Study finds parental pressure gets results

Family pressure keeps many African-American teenagers from getting hooked on cigarettes, according to a new study. The study found that even though most African-American teenagers try smoking cigarettes at a younger age than whites, they are less likely than whites to continue or escalate the habit. The study, which was conducted on the West Coast, suggests that African-American teens are more willing than white teens to talk with their parents and other family members about lifestyle choices, said Phyllis Ellickson, a researcher with the Los Angeles-based Rand Corp. and lead author of the study. The findings are "a success story for African Americans," Ellickson said. Health officials concerned about smoking prevention could learn much from studying how African-American family bonds and parent-child communication work, she said. The finding about family relationships is "very relevant" in Kentucky and Indiana because of the states' high smoking rates, said Anita Fernander, a smoking researcher at the University of Kentucky College of Medicine. In Kentucky high schools, 16 percent of African-American students smoke, compared with 36 percent of white students, according to the 2002 Kentucky Youth Tobacco Survey. A similar survey in Indiana showed that 14 percent of African Americans and 24 percent of whites smoke in high school. Ellickson said researchers need to "understand a lot more about the dynamics of what's going on between child and parent that makes the children listen when parents express concern about smoking." But she speculated that compared with whites, African-American children, at least in the West Coast study, "had fairly positive relationships with their parents and felt comfortable talking with them about personal problems." Dr. Mohammad Shafii, a professor of psychiatry at the University of Louisville School of Medicine, said African Americans, recent immigrants and other groups often tend to view themselves as part of "a small community" that "survives by family cohesiveness. ... I'm not surprised that in African-American families teenagers communicate better with their mother, father and other family members," Shafii said. `Look ... who's smoking' The new study makes sense to Cliff Irons, youth services coordinator at Iroquois High School in Louisville and an African American. Irons said he is trying to get his nephew, who is in his 20s, to give up cigarettes. "I tell him, `Look around you at who's smoking,'" Irons said. "It seems like so many who are in a dependence situation are smoking." After a recent smoking awareness class at a Louisville "Youth Alive" educational program, Fran'Neica Rhodes, who is African American and a freshman at Iroquois, said that despite having several friends who smoke, she decided not to. "My mother said it was up to me to choose what I wanted to do with my body." Garry Rackard, a senior at Valley High School and an African American, said he started smoking earlier in high school. But he quit because he realized "it wasn't the way I wanted to go." He credited an adviser at the school, Ellen Kenzer, and his grandmother with giving him needed encouragement. Rackard's grandmother quit the habit after years of smoking. "I said, `If she can do it, I can do it,'" Rackard said. A smoking state Tobacco use is the nation's leading cause of preventable death and disease, according to the federal Centers for Disease Control and Prevention. Each year in the United States, smoking causes more than 440,000 premature deaths — about 45,000 of them among African Americans. African Americans suffer smoking-related diseases at much higher rates than whites. Kentucky leads the nation in the percentage of adults who smoke cigarettes — 33 percent, according to the Centers for Disease Control and Prevention, citing figures for 2002. Indiana ranks fifth with 28 percent. The national average is 23 percent. In Kentucky, 26 percent of African Americans smoke, while 30 percent of whites do, according to a 2000 CDC analysis, the most recent breakdown available. In Indiana, 28 percent of African Americans smoke, while 27 percent of whites do. Health officials said they don't know why the differences between black and white rates exist in Kentucky and Indiana. "The bottom line is it's high for everyone in both states, and we need to bring it down regardless of race, gender or socioeconomic status," said Karla Sneegas, executive director of the Indiana Tobacco Prevention and Cessation Agency. Teen years critical The findings of the West Coast study are important because the teen years are critical for developing an addiction to cigarettes, regardless of race or ethnicity, health experts said. When they begin smoking, young people underestimate the addictive nature of tobacco and the risks of developing lung cancer, heart disease and other diseases. For years, smoking researchers have been trying to sort out patterns of tobacco use in various age, racial and ethnic groups. These patterns depend on a wide array of factors, including socioeconomic status, culture, biology and targeted advertising. The West Coast study did not examine the reasons adults take up smoking. Other studies have consistently shown similar trends in teen use of marijuana, cocaine and other illicit drugs, with use by whites significantly higher than by blacks. According to the 2002 Kentucky Youth Tobacco Survey, 15 percent of middle school students and 34 percent of high school students are current cigarette smokers, meaning they have smoked on one or more days in the past 30 days. The 2002 Indiana survey showed that 9 percent of middle schoolers and 23 percent of high schoolers are current smokers. The national average is 11 percent of middle school students and 28 percent of high school students. In Kentucky, cigarette use jumps from sixth to seventh grades — from 7 percent to 17 percent of students being current smokers. In Indiana, the big jump in smoking is from 11 percent in eighth grade to 20 percent in ninth grade. But officials in both states said the numbers are down significantly from their 2000 surveys. Social influences The West Coast study indicates that efforts to increase anti-smoking pressure by family and peers on early smokers of all races could cut the bridge from experimenting with cigarettes to getting hooked, Ellickson said in a telephone interview. In their analysis of the 2002 Kentucky youth survey, state health officials concluded that "young people are strongly influenced by the examples they see in their social environment of tobacco use from peers, family and other adult role models such as teachers and coaches." Recent interviews at the "Youth Alive" educational program found family bonds to be an important factor in discouraging cigarette use among several African-American teens. As part of the program, organized by Kenny Boyd and held at the Baptist Fellowship Center, 1351 Catalpa St., two dozen students from Iroquois and Valley high schools listened to a presentation on the dangers of smoking. Shanice Byrd, who is African American and a sophomore at Iroquois who started smoking at 12, said her grandfather has been talking to her about quitting. "I really, really want to quit, but I can't. It's an addiction, like a drug." Ryan Wheatley, who is white and a junior at Valley High, said he started smoking when he was 11 and is now "addicted and can't quit. A lot of people in my family smoke." But he said his mother "tells me every day I need to quit." Hairy tongue gross-out The smoking-risk discussion was led by two health educators, Katie Thompson of the Louisville Metro Health Department and Michelle Higgins of the Community Health Project at Park DuValle. Several of the students involved told Thompson and Higgins that they had started smoking because of pressure from peers and to relieve stress. Several other students said loudly that they disapproved of smoking. Thompson and Higgins talked about the links between smoking and death, then ran a video showing smokers' surgeries, blackened lungs and "hairy tongue." The class issued frequent groans and moans of disapproval. Rhodes, the Iroquois freshman, said afterward that the hairy tongue image, which shows how hair growth on a smoker's tongue is more visible, made her sick. The class "told me a lot of stuff I already knew about smoking, but I didn't know it did that," Rhodes said. Some of the students said the presentation was so "gross" that they had decided to quit. Sasha Ford, a sophomore at Iroquois, said, "I've got to stop."

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