Trends in Susceptibility to Smoking by Race and Ethnicity

Abstract

Objectives: Examine racial/ethnic differences in smoking susceptibility among US youth nonsmokers over time and age.

Methods: We used nationally representative samples of youths who never tried cigarettes (N = 143 917; age, 9-21, mean, 14.01 years) from National Youth Tobacco Survey, 1999 to 2014. We used time-varying effect modeling to examine nonlinear trends in smoking susceptibility adjusted for demographics, living with smokers, and exposure to tobacco advertising.

Results: Compared with non-Hispanic whites (NHWs), Hispanics were more susceptible to smoking from 1999 to 2014 (highest adjusted odds ratio [aOR], 1.67 in 2012). Non-Hispanic blacks were less susceptible to smoking than NHWs from 2000 to 2009 (lowest aOR, 0.80 in 2003-2005). Non-Hispanic Asian Americans were less susceptible to smoking from 2000 to 2009 (aOR, 0.83), after which they did not differ from NHWs. Other non-Hispanics were more susceptible to smoking than NHWs from 2012 to 2014 (highest aOR, 1.40 in 2014). Compared with NHWs, non-Hispanic blacks and other non-Hispanics were more susceptible to smoking at ages 11 to 13 (highest aOR, 1.22 at age 11.5 ) and 12 to 14 (highest aOR, 1.27 at age 12 ), respectively. Hispanics were more susceptible to smoking throughout adolescence peaking at age 12 (aOR, 1.60) and age 16.5 (aOR, 1.46). Non-Hispanic Asian Americans were less susceptible to smoking at ages 11 to 15 (lowest aOR, 0.76 at ages 11-13 ).

Conclusions: Racial/ethnic disparities in smoking susceptibility persisted over time among US youth nonsmokers, especially at ages 11 to 13 . Interventions to combat smoking susceptibility are needed.

FIGURE 1

Proportions of US youth nonsmokers who are susceptible to smoking by race and ethnicity, 1999 to 2014^. “Average” refers to estimated proportions of never smokers who were susceptible to smoking in all 5 racial/ethnic groups. Data presented are from all available NYTS datasets between 1999 and 2014.

FIGURE 2

Odds ratio of susceptibility among racial/ethnic youth compared with NHWs, 1999 to 2014. A, Odds ratio of susceptibility among NHBS compared with NHWs. B, Odds ration of susceptibility among Hispanics compared with NHWs. C, Odds ratio of susceptibility among NHAs compared with NHWs. D, Odds ratio of susceptibility among OHNs compared with NHWs. Time-varying covariates: gender (0 = female, 1 = male), grade (0 = middle school, 1 = high school), living with a cigarette user (0 = no, 1 = yes), exposure to internet tobacco advertising (0 = no, 1 = yes), and exposure to in-store tobacco advertising (0 = no, 1 = yes). Data presented are from all available NYTS datasets between 1999 and 2014

FIGURE 3

Proportions of US youth nonsmokers who are susceptible to smoking by age. “Average” refers to estimated proportions of never smokers who were susceptible to smoking in all 5 racial/ethnic groups.

FIGURE 4

Odds ratio of susceptibility among racial/ethnic youth compared with NHWs by age. A, Odds ratio of susceptibility among NHBs compared with NHWs. B, Odds ratio of susceptibility among Hispanics compared with NHWs. C, Odds ratio of susceptibility among NHAs compared with NHWs. D, Odds ratio of susceptibility among OHNs compared with NHWs. Time-varying covariates: gender (0 = female, 1 = male), year (continuous), living with a cigarette user (0 = no, 1 = yes), exposure to internet tobacco advertising (0 = no, 1 = yes), and exposure to in-store tobacco advertising (0 = no, 1 = yes).