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These ethnic minority populations remain at high risk for using tobacco and often bear a disproportionate share of the human and economic cost of tobacco use. For example, African Americans suffer the highest death rates from several diseases caused by smoking. Although some recent declines in lung cancer trends are encouraging, there is concern about increases in rates of smoking among African-American and Hispanic high school students.
We know tobacco use causes devastating disease and premature death in every population in the United States, but this specific report focuses exclusively on tobacco use among members of these four racial/ethnic groups. Together these groups constitute about 25 percent of the U.S. population and that proportion is growing rapidly. According to estimates from the U.S. Bureau of the Census, the size of these four racial/ethnic minority groups is expected 'to increase dramatically, becoming almost half of the U.S. population by the year 2050. This projection is an indication for a need for public health organizations to develop effective prevention and community based programs to address the health needs for this specific population.
If tobacco use is not reduced among members of these four racial/ethnic groups, they will experience increasing morbidity and mortality from tobacco use. The toll is currently highest for African American adults. Findings also suggest that some close, long-term relationships between tobacco companies and various racial/ethnic communities could hamper U.S. efforts to lower rates of tobacco.
Major Conclusions
1. Cigarette smoking is a major cause of disease and death in each of the four population groups studied in the report. African Americans currently bear the greatest health burden. Differences in the magnitude of disease risk are directly related to
differences in patterns of smoking.
2. Tobacco use varies within and among racial/ethnic minority groups; among adults, American Indians and Alaska Natives have the highest prevalence of tobacco use, and African American and Southeast Asian men also have a high prevalence of smoking. Asian American and Hispanic women have the lowest prevalence.
3. Among adolescents, cigarette smoking prevalence increased in the 1990s among African Americans and Hispanics after several years of substantial decline among adolescents of all four racial/ethnic minority groups. This increase is particularly striking among African American youths, who had the greatest decline of the four groups during the 1970s and 1980s.
4. No single factor determines patterns of tobacco use among racial/ethnic minority groups; these patterns are the result of complex interactions of multiple factors, such as socioeconomic status, cultural characteristics, acculturation, stress, biological elements, targeted advertising, price of tobacco products, and varying capacities of communities
to mount effective tobacco control initiatives.


