TOBACCO USE AMONG AFRICAN-AMERICAN AND LATINA WOMEN AND GIRLS IN MASSACHUSETTS

Transcription

1 TOBACCO USE AMONG AFRICAN-AMERICAN AND LATINA WOMEN AND GIRLS IN MASSACHUSETTS Summary of Telephone Survey Prepared For: Massachusetts Department of Public Health Massachusetts Tobacco Control Program Boston, Massachusetts Prepared By: Market Street Research, Inc. Northampton, Massachusetts on behalf of: causemedia, inc. Watertown, Massachusetts July, 2000

2 TABLE OF CONTENTS INTRODUCTION... 3 METHODOLOGY... 4 EXECUTIVE SUMMARY... 5 DEMOGRAPHIC CHARACTERISTICS OF AFRICAN-AMERICAN AND LATINA WOMEN AND GIRLS... 7 OVERALL HEALTH ISSUES FACING WOMEN AND GIRLS SMOKING HABITS SMOKING CESSATION ATTITUDES TOWARD SMOKING AWARENESS OF AND ATTITUDES ABOUT ANTI-SMOKING MEDIA CAMPAIGNS Market Street Research, Inc.-causemedia -2-

3 INTRODUCTION Massachusetts is committed to finding ways of reducing and preventing smoking among all of the diverse racial, ethnic, and cultural groups in the commonwealth. In order to identify effective means of reaching these groups, the Massachusetts Department of Public Health (MDPH) and the Massachusetts Tobacco Control Program (MTCP) contracted with Market Street Research, Inc. of Northampton, Massachusetts to conduct a multi-phase study of the smoking habits and attitudes of African-American and Latina women and girls. Market Street Research, Inc. collaborated closely with causemedia, an advertising and public relations firm based in Newton, Massachusetts, to design and conduct a culturally-appropriate marketing research study, the results of which are being used to develop and fine-tune the media campaign. This report presents the results of a quantitative study conducted among these populations. The specific goals of the study were to determine: current smoking habits among African-American and Latina women and girls, including the proportion who currently smoke, amount they smoke, and whether they have quit smoking; attitudes about smoking cessation, including desire to quit among current smokers and challenges to cessation; attitudes toward smoking, including why women and girls choose to smoke or abstain from smoking; awareness of the adverse health effects of smoking; and the degree to which women and girls believe information about smoking; and awareness of and attitudes toward anti-smoking media campaigns. This report presents a summary of findings from a telephone survey of 247 African-American women and girls and 253 Latina women and girls. Differences among these groups, as well as between smokers and non-smokers, are presented when appropriate. Market Street Research, Inc.-causemedia -3-

4 METHODOLOGY To achieve the objectives outlined above, causemedia and Market Street Research, Inc. conducted a telephone study of 500 African-American and Latina women and girls. We began the study by meeting with representatives of the MDPH to clarify research objectives and obtain information about previous studies conducted by the MDPH relating to smoking attitudes and behavior. Following the initial meeting, causemedia and Market Street Research prepared a draft questionnaire. When appropriate for comparison purposes, questions were included from the survey instruments for adults and youth designed by the Center for Survey Research. The questionnaire was then reviewed by representatives of the MDPH and revised by causemedia and Market Street Research. Market Street Research pilot-tested the questionnaire on African-American and Latina women and girls. Following the pilot-test, causemedia, Market Street Research and the MDPH agreed upon final revisions to the survey instrument. The final version of the questionnaire was approved by the MDPH prior to data collection, and a copy is presented in Appendix A of this report. We obtained lists of telephone numbers from Survey Sampling, Inc., of Fairfield, Connecticut. Lists were targeted to reach African-American and Latina households. For each household that participated in a survey, we completed a survey with an adult female, and then asked permission to complete the survey with a girl between the ages of 11 and 17 in the household. If there was no adult female living in the household, we asked demographic questions of an adult and then asked permission to complete the survey with a girl. All interviews were conducted by trained, experienced Market Street Research interviewers from our central telephone facility in Northampton, Massachusetts, using TRACE, our proprietary computer-assisted telephone interviewing (CATI) system. Interviews were completed between May 25 and July 6, Surveys were conducted in English for English-speaking respondents, and in Spanish for Spanish-speaking respondents. The response rate for this survey was 63.5%. The sample for this study was designed so that we would interview enough African-American and Latina women and girls to draw statistically accurate conclusions about each group. Therefore, some groups are over-represented, while others are under-represented, in related to the actual population. In order to compensate for this disproportionate sampling, the results presented in this report for the total population are weighted based on actual population proportions. All surveys involve a margin of error, and for this survey, the margin of error is plus or minus 2.6 to 4.4 percentage points. For a complete description of the research methodology, including sampling, analysis, and weighting used for this study, please refer to Appendix B. Market Street Research, Inc.-causemedia -4-

5 EXECUTIVE SUMMARY The purpose of the research presented in this report is to assist the Massachusetts Department of Public Health (MDPH) in gaining an understanding of the habits and attitudes relating to smoking among African-American and Latina women and girls, and their awareness and attitudes toward anti-smoking media campaigns. Causemedia and Market Street Research, Inc. conducted a quantitative study among African-American and Latina women and girls. In general, the majority of women and girls surveyed for this study do not smoke. Anti-smoking educational campaigns have clearly played a role in influencing women s and girls decisions not to smoke, with many citing anti-smoking campaigns specifically, or education about adverse effects in general, as factors that prevented them from beginning to smoke. In addition, women and girls refrain from smoking out of concern about the cosmetic and aesthetic effects; because they never found smoking appealing; because their friends and family never smoked; and because their friends or family smoked and suffered as a result. Among those women and girls who do smoke, most began as a result of peer pressure; wanting to appear cool and fit in with the in crowd, or to relieve stress. Even those women and girls who smoke are conscious of the effects of smoking. Despite the fact that many feel quitting is very difficult, the majority have tried to quit in the past year. They are conscious of the danger of secondhand smoke, and most will smoke elsewhere, refrain from smoking, or open a window if they are in the company of a non-smoker. In addition, smokers are much more likely to want to quit if they are in a household with non-smokers, although they are more likely to smoke if they live with other smokers. Most women and girls believe much of what they hear about the adverse effects of smoking, especially information relating to specific smoking-related illnesses, such as lung cancer, or about the cosmetic and aesthetic effects of smoking, although girls are more likely to believe anti-smoking organizations such as the MDPH exaggerate the health consequences and addictiveness of smoking. However, some continue to view smoking positively as an effective stress reducer, means of weight control, and a small proportion see it as a way of ensuring an easier childbirth experience. Among those who have tried to quit, most have relied upon informal support systems, such as quitting with a friend or relative who smokes, or friends and relatives who offer support. Most find this type of support effective, in that spending time with friends and relatives takes their thoughts off smoking, and they find it helpful to talk with someone who can empathize with their struggle to quit. Women and girls are highly aware of anti-smoking media campaigns, and in general, watch, listen to, or read them with interest. These campaigns are effective, in that smokers feel they would like to quit, and non-smokers feel less likely to start, after encountering one. Four campaigns stand out as being particularly effective: the Pam Laffin ads, the Rick Stoddard ads, other ads in the Arnold campaign, and the Philip Market Street Research, Inc.-causemedia -5-

6 Morris ads. Testimonials of real people who have suffered as a result of smoking are generally effective at reaching women and girls. In general, women differ from girls in terms of their attitudes about smoking. For example, women tend to be more affected by information about the cosmetic and aesthetic effects of smoking and whether or not their friends and family smoke, while girls are more influenced by the adverse health effects of smoking and exposure to antismoking campaigns. This may be due in part to an emphasis on the dangers of smoking in school curriculum. In addition, girls are more likely than women to believe that most girls smoke, and that teenage girls who do smoke are likely to get bad reputations and be less successful in the future than teenage girls who do not smoke. Latina women and girls differ from African-American women and girls in their habits and attitudes relating to smoking. In general, Latina women and girls are more likely to smoke than African-American women and girls, and are more likely to begin smoking in an effort to reduce stress. This may be due in part to many Latina women s and girls socio-economic backgrounds. Research conducted about smoking behavior indicates that less affluent women and girls often begin smoking because it is a relatively affordable luxury. This study indicates that smokers tend to be less affluent than nonsmokers, and Latinas tend to be less affluent than African-American women. In addition, Latinas are more likely than African-American women and girls to believe smaller babies and easier deliveries are good reasons to begin smoking. Market Street Research, Inc.-causemedia -6-

7 DEMOGRAPHIC CHARACTERISTICS OF AFRICAN-AMERICAN AND LATINA WOMEN AND GIRLS We contacted women and girls throughout Massachusetts, with large proportions residing in Boston (21.7%) and Springfield (13.2%) (see Table 1). 1 Most (62.0%) of the women we spoke to were employed full-time, and an additional one-tenth (9.0%) were employed part-time. About nine-tenths (88.0%) of women interviewed have a high school diploma or higher education. About one-half (50.1%) of women are single, and about two-fifths (36.7%) are married. The median household income for women in 1999 was $24, There are several differences between African-American and Latina women who participated in this study. Specifically: a large proportion (26.5%) of African-American women reside in Dorchester, while large proportions of Latina women reside in Lawrence (28.2%) and Chelsea (11.4%); and African-American women are more affluent than Latina women (median household income of $31,000 vs. $20,000). 1 2 Demographic questions were asked of women only. Therefore, this information presents a profile of the types of households interviewed for this study, but does not present specific information regarding the demographic characteristics of girls who participated in the study. Medians represent the midpoint of a sample. For example, one-half of the women who participated in this study have annual incomes over $24,000, and one-half have annual incomes below $24,000. Market Street Research, Inc.-causemedia -7-

8 TABLE 1 DEMOGRAPHIC CHARACTERISTICS OF AFRICAN- AMERICAN AND LATINA WOMEN AND GIRLS* TOTAL** African- American Latina Town of Residence N=484 N=239 N=246 Attleboro 0.2% 0.0% 0.5% Boston 21.7% 29.1% 13.2% Braintree 0.2% 0.0% 0.5% Cambridge 2.8% 3.6% 1.8% Chelsea 6.2% 1.6% 11.4% Chicopee 0.5% 0.3% 0.7% Dorchester 18.3% 26.5% 9.0% Gloucester 1.8% 2.9% 0.5% Holyoke 3.1% 0.2% 6.5% Hyde Park 0.6% 0.7% 0.5% Jamaica Plains 2.9% 4.2% 1.3% Lawrence 14.1% 1.9% 28.2% Leominster 0.1% 0.0% 0.2% Lowell 0.6% 0.0% 1.3% Malden 0.3% 0.0% 0.7% Mattapan 3.4% 6.3% 0.0% Medford 1.4% 2.0% 0.7% Methuen 0.1% 0.0% 0.2% Revere 0.2% 0.0% 0.5% Roxbury 4.1% 5.3% 2.8% Salem 0.2% 0.0% 0.5% Springfield 13.2% 12.9% 13.5% Worcester 3.5% 2.2% 5.0% Other 0.1% 0.3% 0.0% Employment Status N=485 N=241 N=244 Employed part-time 9.0% 6.9% 11.5% Employed full-time 62.0% 67.1% 56.1% Unemployed 6.5% 6.9% 6.1% Retired 0.7% 1.1% 0.2% Disabled 3.7% 3.2% 4.2% Homemaker 8.1% 6.0% 10.7% Full-time student 8.3% 7.0% 9.7% Other 1.8% 1.9% 1.6% Highest Level of Education N=478 N=236 N=242 Some high school 12.1% 5.3% 19.9% High school diploma or GED 27.5% 24.2% 31.2% Technical school 2.6% 2.7% 2.5% Some college 33.4% 38.2% 27.9% College degree 19.9% 23.7% 15.5% Advanced degree 4.6% 6.0% 2.9% Marital Status N=482 N=239 N=243 Single 50.1% 50.7% 49.4% Married 36.7% 35.6% 37.9% In a domestic partnership 5.7% 6.9% 4.2% Divorced 6.3% 5.0% 7.8% Widowed 1.3% 1.8% 0.6% * Demographic questions only asked of adults. ** Weighted total, see Appendix B. Market Street Research, Inc.-causemedia -8-

9 TABLE 1 (continued) TOTAL** African- American Latina Total 1999 Household Income N=425 N=213 N=211 Under $7, % 10.0% 14.6% $7,500 to $15, % 6.9% 19.4% $15,000 to $25, % 21.6% 32.7% $25,000 to $35, % 20.0% 13.9% $35,000 to $50, % 16.1% 7.9% $50,000 to $75, % 17.4% 7.8% $75,000 to $100, % 5.9% 2.1% $100,000 or more 1.8% 2.0% 1.5% Median $24,000 $31,000 $20,000 * Demographic questions only asked of adults. ** Weighted total, see Appendix B. Market Street Research, Inc.-causemedia -9-

10 OVERALL HEALTH ISSUES FACING WOMEN AND GIRLS The majority (87.6%) of women and girls interviewed rated their overall health as excellent, very good, or good, and over one-fourth (27.1%) rated their health excellent (see Table 2). About one-tenth (11.8%) rated their health fair or poor. When asked about specific behaviors that have an adverse effect on health, women and girls identified several behaviors that affect them currently. About one-tenth (9.9%) said that smoking is their biggest health problem. About two-fifths (36.8%) cited a lack of exercise, and about one-fourth each cited poor eating habits (26.9%) and stress (26.9%) as having the most negative effect on their health. About one-tenth (10.7%) said they were sick or suffering from an illness. Over one-fourth (29.9%) do not have any behaviors they think are negatively impacting their health. Women and girls differ from each other in terms of their behaviors. Specifically: women are more likely than girls to cite a lack of exercise, poor eating habits, stress, and smoking as health problems; and girls are more likely than women to say they have no health problems currently. About one-half (47.7%) of women and girls say their stress level is somewhat or very high, and about one-half (51.0%) feel they have a low stress level. Only about onetenth (12.0%) identify their stress level as very high. Women are significantly more likely than girls to report very high stress levels (14.1% vs. 4.4%). About two-thirds (67.4%) of women and girls who smoke have seen or talked to a medical doctor or assistant about their health in the past 12 months. Among those women and girls, about three-fourths (77.1%) report that the doctor or assistant advised them to stop smoking. Market Street Research, Inc.-causemedia -10-

11 TABLE 2 OVERALL HEALTH ISSUES FACING WOMEN AND GIRLS TOTAL* Girls Women AFRICAN-AMERICAN LATINA Total Girls Women Total Girls Women Overall Health N=500 N=198 N=302 N=247 N=53 N=194 N=253 N=54 N=199 Excellent 27.1% 28.9% 26.6% 28.1% 28.5% 28.0% 25.9% 29.3% 25.0% Very good 31.6% 31.2% 31.7% 30.7% 30.9% 30.7% 32.6% 31.6% 32.9% Good 28.9% 33.6% 27.7% 28.1% 35.6% 26.0% 30.0% 31.3% 29.6% Fair 10.1% 5.4% 11.4% 11.5% 5.0% 13.3% 8.5% 5.9% 9.2% Poor 1.7% 0.4% 2.0% 1.6% 0.0% 2.0% 1.8% 0.9% 2.0% Don't know-refused 0.6% 0.4% 0.6% 0.0% 0.0% 0.0% 1.2% 0.9% 1.3% Average** Factor Having the Biggest Negative Effect on Health Right Now N=500 N=198 N=302 N=247 N=53 N=194 N=253 N=54 N=199 Not exercising 36.8% 30.0% 38.6% 36.8% 35.1% 37.3% 36.7% 24.1% 40.1% Poor eating habits 26.9% 18.4% 29.3% 28.0% 18.2% 30.7% 25.7% 18.6% 27.6% Stress 26.9% 20.2% 28.7% 25.6% 19.1% 27.3% 28.4% 21.4% 30.3% Being sick or having an illness 10.7% 10.2% 10.9% 10.6% 13.0% 10.0% 10.8% 7.0% 11.8% Smoking 9.9% 5.1% 11.2% 8.9% 5.0% 10.0% 11.0% 5.2% 12.5% Alcohol or drug use 1.4% 2.0% 1.2% 0.4% 2.1% 0.0% 2.5% 1.9% 2.6% Other 8.5% 6.1% 9.2% 11.1% 7.9% 12.0% 5.5% 4.0% 5.9% None-no health problems 29.9% 44.9% 25.9% 29.7% 40.9% 26.7% 30.2% 49.5% 25.0% Don't know-refused 0.2% 0.9% 0.0% 0.0% 0.0% 0.0% 0.4% 2.0% 0.0% Amount of Stress in Life N=500 N=198 N=302 N=247 N=53 N=194 N=253 N=54 N=199 Very high 12.0% 4.4% 14.1% 10.6% 2.9% 12.7% 13.7% 6.0% 15.8% Somewhat high 35.7% 30.4% 37.2% 33.6% 32.0% 34.0% 38.2% 28.5% 40.8% Somewhat low 32.5% 34.8% 31.9% 37.2% 36.7% 37.3% 27.1% 32.5% 25.7% Very low 18.5% 27.2% 16.2% 17.4% 24.8% 15.3% 19.8% 30.0% 17.1% Don't know-refused 1.2% 3.3% 0.7% 1.3% 3.6% 0.7% 1.1% 2.9% 0.7% Average** Saw or Spoke with a Medical Doctor or Assistant About Health in Past 12 Months N=74 N=9 N=53 N=30 N=2 N=28 N=45 N=3 N=42 Yes 67.4% 67.3% 77.3% 77.3% 59.5% 59.4% No 32.6% 32.7% 22.7% 22.7% 40.5% 40.6% Doctor-Assistant Advised Stopping Smoking in Past 12 Months N=50 N=6 N=36 N=24 N=2 N=22 N=27 N=2 N=25 Yes 77.1% 78.1% 80.9% 82.4% 73.2% 73.7% No 21.8% 21.9% 19.1% 17.6% 24.6% 26.3% Don't know 1.1% 0.0% 0.0% 0.0% 2.2% 0.0% * Weighted total, see Appendix B. ** Averages range from 1.0 to 5.0 or 1.0 to 4.0, with 1.0 representing highest possible rating. Number of respondents too small to analyze statistically. Market Street Research, Inc.-causemedia -11-

12 SMOKING HABITS Adult Cigarette Use: The majority (77.6%) of women interviewed for this study do not smoke at all, and about one-tenth each smoke every day (13.5%) or some days (8.9%) (see Figure A and Table 3). Latina women are significantly more likely than African-American women to smoke (28.3% some days or every day vs. 17.4%). Among all women interviewed, over one-fourth (27.4%) have smoked at least 100 cigarettes in their lifetime. The median age of initiation is 18 among African- American women smokers, and 17 among Latina women smokers. See Figure B for a detailed breakdown of smoking initiation among African-American and Latina women. In the past 30 days, about three-fifths (63.6%) of women smokers smoked every day, and about one-fifth (17.9%) smoked between 16 and 29 days out of the last 30. On an average day, about one-half (46.7%) of women smokers smoke up to five cigarettes a day. About one-third (31.8%) smoke five to ten cigarettes a day, and about one-tenth (14.2%) smoke between 11 and 20 cigarettes a day. A small proportion (3.9%) smoke more than one pack (over 20 cigarettes) per day, with African-American women significantly more likely than Latina women to smoke more than a pack per day (9.1% vs. 0.0%) (see Figure C). In terms of characteristics of smokers, smokers are significantly less likely than non-smokers to be married (22.9% vs. 39.5%), and more likely to be divorced (13.2% vs. 5.2%). Smokers tend to be less affluent than non-smokers (median household income $21,000 vs. $26,000). In addition, smokers are significantly more likely than nonsmokers to have a negative perception of their health (21.2% fair or poor vs. 9.3%), and to report very high stress levels (25.3% vs. 9.4%). Market Street Research, Inc.-causemedia -12-

13 FIGURE A CIGARETTE USAGE AMONG AFRICAN-AMERICAN AND LATINA WOMEN AFRICAN-AMERICAN WOMEN (N=194) Smokes every day 12.7% Smokes some days 4.7% Does not smoke at all 82.7% Smokes every day 14.5% Smokes some days 13.8% LATINA WOMEN (N=199) Does not smoke at all 71.7% Market Street Research, Inc.-causemedia -13-

14 FIGURE B AGE OF INITIATION* 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 9.1% 7.4% 8.8% 12 and younger 5.4% 7.1% 12.5% 16.8% 6.0% 7.1% 7.1% 12.8% or older * Among all African-American and Latina women smokers (N=74). FIGURE C CIGARETTES SMOKED ON AVERAGE DAY 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 50.0% 41.1% 0 to 5 (Less than half a pack) African-American smokers (N=28) Latina smokers (N=45) 27.3% 35.3% 5 to 10 (up to half a pack) 13.6% 14.7% 9.1% 11 to 20 (half to full pack) 0.0% 20+ (more than one pack) Market Street Research, Inc.-causemedia -14-

15 TABLE 3 SMOKING HABITS: ADULT USE TOTAL WOMEN* African- American Women Latina Women Currently Smokes Cigarettes Every Day, Some Days, or Not at All N=393 N=194 N=199 Every day 13.5% 12.7% 14.5% Some days 8.9% 4.7% 13.8% Not at all 77.6% 82.7% 71.7% Smoked at Least 100 Cigarettes in Lifetime N=393 N=194 N=199 Yes 27.4% 26.7% 28.3% No 71.9% 72.7% 71.1% Don't know 0.7% 0.7% 0.7% Age When First Began Smoking Cigarettes on a Regular Basis N=74 N=30 N=46 Never became a regular smoker 3.2% 0.0% 5.7% Less than 9 1.9% 4.3% 0.0% 9 0.0% 0.0% 0.0% % 0.0% 2.9% % 0.0% 2.9% % 4.3% 2.9% % 8.7% 5.7% % 4.3% 11.4% % 4.3% 5.7% % 4.3% 8.6% % 8.7% 14.3% % 21.7% 11.4% % 13.0% 0.0% % 4.3% 8.6% % 4.3% 8.6% 22 or older 12.1% 13.0% 11.4% Don't know-refused 1.9% 4.3% 0.0% Median age Number of Days Smoked in Last 30 Days N=53 N=28 N=42 None 3.5% 0.0% 6.2% 1 to % 18.2% 9.4% 16 to % 9.1% 25.0% Every day 63.6% 72.7% 56.2% Don t know 1.7% 0.0% 3.1% Cigarettes Smoked per Day N=55 N=28 N=45 0 to % 50.0% 44.1% 6 to % 27.3% 35.3% 11 to % 13.6% 14.7% 21 or more 3.9% 9.1% 0.0% Don t know -refused 3.3% 0.0% 5.9% * Weighted total, see Appendix B. Market Street Research, Inc.-causemedia -15-

16 Girl Cigarette Use: In general, most of the girls interviewed for this study have not experimented with smoking. Those who have, however, began at an early age and are likely to continue smoking after their first cigarette. Despite this, few girls interviewed smoke heavily or regularly. Specifically, about one-fifth (21.4%) of the girls interviewed for this study have experimented with smoking, and three-fifths (60.5%) of those who have experimented have smoked a whole cigarette (see Figure D and Table 4). The median age for initiation (i.e., smoking a whole cigarette) among girls is 13. About threefourths (73.6%) of girls who have smoked a whole cigarette have smoked since their first cigarette, and about one-third (30.4%) of girls who have smoked since their first cigarette have smoked at least 100 cigarettes in their lifetime. Among girl smokers, about one-half (46.8%) had their last cigarette less than one month ago. About one-fifth (20.5%) of girl smokers smoked every day in the last 30 days. The number of cigarettes girls smoke on an average day cannot be analyzed accurately, due to the small number of girls who smoke regularly (N=9). In general, however, girl smoking is similar to women s smoking. About one-half of girl smokers smoke up to five cigarettes a day; about one-third smoke five to ten cigarettes a day, and about one-fifth smoke between 11 and 20 cigarettes a day. FIGURE D CIGARETTE USAGE AMONG AFRICAN-AMERICAN AND LATINA GIRLS Among all, ever experimented (N=107) 21.4% If experimented, smoked a whole cigarette (N=23) 60.5% If smoked whole cigarette, smoked since first cigarette (N=14) 73.6% If smoked since first cigarette, smoked 100 cigarettes in lifetime (N=10) 30.4% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Market Street Research, Inc.-causemedia -16-

17 TABLE 4 SMOKING HABITS: GIRL USE TOTAL* African- American Girls Latina Girls Ever Experimented with Smoking N=107 N=53 N=54 Yes 21.4% 21.4% 21.4% No 78.6% 78.6% 78.6% Ever Smoked a Whole Cigarette N=23 N=11 N=11 Yes 60.5% 50.7% 71.9% No 39.5% 49.3% 28.1% Age When Smoked First Whole Cigarette N=14 N=6 N=8 Less than 9 3.8% 9 0.0% % % % % % % % % Don't know-refused 3.6% Median age 13 Smoked Since that First Cigarette N=14 N=6 N=8 Yes 73.6% No 26.4% Smoked at Least 100 Cigarettes in Life N=10 N=5 N=5 Yes 30.4% No 69.6% Smoked Last Cigarette: N=10 N=5 N=5 Less than 1 month ago 46.8% 1 to 2 months ago 4.9% 3 to 6 months ago 21.4% 6 to 12 months ago 0.0% More than 1 year ago 26.9% Don't know-refused 0.0% Number of Days Smoked in Last 30 Days N=19 N=5 N=5 None 57.8% 1 to % 16 to % Every day 20.5% Don t know 5.2% * Weighted total, see Appendix B. Number of respondents too small to analyze statistically. Market Street Research, Inc.-causemedia -17-

18 Reasons for Smoking: We asked women and girl smokers and ex-smokers why they chose to start smoking. Clearly, the major reason for beginning is peer pressure, and smoking because friends are smoking (47.7%) (see Figure E and Table 5). Similarly, almost one-fifth (16.6%) began smoking because they felt smoking is perceived as cool, and it eased acceptance into the in crowd. As a Latina woman said, It was pretty much through peer pressure. I decided to smoke because I thought it was the cool thing to do. I didn t know about the consequences then, and cancer and all that. My friends got me into smoking. I should have never listened to them. Over one-tenth (15.5%) began smoking to relieve stress or settle their nerves. One Latina woman described how she began smoking due to stress, and how stress is a major factor in her decision to continue smoking: [In] college, I had so many papers to write that I would take breaks to have a smoke to take the stress off.... I have a fulltime job and I have an eight month old daughter. Those two aspects of my life can collide and cause a lot of stress.... My daughter makes me nervous and causes stress, and I smoked because of that. Also I had a lot of stresses in my work, just trying to make deadlines. I would always smoke when I was on break just to take the stress off. About one-tenth (11.5%) began smoking out of curiosity. Smaller proportions saw it as something to pass the time (5.3%), enjoyed it (4.5%), felt it was part of socializing and drinking (4.5%), or smoked because their family smoked (4.3%). About one-tenth (11.4%) of women and girls do not know why they began smoking. In terms of differences among smokers, Latina smokers are significantly more likely than African-American smokers to start smoking because it relieves stress (23.0% vs. 9.1%). In addition, girls are somewhat more likely than women to start smoking out of curiosity (25.9% vs. 10.1%), or for stress relief (30.4% vs. 14.1%). Less affluent women (household incomes under $15,000) are more likely to begin smoking for stress relief than more affluent women (37.8% vs. 9.3%). Market Street Research, Inc.-causemedia -18-

19 FIGURE E REASONS FOR BEGINNING TO SMOKE* Peer pressure 47.7% Pass the time Curiosity Cool, with "in crowd" Relieves stress Family smoked Part of socializing, drinking Enjoyed it 5.3% 11.5% 16.6% 15.5% 4.3% 4.5% 4.5% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% * Among all African-American and Latina women and girl smokers and ex-smokers (N=117). Reasons for Not Smoking: We asked women and girls who never began smoking what prevented them from starting. Non-smokers had a variety of reasons for not beginning to smoke, including: they were educated about the adverse health risks of smoking (45.0%); concerns about the cosmetic and aesthetic effects of smoking, such as premature aging and odor (39.1%); smoking was generally not appealing or interesting to them (21.2%); family and friends did not smoke (16.0%); and family and friends did smoke, and suffered health problems as a result (14.5%). Smaller proportions had other reasons for not beginning to smoke. For a Market Street Research, Inc.-causemedia -19-

20 complete list of reasons, refer to Table 5. Women and girls differ in terms of what prevents them from smoking. Specifically: women are more likely than girls to be affected by cosmetic and aesthetic effects of smoking, and by the fact that their family and friends do not smoke; and girl are more likely than women to be educated about the adverse health effects of smoking, and say that anti-smoking ad campaigns affect their attitudes about smoking. Smoking Habits: Smokers are divided in terms of where and when they choose to smoke, with about one-fifth (21.9%) smoking mainly with other people, about one-third (33.0%) smoking mainly by themselves, and about two-fifths (43.2%) smoking as often by themselves as among other people (see Table 5). About three-fifths (59.5%) of smokers smoke regardless of the setting they are in, while about two-fifths (40.5%) smoke mainly in specific situations (see Figure F). Those who smoke mainly in specific situations often smoke at home (61.6%), and some smoke mainly when in bars, clubs, or other entertainment venues (41.1%). About one-fifth (21.4%) smoke mainly in other types of social situations, such as when visiting a friend s home. Some also smoke mainly at work (16.0%), in cars (9.8%), or at restaurants (8.7%). FIGURE F WHERE WOMEN AND GIRLS SMOKE Most settings Specific situations 40.5% 59.5% Among all women and girl smokers, N=74. At home 61.6% At work 16.0% In cars Bars, clubs, entertainment 9.8% 41.1% Among women and girl smokers who smoke in specific situations, N= 30. Restaurants 8.7% Other social situations 21.4% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Market Street Research, Inc.-causemedia -20-

21 In general, smokers are conscious of the adverse effects of second-hand smoke, and most say they would smoke somewhere else if they were in the company of a non-smoker or refrain from smoking, and if that was not possible, they would open a window. Specifically: about four-fifths (81.3%) of all smokers say they smoke in their homes. If a non-smoker was in their home, many would go outside to smoke (32.1%) or smoke in another room with the door closed (28.6%). About one-tenth each would refrain from smoking (11.0%), or say their decision would depend on who the non-smoker was (10.7%); and about three-fifths (57.4%) of all smokers say they smoke while driving. If a non-smoker was in the car with them while they were driving, many would refrain from smoking (43.1%), while others would smoke in that person s presence, but open the window (28.8%). About one-fifth (22.4%) say their decision would depend on who the non-smoker was. Market Street Research, Inc.-causemedia -21-

22 TABLE 5 SMOKING DECISION-MAKING TOTAL* Girls Women AFRICAN-AMERICAN LATINA Total Girls Women Total Girls Women Reasons Started Smoking N=117 N=19 N=82 N=58 N=5 N=53 N=59 N=5 N=54 Peer pressure-did what friends did 47.7% 50.2% 47.5% 48.7% 46.3% 46.6% 48.8% To be cool-be with In Crowd 16.6% 10.1% 17.3% 18.6% 19.5% 14.4% 14.6% Relieves stress-settles nerves 15.5% 30.4% 14.1% 9.1% 7.3% 23.0% 22.0% Curious what it was like 11.5% 25.9% 10.1% 15.2% 14.6% 7.1% 4.9% Saw it as something to pass the time 5.3% 5.2% 5.3% 8.9% 9.8% 1.0% 0.0% Part of socializing-drinking 4.5% 0.0% 4.9% 4.4% 4.9% 4.5% 4.9% Enjoyed it 4.5% 0.0% 4.9% 4.4% 4.9% 4.5% 4.9% Family smokes-did what they did 4.3% 0.0% 4.7% 2.2% 2.4% 6.7% 7.3% Other 8.5% 5.2% 8.8% 11.1% 12.2% 5.4% 4.9% Don t know-nothing 11.4% 4.9% 12.0% 9.7% 9.8% 13.4% 14.6% Reasons Never Smoked Cigarettes N=383 N=179 N=220 N=189 N=48 N=141 N=194 N=49 N=146 Educated about toxicity-adverse health risks 45.0% 69.0% 36.9% 46.9% 74.4% 37.6% 42.7% 62.6% 36.0% Cosmetic-aesthetic concerns-smellwrinkles-etc 39.1% 30.1% 42.1% 37.6% 29.6% 40.4% 40.8% 30.7% 44.1% Not appealing-interesting to me 21.2% 14.0% 23.7% 25.9% 15.6% 29.4% 15.9% 12.1% 17.1% Parents-family-friends don t smoke 16.0% 8.2% 18.6% 15.7% 7.8% 18.3% 16.3% 8.6% 18.9% Parents-family-friends do smoke-got sick 14.5% 11.7% 15.5% 10.4% 11.4% 10.1% 19.2% 12.0% 21.6% Have allergies-asthma-aggravates other conditions 7.8% 6.5% 8.3% 4.6% 7.5% 3.7% 11.5% 5.5% 13.5% Against religion-beliefs 7.6% 3.7% 8.9% 5.9% 4.2% 6.4% 9.6% 3.1% 11.7% Tried-didn t like-tasted bad-made sick 7.3% 8.4% 6.9% 8.5% 9.0% 8.3% 5.9% 7.5% 5.4% Didn t think was cool 4.3% 4.7% 4.2% 4.9% 3.2% 5.5% 3.6% 6.4% 2.7% They are addictive-don t want to be an addict 3.8% 8.6% 2.2% 3.8% 12.4% 0.9% 3.7% 4.1% 3.6% Have children-don t want to smoke around them 3.5% 0.7% 4.5% 3.1% 1.3% 3.7% 4.1% 0.0% 5.4% Very athletic-would have interfered 2.1% 4.4% 1.3% 2.0% 5.2% 0.9% 2.2% 3.4% 1.8% Anti-tobacco ads hit home 1.8% 5.5% 0.5% 2.1% 5.5% 0.9% 1.4% 5.5% 0.0% Other 4.7% 4.7% 4.8% 6.1% 2.3% 7.3% 3.2% 7.5% 1.8% Don t know-nothing 4.6% 2.1% 5.5% 4.4% 1.0% 5.5% 4.9% 3.4% 5.4% Smokes Alone or with Others N=74 N=9 N=53 N=30 N=2 N=28 N=45 N=3 N=42 Mainly with other people 21.9% 20.2% 22.1% 18.2% 21.8% 21.9% Mainly alone 33.0% 35.3% 34.0% 36.4% 32.2% 34.4% As often by self as with others 43.2% 42.5% 39.7% 40.9% 46.0% 43.7% Don't know 1.9% 2.0% 4.2% 4.5% 0.0% 0.0% Smokes in Most Settings or Only in Specific Situations N=74 N=9 N=53 N=30 N=2 N=28 N=45 N=3 N=42 Most settings 59.5% 59.0% 56.0% 54.5% 62.3% 62.5% Specific situations 40.5% 41.0% 44.0% 45.5% 37.7% 37.5% Don't know 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% * Weighted total, see Appendix B. Number of respondents too small to analyze statistically. Market Street Research, Inc.-causemedia -22-

23 TABLE 5 (continued) TOTAL* Girls Women AFRICAN-AMERICAN LATINA Total Girls Women Total Girls Women Specific Settings Smokes in N=30 N=3 N=22 N=13 N=0 N=13 N=17 N=1 N=16 Home 61.6% 61.3% 86.9% 90.0% 37.9% 33.3% Work 16.0% 16.9% 0.0% 0.0% 31.1% 33.3% Cars 9.8% 8.4% 0.0% 0.0% 18.9% 16.7% Bars, clubs, entertainment venues 41.1% 41.6% 51.7% 50.0% 31.1% 33.3% Restaurants 8.7% 9.2% 9.7% 10.0% 7.8% 8.3% Other soc situations-friends' homes 21.4% 22.5% 19.3% 20.0% 23.3% 25.0% School [GIRLS ONLY] 1.7% 0.0% 3.4% 0.0% 0.0% 0.0% Other 9.8% 8.4% 0.0% 0.0% 18.9% 16.7% Frequency of Smoking at Home N=74 N=9 N=53 N=30 N=2 N=28 N=45 N=3 N=42 Frequently 48.0% 48.3% 75.2% 77.3% 26.0% 25.0% Sometimes 18.4% 19.6% 8.5% 9.1% 26.4% 28.1% Rarely 14.9% 15.9% 4.2% 4.5% 23.4% 25.0% Never 18.8% 16.2% 12.1% 9.1% 24.2% 21.9% Don't know-refused 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% Average** Action Would Take if Wanted to Smoke at Home, but a Non-Smoker Was There N=60 N=4 N=45 N=27 N=1 N=26 N=34 N=1 N=33 Go outside to smoke 32.1% 32.4% 21.0% 20.0% 42.5% 44.0% Smoke in another room with door closed 28.6% 26.9% 30.7% 30.0% 26.6% 24.0% Not smoke at all 11.0% 11.4% 14.5% 15.0% 7.7% 8.0% Depends on the non-smoker 10.7% 11.0% 9.7% 10.0% 11.6% 12.0% Smoke in that person's presence 8.7% 9.0% 9.7% 10.0% 7.7% 8.0% Smoke, but near a window 7.0% 7.2% 14.5% 15.0% 0.0% 0.0% Don't know-refused 2.0% 2.1% 0.0% 0.0% 3.9% 4.0% Frequency of Smoking While Driving N=74 N=9 N=53 N=30 N=2 N=28 N=45 N=3 N=42 Frequently 22.2% 22.3% 21.2% 22.7% 23.1% 21.9% Sometimes 13.3% 13.6% 21.2% 22.7% 7.0% 6.2% Rarely 21.9% 23.4% 12.7% 13.6% 29.3% 31.2% Never 37.4% 35.3% 40.6% 36.4% 34.8% 34.4% Don't know-refused 5.1% 5.5% 4.2% 4.5% 5.9% 6.2% Average** Action Would Take if Wanted to Smoke While Driving, but a Non- Smoker Was There N=43 N=3 N=32 N=17 N=0 N=17 N=27 N=2 N=25 Not smoke at all 43.1% 43.4% 38.5% 38.5% 46.6% 47.4% Smoke, but open a window 28.8% 28.8% 38.5% 38.5% 21.6% 21.1% Depends on the non-smoker 22.4% 22.0% 23.1% 23.1% 21.9% 21.1% Smoke in that person's presence 5.6% 5.8% 0.0% 0.0% 9.9% 10.5% Stop the car to smoke outside 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% Don't know-refused 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% Other People in Household Smoke N=500 N=198 N=302 N=247 N=53 N=194 N=253 N=54 N=199 Yes 17.6% 25.7% 15.4% 16.8% 27.1% 14.0% 18.6% 24.1% 17.1% No 75.0% 70.1% 76.3% 76.0% 68.5% 78.0% 73.8% 71.9% 74.3% No one else in household 7.3% 3.6% 8.3% 7.0% 3.2% 8.0% 7.6% 4.0% 8.6% Don't know-refused 0.1% 0.6% 0.0% 0.3% 1.2% 0.0% 0.0% 0.0% 0.0% * Weighted total, see Appendix B. ** Averages range from 1.0 to 4.0, with 1.0 representing highest possible rating. Number of respondents too small to analyze statistically. Market Street Research, Inc.-causemedia -23-

24 Effect of Household Members on Smoking: Among all women and girls interviewed for this study, less than one-fifth (17.6%) say someone else in their household smokes. Girls are more likely to have a smoker in their household than women (25.7% vs. 15.4%). In general, non-smokers likelihood of smoking is relatively unaffected by their household members, or they feel they are less likely to start smoking, regardless of whether the other members of their household smoke. The smoking habits of other household members clearly has an effect on smokers, with smokers more likely to smoke if they live with other smokers, and more likely to consider quitting if they live with non-smokers (see Figure G and Table 6). Although the number of girl smokers is too small to analyze the effects of household members on their behavior, they are generally similar to women. Specifically: women smokers are significantly more likely to say they are more likely to smoke or want to smoke more in smoking households than in non-smoking households (21.2% vs. 2.9%); and women smokers are significantly more likely to want to quit or smoke less if they live in a non-smoking household, than in a smoking household (81.7% vs. 29.7%). FIGURE G EFFECT OF HOUSEHOLD ENVIRONMENT ON SMOKING* 100% 90% 80% 70% 60% Smoking women in nonsmoking household (N=42) Smoking women in smoking household (N=24) 81.7% 50% 40% 30% 21.2% 29.7% 20% 10% 0% 2.9% More likely to smoke More likely to quit * Among women smokers (N=66). The number of girl smokers is too small to analyze their behavior accurately. Market Street Research, Inc.-causemedia -24-

25 TABLE 6 EFFECT OF HOUSEHOLD MEMBERS ON SMOKING NON-SMOKERS (WOMEN AND GIRLS)* Other People in Household Smoke Other People in Household Do Not Smoke Women Girls Women Girls Effect of Others in Household Being/Not Being Smokers on Feelings About Starting Smoking N=37 N=24 N=259 N=73 More likely to start smoking 0.0% 0.0% 0.0% 0.0% Has not affected respondent at all 55.7% 46.8% 53.4% 45.5% Less likely to start smoking 44.3% 53.2% 43.1% 52.0% Don't know-refused 0.0% 0.0% 3.5% 2.6% SMOKERS (WOMEN ONLY)* Other People in Household Smoke Other People in Household Do Not Smoke Effect of Others in Household Being/Not Being Smokers on Feelings About Quitting Smoking N=24 N=42 More likely to smoke or smoke more 21.2% 2.9% Has not affected respondent at all 38.1% 12.5% More likely to quit, or to smoke less 29.7% 81.7% Don't know-refused 11.0% 2.9% * Weighted data, see Appendix B. SMOKING CESSATION About two-fifths (41.1%) of smokers feel they could quit anytime they wanted, while about three-fifths (57.4%) feel they are unable to quit anytime (see Figure H and Table 7). Although the proportion of girl smokers is too small to analyze their attitudes accurately (N=9), girls are generally more likely than women to feel they could quit at any time. In the past year, about three-fifths (62.8%) of smokers have made a serious attempt to quit smoking. In other words, despite the fact that many feel quitting will be a major challenge, many have made the attempt. Among ex-smokers, the majority quit between two to five years ago (37.2%) or more than five years ago (44.4%), and about one-fifth (18.3%) quit more recently, within the past year. Those who have made a serious attempt to quit in the past year have primarily used informal support systems, such as trying to quit smoking with a friend or relative who smokes (46.6%), and friends or relatives offering support to help them Market Street Research, Inc.-causemedia -25-

26 quit smoking (44.1%) (see Figure I). Some smokers used formal support systems. About one-tenth (13.8%) called telephone help lines. Only one individual went to a smoking-related web site. Among women and girls who received support from friends and relatives, about two-thirds (68.1%) said it was very or somewhat effective. Those who found this support effective had a variety of reasons for finding it helpful, including that their friends and relatives involvement and presence kept their thoughts off smoking (25.0%); quitting smoking with a friend or relative provided moral support from someone who could empathize with their situation (21.2%); it helped to talk to friends and relatives who had personally suffered from smoking (16.7%); receiving positive reinforcement and encouragement from friends and relatives was helpful, as opposed to criticism (13.4%); and that friends and relatives reminded them of adverse health effects whenever they wanted to smoke (11.8%). Individuals had other reasons for finding the support of family and friends helpful. Could Quit Anytime They Wanted To FIGURE I SMOKING CESSATION: DESIRE* Serious Attempt to Quit in Past Year Yes 41.1% Yes 62.8% Don't know 1.6% No 57.3% No 37.2% * Among women and girl smokers (N=77). Market Street Research, Inc.-causemedia -26-

27 FIGURE I SUPPORT SYSTEMS USED* 100% 90% 80% 70% 60% 50% 46.6% 44.1% 40% 30% 20% 10% 13.8% 2.9% 0% Telephone help line Web site Quit with friend or relative Friend or relative offered support * Among those who have made a serious attempt to quit smoking in the past year (N=48). TABLE 7 SMOKING CESSATION TOTAL* Girls Women AFRICAN-AMERICAN LATINA Total Girls Women Total Girls Women Respondent Believes She Can Quit Smoking Any Time She Wants to N=77 N=9 N=55 N=30 N=2 N=28 N=47 N=3 N=45 Yes 41.1% 38.5% 32.1% 27.3% 47.9% 47.1% No 57.4% 59.8% 67.9% 72.7% 49.3% 50.0% Don't know 1.6% 1.7% 0.0% 0.0% 2.8% 2.9% Made a Serious Attempt to Quit Smoking in Past Year N=77 N=9 N=55 N=30 N=2 N=28 N=47 N=3 N=45 Yes 62.8% 63.4% 48.2% 50.0% 73.9% 73.5% No 37.2% 36.6% 51.8% 50.0% 26.1% 26.5% When Quit Smoking N=36 N=0 N=28 N=23 N=0 N=23 N=12 N=0 N=12 Within the past year 18.3% 18.3% 16.7% 16.7% 22.2% 22.2% 2 to 5 years ago 37.2% 37.2% 38.9% 38.9% 33.3% 33.3% More the 5 years ago 44.4% 44.4% 44.4% 44.4% 44.4% 44.4% Don't know 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% Called a Telephone Help Line for Smoking Cessation N=48 N=5 N=35 N=15 N=0 N=14 N=35 N=2 N=33 Yes 13.8% 14.5% 26.4% 27.3% 7.5% 8.0% No 86.2% 85.5% 73.6% 72.7% 92.5% 92.0% * Weighted total, see Appendix B. Number of respondents too small to analyze statistically. Market Street Research, Inc.-causemedia -27-

28 TABLE 7 (continued) TOTAL* Girls Women AFRICAN-AMERICAN LATINA Total Girls Women Total Girls Women Gone to Any Web Site on Internet Relating to Smoking Cigarettes N=48 N=5 N=35 N=15 N=0 N=14 N=35 N=2 N=33 Yes 2.9% 3.1% 8.8% 9.1% 0.0% 0.0% No 97.1% 96.9% 91.2% 90.9% 100.0% 100.0% Tried Quitting with Someone Else N=48 N=5 N=35 N=15 N=0 N=14 N=35 N=2 N=33 Yes 46.6% 43.6% 29.6% 27.3% 55.0% 52.0% No 53.4% 56.4% 70.4% 72.7% 45.0% 48.0% Friend or Relative Offered Support to Help Respondent Quit Smoking N=48 N=5 N=35 N=15 N=0 N=14 N=35 N=2 N=33 Yes 44.1% 41.0% 29.6% 27.3% 51.3% 48.0% No 55.9% 59.0% 70.4% 72.7% 48.7% 52.0% Effectiveness of Support Friend or Relative Offered N=21 N=5 N=14 N=4 N=0 N=4 N=18 N=2 N=16 Very effective 19.3% 14.0% 13.3% 8.3% Somewhat effective 48.8% 52.7% 54.3% 58.3% Somewhat ineffective 17.0% 19.3% 21.9% 25.0% Very ineffective 14.8% 14.0% 10.5% 8.3% Don't know 0.0% 0.0% 0.0% 0.0% Average** Ways in Which Support Was Effective N=14 N=4 N=10 N=3 N=0 N=3 N=12 N=2 N=10 Involvement-presence kept thoughts away from smoking 25.0% 29.0% 32.4% 37.5% Moral support-stopping togethercould sympathize 21.2% 21.0% 14.9% 12.5% Talking about family-friends who had suffered from smoking 16.7% 19.3% 21.6% 25.0% Said positive things-encouraged without saying negative things 13.4% 11.3% 4.7% 0.0% Kept reminding respondent of dangers whenever wanted to smoke 11.8% 9.7% 10.8% 12.5% Had information too-to seminarsprograms about quitting 8.3% 9.7% 10.8% 12.5% Family member-friend health advisorpresence kept from smoking 3.6% 0.0% 4.7% 0.0% Don t know 8.3% 9.7% 10.8% 12.5% * Weighted total, see Appendix B. ** Averages range from 1.0 to 4.0, with 1.0 representing highest possible rating. Number of respondents too small to analyze statistically. Market Street Research, Inc.-causemedia -28-

29 ATTITUDES TOWARD SMOKING In order to gain an understanding of how cigarettes and smoking are perceived among African-American and Latina women and girls, we asked women and girls about their attitudes relating to various cosmetic effects, adverse health effects, and social/media issues regarding smoking. Overall, the findings indicate that women and girls generally believe much of what they hear about the adverse cosmetic and health effects of smoking, although some still see smoking positively, such as a means of stress reduction, method of weight control, or for ensuring easier deliveries. In terms of the cosmetic effects of smoking, most women and girls believe that smoking yellows teeth (95.6%) and smells bad (95.0%), and only a few individuals feel that smoking makes smokers look more attractive (3.9%) (see Table 8). However, about one-fifth (23.1%) believe that smoking helps to control weight. Most women and girls believe most of what they hear about the adverse health effects of smoking. They are most likely to believe information about specific smokingrelated illness, such as lung cancer. Specifically: in terms of smoking-related illness, almost all (98.4%) women and girls believe that smoking makes people more likely to get lung cancer, heart disease, and other serious health problems. Most (90.4%) believe that inhaling someone else s cigarette smoke can cause lung cancer in non-smokers; in terms of usage and relative risk, only a small proportion (8.6%) believe that there are a certain number of cigarettes you can smoke and not harm your health. Despite this, about one-fifth (22.5%) believe that if you have only smoked for a short time, it is not dangerous. Most (87.2%) believe a smoker s health would improve if they quit smoking now; and in terms of the dangers of smoking while pregnant, almost all (95.5%) women and girls believe smoking while pregnant is harmful to the developing baby. Despite this, however, about one-tenth (13.2%) of women and girls feel that smaller babies and easier deliveries are good reasons for smoking while pregnant. Women s and girl s attitudes about social issues and media relating to smoking are complex. Although most tend to believe the information they hear about the cosmetic and health effects of smoking, some also believe this information is exaggerated and that smoking is normative, and effective at reducing stress. They have somewhat divided opinions regarding the image and future success of young smokers. Specifically: in terms of anti-smoking campaigns, about one-fourth (24.9%) of women and girls believe that anti-smoking organizations such as the Department of Public Market Street Research, Inc.-causemedia -29-

30 Health exaggerate the health consequences of smoking to keep people from smoking or to get them to quit. In addition, about one-fifth (23.0%) believe antismoking organizations exaggerate how addictive smoking is to keep people from smoking or to get them to quit; in terms of girls and smoking, about three-fifths (62.0%) of women and girls believe that most teenagers smoke cigarettes. About three-fifths (58.0%) of women and girls believe that smoking gives teenage girls a bad reputation, and about one-third (30.9%) believe teenagers who smoke are less likely to have successful futures than teenagers who do not smoke; and about two-fifths (43.6%) of smokers surveyed believe that cigarette smoking helps reduce stress. Women and girls differed from each other in terms of their attitudes about some of these attitudes, as did smokers, non-smokers, and ex-smokers, and Latinas and African-American women and girls. Specifically: women are more likely than girls to believe smoking helps control weight, that a smoker s health will improve if they quit smoking now, and that smoking while pregnant is harmful to the developing baby; girls are more likely than women to believe that most teenage girls smoke cigarettes, that smoking gives teenage girls a bad reputation, and that teenage girls who smoke will have less successful futures than non-smokers. They are also more likely to believe, however, that there are a certain number of cigarettes that you can smoke and not harm your health, and that antismoking organizations exaggerate the health consequences and addictiveness of smoking; non-smokers are more likely than smokers to believe smoking smells bad, yellows teeth, gives teenage girls a bad reputation, and that teenage smokers will have less successful futures than non-smokers; smokers are more likely than non-smokers to believe that their health will improve if they quit smoking now, and that there are a certain number of cigarettes people can smoke and not harm their health; ex-smokers are more likely than non-smokers to believe smoking helps control weight, and are less likely to think it gives teenage girls a bad reputation; Latina women and girls are significantly more likely than African-American women and girls to believe that smaller babies and easier deliveries are good reasons to smoke while pregnant. Market Street Research, Inc.-causemedia -30-

31 TABLE 8 ATTITUDES TOWARD SMOKING TOTAL* Girls Women AFRICAN-AMERICAN LATINA Total Girls Women Total Girls Women Respondent Agrees with the Following Statements: N=500 N=198 N=302 N=247 N=53 N=194 N=253 N=54 N=199 Smoking makes people more likely to get lung cancer, heart disease, and other serious health problems 98.4% 99.1% 98.3% 97.9% 100.0% 97.3% 99.1% 98.0% 99.3% Smoking makes a person's teeth yellow 95.6% 96.0% 95.5% 93.7% 95.0% 93.3% 97.8% 97.1% 98.0% Smoking is harmful to the baby if you are pregnant 95.5% 91.0% 96.7% 95.4% 88.2% 97.3% 95.7% 94.2% 96.1% Smoking makes people smell bad 95.0% 96.5% 94.6% 94.6% 96.8% 94.0% 95.5% 96.1% 95.4% Inhaling someone else's cigarette smoke can cause lung cancer in non-smokers 90.4% 86.9% 91.4% 87.1% 86.5% 87.3% 94.2% 87.4% 96.1% A smoker's future health would improve if she quit smoking now 87.2% 82.2% 88.5% 87.7% 79.1% 90.0% 86.6% 85.8% 86.8% Most teenagers smoke cigarettes 62.0% 69.9% 59.8% 49.8% 61.5% 46.7% 76.0% 79.6% 75.0% Smoking gives teenage girls a bad reputation 58.0% 70.3% 54.6% 54.4% 68.1% 50.7% 62.1% 73.0% 59.2% Cigarette smoking helps reduce stress 43.6% 69.2% 41.9% 29.0% 54.1% 27.3% 54.7% 82.0% 52.9% Teenagers who smoke are less likely to have successful futures than teenagers who do not smoke 30.9% 46.0% 26.9% 27.0% 40.3% 23.3% 35.5% 52.8% 30.9% Anti-smoking organizations like the DPH exaggerate the health consequences of smoking to keep people from smoking or get them to quit 24.9% 35.9% 22.0% 27.4% 42.5% 23.3% 22.1% 28.3% 20.4% Smoking helps people control their weight 23.1% 12.5% 25.9% 23.6% 9.7% 27.3% 22.5% 15.8% 24.3% Anti-smoking organizations like the DPH exaggerate how addictive smoking is to keep people from smoking or get them to quit 23.0% 38.5% 18.9% 23.6% 41.5% 18.7% 22.5% 35.1% 19.1% If you have only smoked for a short time, it is not dangerous 22.5% 27.2% 21.2% 20.4% 31.8% 17.3% 24.8% 21.8% 25.7% A good reason to smoke while pregnant is that the baby will be smaller and easier to deliver 13.2% 11.9% 13.6% 9.9% 9.4% 10.0% 17.1% 14.9% 17.8% There are a certain number of cigarettes you can smoke and not harm your health 8.6% 13.1% 7.4% 6.7% 11.5% 5.3% 10.9% 14.9% 9.9% Smoking makes people look more attractive 3.9% 4.8% 3.7% 4.3% 5.6% 4.0% 3.4% 3.9% 3.3% * Weighted total, see Appendix B. Market Street Research, Inc.-causemedia -31-