Associations Among Experiences With Racial Discrimination, Religion/Spirituality, and Cigarette Smoking Among African American Adults: The Jackson Heart Study

Background African American adults exhibit disproportionately high rates of tobacco-related diseases and associated death. Experiences with racial discrimination contribute to health disparities among African Americans, but more research is needed to understand associations between perceived discrimination and tobacco use as well as potential protective factors. Purpose This study examined associations between perceived racial discrimination and cigarette smoking, as well as religion and spirituality as moderators of any associations. Methods Cross-sectional data were drawn from the Jackson Heart Study, a study of cardiovascular disease risk factors among African American adults in Jackson, MS. Measures included perceived everyday discrimination and major life events discrimination that was attributed to race. Participants also reported religious attendance, prayer, spirituality, and whether they prayed in response to discriminatory experiences. Logistic regression models tested associations between perceived racial discrimination and cigarette smoking status, and interactions between religiosity/spirituality and discrimination in predicting smoking status. Results A total of 2,972 participants were included in the analysis (62.7% female, mean age 55.1 years). Thirteen percent reported currently smoking cigarettes. Everyday racial discrimination was associated with a higher likelihood of current smoking (p = .01). The association between lifetime racial discrimination and current smoking status was weaker for those who reported prayer as a reaction compared to those who did not report prayer as a reaction (adjusted odds ratio = 0.32, 95% confidence interval: 0.11 to 0.91) while adjusting for demographics and covariates. Conclusions Stressful experiences with racial discrimination may create risks for health behaviors like smoking. However, prayer may act as a coping strategy to help buffer the effects of racial discrimination on smoking behavior.