Smoking initiation and cessation in African Americans attending an inner-city walk-in clinic

Objectives: Data collected from a population of African Americans were analyzed to examine patterns of smoking initiation, smoking cessation, and factors related to smoking cessation. Methods: Over a 4-month period, all (N = 2,928) patients attending an inner-city medicine clinic were recruited to participate in a smoking intervention trial. Over 99% participated, providing information on their smoking experiences, including smoking status (current, former, or never a smoker), duration of regular smoking, and year of quitting when applicable. Data on African Americans with complete information on these variables (n = 2,428) were analyzed with respect to initiation and duration of smoking. Results: More than half of African-American smokers in the population studied initiated regular smoking after age 19. Later age of initiation of smoking and female gender were associated with short duration smoking (i.e., quitting before 10 years of regular smoking); these variables, but not age, were identified as significant factors in a Cox Proportional Hazards model with duration of smoking as the outcome variable. Conclusions: A sizable opportunity for primary prevention of regular smoking appears to exist among African Americans aged 20 to 30 years as evidenced by patterns of smoking initiation in the population studied. The importance of age at initiation of regular smoking to the duration of smoking is demonstrated in this population over a wide range of duration.