Intergenerational differences in smoking among West Indian, Haitian, Latin American, and African blacks in the United States.

Due in large part to increased migration from Africa and the Caribbean, black immigrants and their descendants are drastically changing the contours of health disparities among blacks in the United States. While prior studies have examined health variation among black immigrants by region of birth, few have explored the degree of variation in health behaviors, particularly smoking patterns, among first- and second- generation black immigrants by ancestral heritage. Using data from the 1995-2011 waves of the Tobacco Use Supplements of the Current Population Survey (TUS-CPS), we examine variation in current smoking status among first-, second-, and third/higher- generation black immigrants. Specifically, we investigate these differences among all black immigrants and then provide separate analyses for individuals with ancestry from the English-speaking Caribbean (West Indies), Haiti, Latin America, and Africa-the primary sending regions of black immigrants to the United States. We also explore differences in smoking behavior by gender. The results show that, relative to third/higher generation blacks, first-generation black immigrants are less likely to report being current smokers. Within the first-generation, immigrants who migrated after age 13 have a lower probability of smoking relative to those who migrated at or under age 13. Disparities in smoking prevalence among the first-generation by age at migration are largest among black immigrants from Latin America. The results also suggest that second-generation immigrants with two foreign-born parents are generally less likely to smoke than the third/higher generation. We find no statistically significant difference in smoking between second-generation immigrants with mixed nativity parents and the third or higher generation. Among individuals with West Indian, Haitian, Latin American, and African ancestry, the probability of being a current smoker increases with each successive generation. The intergenerational increase in smoking, however, is slower among individuals with African ancestry. Finally, with few exceptions, our results suggest that intergenerational gaps in smoking behavior are larger among women compared to men. As additional sources of data for this population become available, researchers should investigate which ancestral subgroups are driving the favorable smoking patterns for the African origin population.