New Study on Demographic Groups and Smoking

Graphic Warnings On Cigarettes Effective Across Demographic Groups

Jan. 14, 2013 — Quitting smoking is a common New Year's resolution for Americans each year, but research has repeatedly shown it is not an easy task. Some groups, such as racial/ethnic minorities, have an even harder time quitting. New research suggests hard-hitting graphic tobacco warnings may help smokers of diverse backgrounds who are struggling to quit. A new study by researchers at Legacy® and Harvard School of Public Health provides further evidence that bold pictorial cigarette warning labels that visually depict the health consequences of smoking -- such as those required under the 2009 Family Smoking and Prevention Tobacco Control Act -- play a life-saving role in highlighting the dangers of smoking and encouraging smokers to quit.

The study is one of the first to examine the effectiveness of pictorial warning labels versus text-only labels across diverse racial/ethnic and socioeconomic groups. Although a growing body of research has shown that disadvantaged groups may differ in their ability to access, process and act on health information, little is known about communication inequalities when it comes to cigarette warning labels.

The study authors note that text-only cigarette warnings have been repeatedly characterized as unlikely to be noticed or have an impact, and cite prior research indicating pictorial warning labels are more effective.

"Interventions that have a positive impact on reducing smoking among the general population have often proven ineffective in reaching disadvantaged groups, worsening tobacco-related health disparities," said Jennifer Cantrell, DrPH, MPA, and Assistant Director for Research and Evaluation at Legacy®, a national public health foundation devoted to reducing tobacco use in the U.S. "It's critical to examine the impact of tobacco policies such as warning labels across demographic groups."

Senior author Vish Viswanath, associate professor of society, human development, and health at Harvard School of Public Health, said, "There is a nagging question whether benefits from social policies accrue equally across ethnic and racial minority and social class groups. The evidence from this paper shows that this new policy of mandated Graphic Health Warnings would benefit all groups. Given the disproportionate burden of tobacco-related disease faced by the poor and minorities, mandating strong pictorial warnings is an effective and efficient way to communicate the risk of tobacco use."

The new study, published January 14, 2013, in the journal PLOS ONE, examined reactions to cigarette warning labels from more than 3,300 smokers. Results show that hard-hitting, pictorial graphic warnings are more effective than text-only versions, with smokers indicating the labels are more impactful, credible, and have a greater effect on their intentions to quit. Moreover, the study found that the stronger impact of pictorial warnings was similar across vulnerable subpopulations, with consistent reactions across race/ethnicity, education, and income.

"The implementation of graphic warning labels appears to be one of the few tobacco control policies that have the potential to reduce communication inequalities across groups," Cantrell said.
"Tobacco use is a social justice issue," added Donna Vallone, PhD, Senior Vice President for Research and Evaluation at Legacy®. "Given that low income and minority communities have higher smoking rates and suffer disproportionately from tobacco's health consequences, studies like this show us that graphic warning labels can help us reach these subgroups in a more effective way, ultimately saving more lives."
Source: ScienceDaily and Harvard School of Public Health, via EurekAlert!, a service of AAAS.

Race and Ancestry Important in Medicine

We agree that ancestry and racial information are BOTH important to the personal medical history, especially for the multiracial population.

Ancestry, not just race, is important to personal medical history

Doctors often ask patients to list their race -- white, Latino, African American, Asian, Native American -- to help them provide better healthcare. They do this because loads of medical research shows that the incidence of certain diseases and treatment success can vary somewhat from race to race.
But the more important question may be: What is your genetic ancestry?

A study released Wednesday in the New England Journal of Medicine examined the accuracy of a lung function test and how race and ancestry played a role in the test's accuracy. A lung function test measures damage to the lungs caused by asthma or other disease. However, the definition of "normal" lung function is known to vary substantially by race. For example, doctors have long known that vital lung capacity (the maximum amount of air that can be expelled after maximum inhalation) is 6% to 12% lower in blacks compared with whites and Native Americans.

Researchers looked at data from more than 3,000 patients that included their lung function test results, standard information on race and additional information on genetic ancestry that was obtained through genotyping. The study found that standard race categories don't capture the extent of ancestral diversity and, thus, may limit the amount of information available to a doctor in making a diagnosis or ordering treatment. Instead, many people have a rich and diverse genetic background that does not lend itself to a simple classification, such as "white" or "Asian."

For example, when using genetic ancestry data, the study showed a strong link between African ancestry and lung function measurement in both men and women. According to the findings, for 6.4% of people in the United States who identify themselves as African American, the actual percentage of African ancestry would be 15% higher or lower than average -- a difference that would result in an incorrect estimation of lung function test, and possibly, mistakes about the severity of lung disease. About 2.1 million self-identified African Americans have asthma. But based on the study conclusions, the severity of the asthma would be misclassified in about 4% of those patients.

"When we force patients into an individual box, such as 'African American' or 'Caucasian,' we're missing a lot of genetic information," senior author of the study Dr. Esteban G. Burchard, of UC San Francisco, said in a news release. "This study provides new evidence that genetic ancestry correlates to physiological measures. With it, we're one step closer to personalized medicine."

On a more practical level, the study points to the need for improvements in measuring lung function in some people. In an editorial accompanying the paper, authors noted: "Refinements are needed for poorly represented or misrepresented populations and for persons of mixed ancestry, who represent an increasing proportion of the U.S. population."
-- Shari Roan
SOURCE: LA Times July 7, 2010