Abstract A081: Using the Arkansas State-Wide Health and Nutrition Examination Survey to understand metabolic health among healthy African-American and White smokers and non-smokers
Authors: Hsu Ping-Ching , Nowell Abigail , Sutphin Brandy , Fagan Pebbles , Su Lihchyun Joseph , Zohoori Namvar 
Published: September 2020

Abstract
Introduction. African-Americans (AAs) have a higher smoking–attributable cancer mortality than any other racial/ethnic groups in the United States and in Arkansas. Cigarette smoking prevalence among adults in Arkansas is the 5th highest (22.3%) and smokeless tobacco (ST) use is 3rd highest in the nation (7.8%). Use of tobacco products, poor nutrition, as well as obesity, have been indicated as major risk factors for various cancers and other chronic diseases. Few studies have examined state-specific metabolic biomarkers representing the status of metabolism among smokers and non-smokers in Arkansas and among racial/ethnic groups. The purpose of this study was to compare the differences in markers of dietary lipids and metabolic health in blood among healthy AA and non-Hispanic white (NHW) adult smokers and non-smokers. Methods. Data were analyzed using the 2008 Arkansas Cardiovascular Health Examination Survey (ARCHES, n=1,385), a survey that used probability sampling methods to obtain a representative sample of Arkansas residents, and the analytical sample was limited to adults with no history of cancer or chronic diseases such as diabetes (n=769). Two-way ANCOVA was used adjusting for age and sex to determine the differences in biomarkers among four groups: non-smokers (n=587, 76.3%), current cigarette smokers (n=130, 16.9%), and current smokeless tobacco users (n=21, 2.7%), and dual users of any two tobacco products (n=21, 2.7%). P-value less than 0.05 was considered significant. Results. Of the 769 adult participants, 25% were AA and 75% were NHW. Nearly 31% were male and the mean age was 52.0 (SD=14.8) years. AA non-smokers had a significant higher BMI (mean 34.1, SD=7.9; NHW mean 29.5, SD=6.3), higher markers of fasting glucose (mean 110.0, SD=64.4; NHW mean 95.6, SD=28.3), fasting insulin (mean 28.3, SD=27.8; NHW mean 20.9, SD=32.8), and levels of dietary fats than NHWs. NHW non-smokers had a higher LDL (mean 124.9, SD=33.4; AA mean 115.5, SD=35.6) and triglycerides (mean 177.3, SD=116.7; AA mean 143.7, SD=107.8) than AA non-smokers. NHW cigarette smokers had significant higher levels of triglycerides than AA smokers. AA smokers had higher blood pressure, trans-fat than NHWs. NHW ST users had higher pulse rate than AA ST users. AA dual users had higher BMI and dietary fats than NHWs. Conclusions. Our results indicate poorer metabolic health among AAs compared to white adult non-smokers, smokers, and ST users. However, differences varied by tobacco use type and for some indicators, there were no differences between racial/ethnic groups potentially due to small sample sizes. Larger and more recent studies including dual use of different products are needed in Arkansas to understand the health burden among tobacco user.
Citation Format: Ping-Ching Hsu, Abigail Nowell, Brandy Sutphin, Pebbles Fagan, Lihchyun Joseph Su, Namvar Zohoori. Using the Arkansas State-Wide Health and Nutrition Examination Survey to understand metabolic health among healthy African-American and White smokers and non-smokers [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr A081.