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The influence of racism on cigarette smoking : longitudinal study of young people in a British multiethnic cohort

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Correa-Velez, Ignacio, Read, Ursula M., Karamanos, Alexis, João Silva, Maria, Molaodi, Oarabile R., Enayat, Zinat E., Cassidy, Aidan, Cruickshank, J. Kennedy and Harding, Seeromanie (2018) The influence of racism on cigarette smoking : longitudinal study of young people in a British multiethnic cohort. PLoS One, 13 (1). e0190496. doi:10.1371/journal.pone.0190496

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Official URL: http://dx.doi.org/10.1371/journal.pone.0190496

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Abstract

Introduction
Studies, predominantly from the US, suggest that positive parenting, social support, academic achievement, and ethnic identity may buffer the impact of racism on health behaviours, including smoking, but little is known about how such effects might operate for ethnically diverse young people in the United Kingdom. We use the Determinants of young Adult Social well-being and Health (DASH), the largest UK longitudinal study of ethnically diverse young people, to address the following questions: a) Is racism associated with smoking? b) Does the relationship between racism and smoking vary by gender and by ethnicity? (c) Do religious involvement, parenting style and relationship with parents modify any observed relationship? and d) What are the qualitative experiences of racism and how might family or religion buffer the impact?

Methods
The cohort was recruited from 51 London schools. 6643 were seen at 11-13y and 4785 seen again at 14-16y. 665 participated in pilot follow-up at 21-23y, 42 in qualitative interviews. Self-report questionnaires included lifestyles, socio-economic and psychosocial factors. Mixed-effect models examined the associations between racism and smoking.

Results
Smoking prevalence increased from adolescence to age 21-23y, although ethnic minorities remained less likely to smoke. Racism was an independent longitudinal correlate of ever smoking throughout adolescence (odds ratio 1.77, 95% Confidence Interval 1.45–2.17) and from early adolescence to early 20s (1.90, 95% CI 1.25–2.90). Smoking initiation in late adolescence was associated with cumulative exposure to racism (1.77, 95% CI 1.23–2.54). Parent-child relationships and place of worship attendance were independent longitudinal correlates that were protective of smoking. Qualitative narratives explored how parenting, religion and cultural identity buffered the adverse impact of racism.

Conclusions
Racism was associated with smoking behaviour from early adolescence to early adulthood, regardless of gender, ethnicity or socio-economic circumstances adding to evidence of the need to consider racism as an important social determinant of health across the life course.

Item Type: Journal Article
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Mental Health and Wellbeing
Journal or Publication Title: PLoS One
Publisher: Public Library of Science
ISSN: 1932-6203
Official Date: 24 January 2018
Dates:
DateEvent
24 January 2018Published
17 December 2017Accepted
Volume: 13
Number: 1
Article Number: e0190496
DOI: 10.1371/journal.pone.0190496
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access
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