Contrasting with results from the National Comorbidity Survey [3], a lower rate of remission from nicotine dependence was observed in Blacks. Compared to White smokers, Black smokers start smoking later in life, have lower daily nicotine consumption, tend to smoke cigarettes with longer rod length and higher tar and nicotine content (i.e., menthols), and have slower clearance of cotinine and higher intake of nicotine per cigarette.[36, 37] Furthermore, the reduced access of Blacks and Hispanics to tobacco preventive services [38], as well as the intensive targeting of these minority groups by tobacco companies [39], could also help explain the observed racial-ethnic differences in the probability of nicotine dependence remission. Consistent with previous studies [40], we also found that Blacks with a lifetime diagnosis of cocaine dependence report lower rates of remission than their White counterparts. Psychosocial factors that commonly affect Black populations, including discrimination and lower levels of social capital, have been recognized as established barriers to dependence remission and triggers to use or relapse [41]. Furthermore, an array of genetic factors appear to increase the vulnerability to develop cocaine dependence among Blacks [42].
