CN03-04

Differences in risk indicators along the tobacco disease continuum do not fully explain tobacco-related cancer consequences among some minority racial/ethnic groups. The lack of within-race/ethnic group data, its interactions with socioeconomic factors, and our poor understanding of the addiction cycle and biological processes across the lifespan contribute to the inconsistencies that we observe in the dose-response model for lung cancer. This paper delineates the known disparities for racial/ethnic and socioeconomic groups; discusses gaps in knowledge; and highlights several conceptual frameworks for closing the gaps in tobacco use, exposure to tobacco, and related cancer outcomes. Results indicate that there is variability in lung cancer rates among racial/ethnic groups, with Black men having substantially higher incidence and deaths rates than other racial/ethnic groups. A number of evidence-based interventions (i.e. policies, quitlines, counseling, nicotine replacement therapy) have been shown to reduce smoking in the United States; however, there is little evidence to suggest that these interventions reduce disparities along the tobacco disease continuum. The lack of progress may be due to having the wrong targets and a lack of specific focus on populations at higher risk for lung and other tobacco-related cancers. Conceptual models that integrate strategies for addressing disparities, social context, diversity, inequalities, inequities, the addiction cycle, biopsychosocial factors, and capacity may help researchers, communities, and policy makers identify the best targets for reducing tobacco-related disparities in the United States.

First AACR International Conference on the Science of Cancer Health Disparities-- Nov 27-30, 2007; Atlanta, GA