Racial differences in alcohol and tobacco use in adolescence and mid-adulthood in a community-based sample

• Published in: Social Psychiatry and Psychiatric Epidemiology 2020-04, Vol.55 (4), p.457-466
• Main Authors: Pamplin, John R., Susser, Ezra S., Factor-Litvak, Pam, Link, Bruce G., Keyes, Katherine M.
• Format: Article
• Language: English
• Subjects: Adolescence; Adolescent; Adult; African Americans - psychology; African Americans - statistics & numerical data; Age; Alcohol Drinking - epidemiology; Alcohol Drinking - ethnology; Alcohol use; Alcohols; Child development; Comparative analysis; Drinking of alcoholic beverages; Epidemiology; European Continental Ancestry Group - psychology; European Continental Ancestry Group - statistics & numerical data; Female; Health aspects; Humans; Logistic Models; Male; Medicine; Medicine & Public Health; Middle Aged; Odds Ratio; Original Paper; Psychiatry; Regression analysis; Smoking; Social factors; Teenagers; Tobacco; Tobacco Use - epidemiology; Tobacco Use - ethnology; Young adults
• ISSN: 0933-7954; 1433-9285
• DOI: 10.1007/s00127-019-01777-9

Purpose Smoking and alcohol use have been posited as possible contributors to racial health disparities, despite higher smoking and alcohol use among non-Hispanic White youth and young adults compared to Blacks. To further investigate this claim, we aim to assess variation in alcohol and cigarette use across two distinct points of the life course. Method Data are from a subset of 559 (279 male, 280 female) self-identified Black and White participants of the Child Health and Development study. Self-report alcohol and cigarette use were collected between age 15–17 and at mean age 50. Logistic regressions were estimated; supplementary analyses adjusted for maternal age, prenatal smoking, household income, childhood SES, and education. Results White participants were more likely to drink regularly (Odds ratio (OR) 2.2; 95%CI 1.2, 4.0) and be intoxicated (OR 2.0; 95%CI  1.2, 3.2) in adolescence compared with Blacks. In mid-adulthood, Whites remained more likely to currently drink (OR  2.3; 95%CI 1.6, 3.4) but among drinkers, less likely to binge drink (OR 0.4; 95%CI  0.2, 0.8). White participants were less likely to smoke in mid-adulthood (OR  0.4; 95%CI  0.3, 0.6), but among smokers, were more likely to smoke ≥ ½ a pack per day (OR 3.4; 95%CI  1.5, 7.8). Conclusions Blacks were less likely to engage in drinking across the life course, but, among drinkers, more likely to binge drink in mid-adulthood. Blacks were more likely to smoke in mid-adulthood, but smoked infrequently compared with Whites. These patterns suggest that a reframing of disparities mechanisms to focus on broader structural and social factors may benefit progress in understanding and ameliorating inequities.