Smoking and the health gap in minorities.

Over the past decade, tobacco companies have targeted minority populations when advertising and promoting their products, containing the most widely available, legal addictive drug in the United States. This has contributed to a greater prevalence of cigarette smoking among some minorities and lower-income groups. Black males are more likely to smoke than white males and more often they smoke high-tar cigarettes. They are also less likely to quit smoking. Compared to the national average, a greater proportion of Hispanic males smoke, but not Hispanic females. Smoking prevalence rates among Asians and Native Americans are available from local surveys but there are no reliable national estimates. Blacks experience substantially higher rates of mortality and morbidity from all causes, heart disease, stroke, and smoking-related cancers as well as adverse pregnancy outcomes. Substantially lower rates of death from heart disease, stroke, and cancers are observed among Asians and Native Americans than among whites. Disparities in cigarette smoking among racial and ethnic groups do not mirror the observed racial and ethnic disparities in mortality. Other health risk factors, access to medical care and premature death from other causes, may partially explain the morbidity/mortality gap between minorities and nonminorities. Reliable national estimates on smoking prevalence and morbidity and mortality among minorities are needed. The role of tobacco use in the etiology of diseases that are disproportionately prevalent among minorities should be studied. Culturally sensitive and acceptable smoking interventions should be developed with the involvement of minorities.