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"Tobacco advertisements represent 60% of advertising space for most African-American newspapers, and the three major African-American magazines (Ebony, Jet, Essence) included 12% more cigarette advertisements than other mainstream publications". |
The recent increase in smoking among minority youth, especially African Americans and Hispanics, suggests they have been specifically targeted by cigarette manufacturers (4,6,7). According to the Centers for Disease Control and Prevention, the three most commonly purchased brands of cigarettes among adolescent smokers (Marlboro, Winston, and Camel) are also the three most heavily advertised. These three brands account for 86% of total purchases by adolescents. Only 35% of adults smoke these brands (2). Point-of-purchase advertising and promotion in retail stores represent important elements in the overall sales strategy of the tobacco industry (8). Such advertising exposes children and other vulnerable populations (low-income, teens, minorities) to tobacco use; however, stores do not provide anti-smoking information to inform consumers about the health risks involved (3). Efforts have been made to reduce the incidence and prevalence of smoking cigarettes through several measures: sales and excise taxes, medical model of delivery, print media, alternative approaches, and cessation programs. Sales and excise taxes. Studies show that low-income and minority smokers, moreso than other smokers, are inclined to quit in response to a price increase (Centers for Disease Control, 1998). Regardless of income and education levels, Hispanics and African Americans are significantly more responsive to price than other smokers. Hispanics are the most price responsive and African Americans are more likely to quit rather than reduce the number of cigarettes smoked per day (9). Medical model of delivery. Barriers to using health care professionals for tobacco education with racial/ethnic minority groups include lack of transportation, financial problems, limited access to health care, and limited cultural competence of the providers. In addition, few physicians express interest in counseling patients to quit smoking (10). Likewise, the medical school curriculum leaves little time for tobacco education, not only in the physiologic and pathological aspects, but also on instructing patients about how to quit (11). An alternative approach involves training health personnel with diverse backgrounds and language skills to provide personal consultations, either by phone or in person with people who want to quit smoking (12). Print media. The tobacco industry and African-American newspapers and magazines have enjoyed a long, cooperative, and profitable relationship. Cigarette manufacturers were among the first businesses to advertise in African-American publications. Tobacco advertisements represented 60% of advertising space for most African-American newspapers, and the three major African-American magazines (Ebony, Jet, Essence) included 12% more cigarette advertisements than other mainstream publications (5). An apparent barrier to getting the prevention message out involves the fact that these publications may not print tobacco prevention and control articles and tobacco use prevention ads (3). Alternative approaches. More faith-based programs are being used to provide health education, including smoking cessation programs (13), but their effectiveness has not been evaluated extensively (14). Another approach involves training lay health advisors to deliver smoking cessation programs in their neighborhoods (15). Reaching employees at the work site represents another viable alternative, but few individuals report that such programs are available to them (3). Cessation programs. Members of racial/ethnic groups are less likely than the general population to receive smoking cessation information from health care providers (16). Health care providers, especially physicians and dentists, can play a major role in educating patients on the health consequences of smoking and the need to quit smoking. African Americans’ concern for their children ranks among the strongest motivators for them to quit smoking (13). Consequently, health personnel can encourage pregnant women to quit smoking, and they can discuss the effects of passive smoking on young children with parents who smoke. A paucity of research exists on smoking cessation programs developed specifically for diverse groups (17). Group approaches to smoking cessation generally have not proven successful with members of racial/ethnic minority groups. These programs usually face difficulty attracting participants, and the programs report high attrition rates. These problems may be compounded more for racial/ethnic minority groups who do not speak English, and those who lack transportation, adequate childcare, and access to health care (3). |