Familial and psychological correlates of smoking in black and white adolescents.

Cigarette smoking is considered to be the single most preventable contributor to chronic diseases, but there is still great controversy about the initiation and maintenance of smoking among adolescents. The goal of this study was to examine familial and psychological factors that contribute to the initiation and maintenance of smoking among black and white adolescents. To accomplish this, we tested 602 male (275 black and 327 white) and 460 female (174 black and 286 white) adolescent students enrolled in health classes in Tampa, Florida. Among blacks, 15.6% were currently smoking cigarettes, compared to 34.8% of the white students. Blacks who initiated smoking were most influenced by having a sister who smoked, while maintenance was most influenced by an older brother who smoked. In contrast, white adolescents who initiated smoking were more likely to have an older brother who smoked, while maintenance of smoking was predicted by having a father who smoked. Furthermore, the data show that both the initiation and the maintenance of smoking among blacks is related to the experience of intense feelings of anger and irritability, while among white adolescents, these emotions contribute only to the initiation of smoking. These data indicate that smokers and nonsmokers differ in their emotional reactions to stress, and that ethnicity (black vs white) is an important determinant in the association between smoking and emotional reactions to stress. The overall pattern of the findings in this inquiry suggests that the efficacy of antismoking treatment procedures could be enhanced by targeting exaggerated emotional reactions for modification. The data also suggest that smoking prevention programs for adolescents should take into consideration pressures to smoke that may arise from having family members who smoke. Given the inherent problems of a cross-sectional research design, future research is needed to clarify the interrelationships between smoking, ethnicity, and measures of the experience and expression of anger.