Smoking cessation advantage among adult initiators: does it apply to black women?

Smokers who initiate as adults are more likely to quit than those who initiate as adolescents. Black women are more likely than White women to initiate smoking in adulthood and are less likely to quit. There is a paucity of research examining whether the smoking cessation advantage among adult initiators applies to Black women. The study objective is to examine race differences in the effect of developmental stage of smoking initiation on number of years until cessation among Black and White women.

Data were extracted from the National Longitudinal Survey of Young Women, a national cohort of women between the ages of 49 and 61 years in 2003. The analytic sample comprised 1,008 White women and 271 Black women with a history of smoking. Survival analysis procedures were utilized to address the study objective.

Racial disparities in smoking cessation were most evident among women who initiated smoking as adults. White young adult initiators had a 31% increased hazard of smoking cessation advantage (adjusted hazards ratio [HR]: 1.31, 95% CI: 1.04-1.65) over adolescent initiators, whereas Black young adult initiators had no smoking cessation advantage (adjusted HR: 0.85, CI: 95% 0.55-1.30) over adolescent initiators.

Prior observations that smoking initiation in adulthood is associated with high rates of cessation do not apply to black women. To contribute to the reduction of disparities in women's cessation efforts to prevent initiation should target young adult women, particularly Black young adult women.