In the United States, African Americans develop a higher number of preventable diseases relative to white Americans. The three leading causes of death among the black population are heart disease, cancer and stroke. In addition, black Americans are at higher risk for a number of lung conditions, including asthma and infections. Smoking and tobacco use are major contributors to all of these conditions.

According to the most recent data from the Centers for Disease Control and Prevention (CDC), there were 44.5 million smokers in the United States in 2004. Among the black population, approximately 20 percent of adults smoked cigarettes as compared to 22 percent on all non-Hispanic whites.

In the 1990s, smoking rates were higher for black men than white men. By 2004, the smoking rate for black men dropped below the rate of white men. In addition, the incidence of smoking dropped significantly between 1999 and 2003 among black American middle and highs school students, according to the CDC Youth Risk Behavior Survey. Given the strikingly high rate of smoking among black American youth in the 1970s, this information is very encouraging.

Unfortunately, black American adults continue to be diagnosed with smoking-related diseases at a greater rate than other groups in the United States, often with greater associated mortality. Although black Americans are only 12 percent of the U.S. population, almost a quarter of all asthma deaths are among black Americans. According to figures compiled by the American Lung Association, in 2004, about 4.7 million black American adults smoked - roughly 11 percent of the total smokers in the United States.

Smoking tends to aggravate other known risk factors and diseases that are more common among black Americans. Smoking is a major risk factor for stroke, and recent research has suggested that black Americans are three to five times more likely to have a stroke than white Americans of the same age. This may be related to the fact that black Americans have significantly higher rates of high blood pressure and diabetes. Furthermore, black American women are struggling with greater rates of obesity.

As a result of this information, black Americans are urged to reduce these risk factors as much as possible by not smoking, controlling blood pressure, monitoring blood sugar, exercising and maintaining a healthy weight.

This article reviews the research that has been done on tobacco use in the black American community and programs that are available to help educate the public about this issue.