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Does cigarette smoking mediate the relationship between racial discrimination and depression for African Americans participating In the National Survey of American Life?

  • Author(s): Hickman, Norval Joseph
  • et al.
Abstract

Cigarette smoking contributes to the higher rates of morbidity and mortality among African Americans compared to Caucasians. African Americans report that one of the functions of cigarette smoking is to alleviate stress. A unique stressor experienced by African Americans and reported to be very distressing is racial discrimination. Studies show that discrimination is positively related to depression, that discrimination is associated with an increased risk of cigarette smoking, and that being a cigarette smoker predicts more depression symptoms. Lazarus and Folkman's (1984) stress and coping theoretical model would suggest that poor coping to stress from discrimination should be associated with more depression; however, that is not the case for African Americans. African Americans have lower rates of major depression than Caucasians at similar socioeconomic levels. To date, there is no explanation for why the increased stress from discrimination is not associated with a similar increase in depression for African Americans. One explanation is that cigarette smoking plays a mediating role between the effects of racial discrimination and depression. This assertion was evaluated using the Baron and Kenny (1986) procedures for testing mediation effects. The sample consisted of 1,412 African American adults who participated in the National Survey of American Life. Racial discrimination was measured using the 10-item Every Day Discrimination scale (Williams, Yu, Jackson, & Anderson, 1997). Cigarette smoking was measured by asking participants whether they have smoked 100 cigarettes in their lifetime and smoke now; participants who responded "yes" to both questions were categorized as "smokers" and those who responded "no" to both questions were categorized as nonsmokers. Depression symptoms were measured using the 12-item Center for Epidemiologic Studies Depression scale (Radloff, 1977). Regression analyses were conducted separately for men and women because they significantly differed in smoking prevalence, frequency of discrimination, and depression symptoms. Results showed that cigarette smoking did not significantly reduce the relationship between discrimination and depression for men or women, suggesting no mediation effect by cigarette smoking. Findings are discussed in terms of methodological weaknesses of the study and factors that have been found to mediate the discrimination-depression and discrimination-smoking relationship in other studies

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