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A biopsychosocial approach to examining tobacco-related health disparities among racially classified social groups

  1. Anita F. Fernander1,
  2. Vickie L. Shavers2,
  3. George J. Hammons3,*

Article first published online: 10 SEP 2007

DOI: 10.1111/j.1360-0443.2007.01954.x

Issue

Addiction

Addiction

Special Issue: Conceptual and Methodological Issues for Research on Tobacco-Related Health Disparities

Volume 102, Issue Supplement s2, pages 43–57, October 2007

Additional Information

How to Cite

Fernander, A. F., Shavers, V. L. and Hammons, G. J. (2007), A biopsychosocial approach to examining tobacco-related health disparities among racially classified social groups. Addiction, 102: 43–57. doi: 10.1111/j.1360-0443.2007.01954.x

Author Information

  1. 1

    Behavioral Science Department, College of Medicine, University of Kentucky, Lexington, KY, USA,

  2. 2

    Division of Cancer Control and Population Sciences Applied Research Program, National Cancer Institute, Bethesda, MD, USA and

  3. 3

    Department of Chemistry, Philander Smith College, Little Rock, AR, USA

*G. J. Hammons, Department of Chemistry, Philander Smith College, 812 West 13th Street, Little Rock, AR 72202, USA. E-mail: ghammons@philander.edu

Publication History

  1. Issue published online: 10 SEP 2007
  2. Article first published online: 10 SEP 2007

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Keywords:

  • Biopsychosocial;
  • health disparities;
  • racially classified social groups;
  • tobacco

ABSTRACT

Aims  To articulate a broader, multi-causal model that incorporates psychosocial and environmental factors that can differ systematically across racially classified social groups (RCSGs) and impact biological pathways related to the development of tobacco-related diseases.

Methods  This paper is built upon a review of the existing scientific literature on selected biopsychosocial factors (diet/nutrition, obesity, alcoholic intake, psychosocial stress, occupational/environmental exposures and exposure to other diseases and illnesses) and tobacco use in examining the biological contributions to differences in tobacco-related health outcomes among RCSGs.

Findings  Recent work has focused on RCSG genetic variations as a possible explanation for differences in tobacco-related health disparities. It is argued in this paper that, given the genetic heterogeneity ‘within’ RCSGs, it is unlikely that across RCSG genetic variations are likely to be the major source of differences impacting biological pathways in tobacco-related health outcomes. The evidence shows that results, even at the level of within-population genetic variations, have been limited and often inconsistent. A conceptual framework is proposed to account for biological pathways related to the development of tobacco-related diseases.

Conclusions  Determinants of tobacco-related health disparities are not understood clearly. The contribution of biological factors may be important. Current efforts to determine biological differences in tobacco use and related diseases among RCSGs have focused primarily on genetic variations. However, this approach has limitations. An alternative biopsychosocial framework that examines the potential biological mechanisms through which life experiences and behavior might affect tobacco use and health outcomes in these population groups is needed, including those of life-style (e.g. diet/nutrition, obesity, physical exercise, alcohol consumption), psychosocial (e.g. stress and coping), occupational/environmental exposures and the presence of other diseases/illnesses.

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