabilities—15.3% and 13.0%, respectively. NHW had greater odds of using 300+ cigarettes: AOR = 1.47 (CI: 1.19–1.83); predicted probabilities—13.6% and 9.9%. NHW had greater odds of being nicotine dependent: AOR = 1.57 (CI: 1.31–1.89); predicted probabilities—10.3% and 7.1%. A difference in current use was not found. As controls, income and education were especially impactful. Conclusions: With controls, particularly for socioeconomic status, heavier cigarette use was lower among AI/AN than NHW, and a current cigarette use difference was not indicated. This contradicts the idea that being AI/AN versus NHW independently predicts greater cigarette use, and it underscores the importance of socioeconomic status for understanding cigarette use among AI/AN.
KW - American Indians/Alaska Natives
KW - Cigarette use
KW - Daily smoking
KW - Race/ethnicity
KW - Socioeconomic status
KW - Stereotype
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U2 - 10.1016/j.drugalcdep.2020.107836
DO - 10.1016/j.drugalcdep.2020.107836
M3 - Article
C2 - 32145982
AN - SCOPUS:85084060891
SN - 0376-8716
VL - 211
JO - Drug and Alcohol Dependence
JF - Drug and Alcohol Dependence
M1 - 107836
ER -