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

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Abstract

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.

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Acknowledgments

We would like to acknowledge Barbara Cohn and Katrina Kezios for their assistance. This work was supported by the National Institutes of Health R01HD058515 (Co-PIs: Link & Cohn), and K01AA021511 (PI: Keyes). John Pamplin is a fellow in T32-MH013043 (PI: Susser).

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Authors and Affiliations

  1. Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W. 168th St., 7th Floor, 720-D, New York, NY, 10032-3727, USA

    John R. Pamplin II., Ezra S. Susser, Pam Factor-Litvak & Katherine M. Keyes

  2. New York State Psychiatric Institute, New York, NY, USA

    Ezra S. Susser

  3. Department of Sociology, University of California Riverside, Riverside, CA, USA

    Bruce G. Link

  4. Center for Research on Society and Health, Universidad Mayor, Santiago, Chile

    Katherine M. Keyes

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  1. John R. Pamplin II.
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Pamplin, J.R., Susser, E.S., Factor-Litvak, P. et al. Racial differences in alcohol and tobacco use in adolescence and mid-adulthood in a community-based sample. Soc Psychiatry Psychiatr Epidemiol 55, 457–466 (2020). https://doi.org/10.1007/s00127-019-01777-9

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