African Americans and Tobacco

A man smoking

African Americans continue to suffer disproportionately from chronic and
preventable disease compared with white Americans. Of the three leading causes
of death in African Americans — heart disease, cancer, and stroke — smoking and
other tobacco use are major contributors.

Health Effects

  • Each year, approximately 45,000 African Americans die from a preventable
    smoking-related disease.
  • If current trends continue, an estimated 1.6 million African Americans who
    are now under the age of 18 years will become regular smokers. About 500,000 of
    those smokers will die of a smoking-related disease.
  • Smoking is responsible for 87% of lung cancers. African American men are at
    least 50% more likely to develop lung cancer than white men. African American
    men have a higher mortality rate of cancer of the lung and bronchus (100.8 per
    100,000) than do white men (70.1 per 100,000).
  • Stroke is associated with cerebrovascular disease and is a major cause of
    death in the United States. Smoking significantly elevates the risk of stroke.
    Cerebrovascular disease is twice as high among African American men (53.1 per
    100,000) as among white men (26.3 per 100,000) and twice as high among African
    American women (40.6 per 100,000) as among white women (22.6 per
  • Levels of serum cotinine (metabolized nicotine) are higher among African
    American smokers than among white or Mexican American smokers for the same
    number of cigarettes.

Cigarette Smoking Prevalence

  • In 1997, current smoking prevalence rates were similar among African
    American adults (26.7%) and white adults (25.3%) in the United
  • In 1997, African American men (32.1%) smoked at a higher rate than white men
    (27.4%); African American women (22.4%) and white women (23.3%), however, smoked
    at a similar rate.
  • The decline of smoking among African American young people during the 1970s
    and 1980s was widely viewed as a great public health success. Unfortunately,
    recent national surveys have shown that smoking rates among African American
    high school students are starting to increase, although those rates are still
    lower than those for other students.
  • The 1999 National Youth Tobacco Survey (NYTS) estimates that  cigarette
    smoking prevalence during the past month was higher among white high school
    students (32.8%) and lower among African American (15.8%) students. However, the
    rate of smoking among middle school students was similar; about 1 in 10 African
    American (9.0%) and white (8.8%) middle school students reported having smoked
    cigarettes in the past month.
  • The Centers for Disease Control and Prevention’s 1999 Youth Risk Behavior
    Surveillance System (YRBSS) report estimates that cigarette smoking prevalence
    during the past month was higher among white (38.6%) and Hispanic (32.7%) high
    school students than among African American (19.7%)
  • According to 1999 the Monitoring the Future Survey data, past month smoking
    prevalence was lower among African American high school seniors (14.9%) than
    among white (40.1%) high school seniors.

Cigarette Smoking Behavior

  • Approximately three of every four African American smokers prefer menthol
    cigarettes. Among whites, approximately a quarter of smokers prefer menthol
    cigarettes. Menthol may facilitate absorption of harmful cigarette smoke
  • Among adult African American smokers the most popular brands are Newport,
    Kool, and Salem. Similar brand preference was found among African American teens
    with 61.3 % preferred Newport, 10.9% preferred Kool, and 9.7% preferred

Prevalence of other forms of tobacco use