One of the greatest public health success stories of the past 50 years has been the reduction in cigarette smoking in the United States. Smoking prevalence has decreased by 50% or more in the United States since the 1960s, and although recent reports indicate a plateau in this decline, the long-term downward trend has resulted in an overall smoking prevalence rate of 20.6% in 2009.
This is, in large part, due to the fact that tobacco control efforts have not impacted population subgroups equally. In general, racial/ethnic minority groups and persons of lower socioeconomic status (SES) have not benefited as much as whites and those of higher SES from smoking prevention and cessation programs.
If we are to meet the goal of 12% or less smoking prevalence among the overall adult population, more effort is needed to influence tobacco use behaviors among racial/ethnic and low SES populations. Articles in this special issue of the American Journal of Health Promotion address how and to what extent tobacco control efforts can be implemented to reduce the burden of cigarette smoking among racial/ethnic minority and low SES groups.
Understanding how to effectuate behavior change in these populations is paramount if we are to achieve both our national health objective of reducing cigarette smoking and improve the nation’s health status overall.
Reductions in the prevalence of cigarette smoking have occurred because of multiple strategies, which include
- Policy changes such as bans on indoor smoking
- Increased cigarette taxes
- Clinical interventions
- Dedicated population-based tobacco control programs, such as mass media campaigns, quit lines, and Web-based interventions.
These tobacco control strategies have also resulted in the reduction of secondhand smoke exposure, more frequent quit attempts, and fewer cigarettes smoked per day among persons continuing to smoke.
Recommendations to promote cessation include brief clinical interventions such as individual, telephone, and group counseling and pharmacotherapy, including five types of nicotine replacement products and two other classes of medications.6 However, specific recommendations for racial/ethnic minorities were omitted in the most recent clinical practice guidelines because of lack of evidence that culturally specific interventions are more efficacious than general population approaches.
This suggests that evidence-based strategies and programs known to be effective at reducing smoking within the general population should be tested in randomized clinical trials with sufficient samples of racial/ethnic minority and low SES participants to determine their efficacy within these groups and where indicated, programs should be developed specifically for these groups.
- Age, gender and social advantage affect success in quitting smoking
- Anti-Tobacco Education in Singapore Schools
- Tobacco Prevention Programs Work in Alaska