Fighting Tobacco Use Among Blacks
Pilot projects at NCCU, Morgan State train students to be better informed on tobacco issues
By Eleanor Lee YatesSignificant pilot projects at two historically Black colleges and universities will train students to gather more data and address the problems facing African American smokers. The programs may well provide policy models for other HBCUs around the country.
North Carolina Central University (NCCU) in Durham, N.C. and Morgan State University in Baltimore are among 40 organizations receiving part of a $21 million grant from the American Legacy Foundation. The nonprofit organization, whose goal is to decrease tobacco use in the United States, was founded as part of the 1998 settlement between 46 states and the major tobacco companies. American Legacy's Priority Population program grants are aimed at fighting tobacco use among racial and ethnic minorities, low-income and other populations.
African Americans are no more likely to smoke than Whites — the smoking rate is 26.7 percent for African American adults compared with 25.3 percent for Whites. But they are more likely to suffer from and die of lung cancer and related problems than Whites because of limited access to health care, later detection, less aggressive treatment and other factors. According to the Centers for Disease Control and Prevention (CDC), about 45,000 African Americans die of a preventable smoking-related disease annually. Smoking is responsible for 87 percent of lung cancer cases, and African American men are at least 50 percent more likely to develop lung cancer than White men. However, by most accounts the tobacco control movement traditionally has been a White initiative. The American Legacy Foundation, however, hopes to raise awareness.
NCCU's $100,000 pilot program goal is to develop leadership, advocacy and coalition-building skills on tobacco issues. The program centers on a two-semester class, which begins next spring. Students gather information about smoking rates, students' habits and the effectiveness of non-smoking policies on the NCCU campus. Students will learn important health information as well as hone future career skills, say grant principal investigators Dr. David Jolly, an assistant professor of health education and Dr. Patricia Wigfall, associate professor of public administration at NCCU. Students will conduct surveys, interviews and focus groups. In addition, they will talk to organizations and invite health researchers to come speak. During the second semester, students will assess the data and learn how to identify policy initiatives. Jolly says students probably would select two initiatives to pursue. Examples of final initiatives might be whether the university should expand smoking cessation efforts or more strictly enforce its non-smoking policy. The students' work likely will expand to the city of Durham.
"The course will allow students to look at how public policy is made and what influences public policy," Wigfall says. "One goal is to give students the public policy skills to be players."
The project also will create a more knowledgeable citizenry, Jolly says. "They will leave the course better informed about tobacco."
Statistics from the surgeon general report that the smoking rate among Black teen-agers rose sharply in the 1990s after two decades of decline. Kenneth Ray of the state branch of Tobacco Prevention and Control sees the tobacco industry increasingly targeting college campuses through publications and other outlets. He says many young Blacks, like Whites, begin to smoke in middle school and high school.
"By the time they get on campus they may have been smoking five or six years," Ray says. "Young people need to be more aware of the problems of smoking."
Helen Lettlow, director of program development for American Legacy's Priority Populations program, says teens may experiment with tobacco but heavier use typically comes after high school.
"And when they're hooked, they're hooked," she says. According to the CDC, the cessation rate is lower for Blacks than for Whites, 35 percent and 50 percent respectively.
Morgan State University's grant will enable graduate students in the School of Public Health to sharpen their research skills and become astute about public policy as well as health   issues. Students will be part of a mentoring program with the Maryland Health and Hygiene Department in Baltimore. Students also will work with Morgan State faculty. Through the program, students will learn about public policy issues and explore the enforcement of laws such as selling tobacco to minors. They also will look at policies on tobacco advertisements and clean indoor air, as well as campus smoking policies.
Principal investigator of the project at Morgan State is Dr. Dorothy Browne, director of the Prevention Research Center and director of the Drug Abuse Research Program and professor in the School of Public Health. According to Browne, students will learn how to research public health data to identify whether the health of certain groups is affected disproportionately.
"There are still not many African Americans in this research," Browne says. "Because the consequences are greater for African Americans who smoke, we need to get our students interested in data analysis. And we want to train our students who go on to agencies to be proficient," she says.
Students will conduct surveys primarily on campus, then analyze the data. They will learn to prepare reports from a scientific perspective, Browne says. The students will prove invaluable to the Department of Health and Hygiene because of an economy-related manpower shortage.
Both universities' applications for the pilot projects immediately sparked the interest of the American Legacy grant selection panel.
"Both are fascinating projects and have the potential to become future model programs for national replication," Lettlow says. "We need to train new researchers in the tobacco field. And the skills the students are learning can be applied to other health areas, such as diabetes." She added that students will bring a fresh perspective to these health issues.
"They have an amazing power to influence parents and can broaden the health agenda," Lettlow says. "Students can point the way. They will help adults hear the information for the first time again."   

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