Tobacco use among rural African American young adult males.

OBJECTIVE: Tobacco-related disease is a primary source of mortality for African American men. Recent studies suggest that alternative tobacco products may have supplanted cigarettes as the most common products used by young African Americans. Effective cessation strategies require community-specific prevalence data. This project measures the prevalence of 9 tobacco products among young African American men in rural Alabama.

STUDY DESIGN: Principles of community-based participatory research were used to design a verbally administered tobacco product survey to measure the prevalence and behavioral factors influencing use.

SETTING: Black Belt counties of rural Alabama.

SUBJECTS AND METHODS: African American men aged 19 to 30 years were recruited from the target counties. Participants were stratified by income and education level. Prevalence rates for 9 products were determined, and logistic regression analysis was performed.

RESULTS: A total of 415 participants completed surveys. Cigarettes were the most common product ever (54%) and currently (39.9%) used. Participants who attended school for more than 12 years or attended religious services were less likely to use cigarettes. Marijuana and blunts were used next most commonly. Only 35 respondents (8.9%) currently used mini-cigars. Other products, bidis/kreteks, smokeless tobacco, and pipes were used uncommonly in this sample.

CONCLUSIONS: Cigarettes remain the dominant tobacco product used by young African American men in rural Alabama. Cigarette prevalence far exceeds that measured statewide for African American men of the same age. Alternative products were not commonly used in this study population. Effective community-based intervention must target cigarette initiation and cessation in this vulnerable population.