Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #114201

Katherine Clegg Smith, PhD¹, Lee Bone, MPH, RN², Frances Stillman, EdD³, Precilla Lorene Belin, PhD, MA, CHES⁴, Emmanuel Price⁵, and Norman Yancey⁵. (1) Health Policy and Management, Johns Hopkins University, 624 N. Broadway, Baltimore, MD 21205, 410 502-0025, kasmith@jhsph.edu, (2) Department of Health Policy & Management, Johns Hopkins University, Bloomberg School of Public Health, Hampton House 608, Baltimore, MD 21205, (3) Bloomberg School of Public Health, Johns Hopkins, 615 N. Wolfe Street, Baltimore, MD 21209, (4) Public Health Program, Morgan State University, Jenkins Bldg. 343, 1700 East Cold Spring Lane, Baltimore, MD 21251, (5) Sandtown Winchester, Community Building in Partnership, 1135 Gilmor Street, Baltimore, MD 21217

Smoking prevalence and initiation rates among the 18-24 year old young adult, unemployed, blue-collar, low socioeconomic population are rising (Lawrence et al. 2003), and yet inner-city young adults are largely ignored in existing studies. In this pilot project, we adopted a community-based participatory research (CBPR) approach to explore the factors influencing an observed increase in young adult initiation in Baltimore City from 24.7% in 2000 to 39.8% in 2002 (MD DHMH 2002). Our findings indicate that policy initiatives such as tax increases yield community appropriate behavioral responses such as collective purchasing of cigarettes, buying ‘loosies' and an significant social value being placed on informal exchange through sharing and bumming.

Here, we present the two first stages of our three stage exploratory study. We discuss results from four focus groups with 36 African-American young adults participating in work programs, and a community mapping of tobacco outlets and outdoor single cigarette sales in the community in which the work programs are housed. The focus of the community mapping resulted from the focus group data.

Our analysis revealed communal norms as to the acceptability and usefulness of smoking within this stressful environment as well as intricate rules and strategies around sharing, buying and smoking cigarettes that fit easily into a wider, shared cultural context. Our findings suggest that successful policy formation and implementation requires consideration of the availability of culturally appropriate strategies that facilitate the avoidance of the desired behavior change.

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