Cigarette Smoking among Economically Disadvantaged African-American Older Adults in South Los Angeles: Gender Differences.

James Smith,Shervin Assari,Marc Zimmerman,Mohsen Bazargan

doi:10.3390/ijerph16071208

Abstract

The current study aims to explore gender differences in the risk of cigarette smoking among African-American (AA) older adults who live in economically disadvantaged urban areas of southern Los Angeles. This cross-sectional study enrolled 576 older AA adults (age range between 65 and 96 years) who were residing in Service Planning Area 6 (SPA 6), one of the most economically challenged areas in southern Los Angeles. All participants had cardiometabolic disease (CMD). Data were collected using structured face-to-face interviews. Demographic factors (age and gender), socioeconomic status (educational attainment and financial difficulty), health (number of comorbid medical conditions and depressive symptoms), and health behaviors (current alcohol drinking and current smoking) were measured. Logistic regressions were used to analyze the data without and with interaction terms between gender and current drinking, depressive symptoms, and financial difficulty. AA men reported more smoking than AA women (25.3% versus 9.3%; p < 0.05). Drinking showed a stronger association with smoking for AA men than AA women. Depressive symptoms, however, showed stronger effects on smoking for AA women than AA men. Gender did not interact with financial difficulty with regard to current smoking. As AA older men and women differ in psychological and behavioral determinants of cigarette smoking, gender-specific smoking cessation interventions for AA older adults who live in economically deprived urban areas may be more successful than interventions and programs that do not consider gender differences in determinants of smoking. Gender-tailored smoking cessation programs that address drinking for AA men and depression for AA women may help reduce the burden of smoking in AA older adults in economically disadvantaged urban areas. Given the non-random sampling, there is a need for replication of these findings in future studies.

Highlights

Smoking is the single most important preventable behavioral risk factor of early mortality in the United States [1]
Gender impacts the smoking prevalence of AA older adults with cardiometabolic disease (CMD) who reside in economically deprived urban areas in multiple ways
Gender has a primary effect on smoking, with men having a higher tendency to smoke than women

Summary

Introduction

Smoking is the single most important preventable behavioral risk factor of early mortality in the United States [1]. Smoking is linked to depression [2] and poor quality of life [3]. Smoking increases risk of several chronic medical conditions (CMCs), cardiometabolic disease (CMD), such as diabetes, hypertension [4], heart disease [5], and stroke [6]. Smoking increases the risk of other chronic conditions, such as cancer [7]. Smoking is linked to risk factors for cancers of the lungs [8], breasts [9], cervix [10], pancreas [7], stomach [11], and mouth [8]. As a result, smoking is a predictor of

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