Racism linked to uptake of smoking in young people

Published in PLOS ONE, the study analysed questionnaire and interview data from the Determinants of young Adult Social well-being and Health (DASH) study, one of the UK's largest longitudinal studies of ethnically diverse young people.

Information about smoking and experiences of racism was collected from over 6500 pupils at 51 London schools. Surveys were completed when pupils were aged 11-13 and then again with 4785 of the pupils at age 14-16. Over 600 participants were then followed up aged 21-23 as part of a pilot study and 42 undertook qualitative interviews.

The team, working in collaboration with researchers at UCL and the MRC Social and Public Health Sciences Unit at the University of Glasgow, discovered that the young people they studied were around 80 per cent more likely to have smoked if they also indicated that they had experienced some form of racism. The findings support theories from previous studies that have suggested racism can trigger a stress response that results in risky health behaviours, such as smoking.

The study also found:

• Those who reported racism at both 11-13 and 14-16 were around 80 per cent more likely to report smoking for the first time by the time they were 16
• Similar associations were shown between reported racism and having smoked at any time in their young lives
• Those who reported good relationships with their families or regularly attending a place of worship were less likely to smoke
• Less than 20 per cent of ethnic minority participants reported no religion
• Young people from ethnic minority backgrounds were still less likely to smoke than their White British peers
• The link with religious adherence cannot be proven by this study but around 40 per cent of White British participants reported no religion

Whilst the study cannot show any causation, the links suggested by the quantitative analysis were supported by the outcomes of the qualitative interviews. These interviews highlighted persistent exposure to racism from an early age and the positive impact of parental and religious support. This appeared to help participants find different coping strategies and nurture self-esteem.

Commenting on the findings, lead author, Dr Ursula Read, said: 'As well as analysing the DASH data, our study looked at the qualitative detail of participant experiences of racism, relationships and religion. The findings overall highlight the role of racism as an important social determinant of health.

'This integrated analysis also supports theories that racism can trigger a stress response that could lead to smoking as a type of coping strategy. Public health organisations should consider carefully the impact of discrimination and disadvantage on these kinds of risky health behaviours.'

These findings are specific to the London-based study although the large, diverse sample studied means the results may be generalisable to other urban settings in the UK and elsewhere.

Professor Seeromanie Harding, Principal Investigator of the DASH study, said: 'Despite recent decreases in smoking in the UK, the Office for National Statistics has said that 58 per cent of heavy smokers report having started smoking regularly before the age of 16.

'Our findings have public health implications for improving community interventions and finding new ways to support and encourage people not to take up smoking at a young age. An important point here is that racism affects both physical and mental health outcomes. Addressing racism is an important public health priority for young people.'