Cigarette Smoking and the Hispanic Paradox in the United States

Andrew Fenelon, University of Pennsylvania

The tendency for Hispanics to outlive non-Hispanic whites in the United States despite lower socioeconomic status has perplexed demographers for many years. The so-called “Hispanic Paradox” has produced a number of possible explanations, but none has received consistent support. This paper uses two attributable-risk methods to examine the contribution of mortality related to cigarette smoking to the advantage in adult life expectancy of Mexican-Americans and other Hispanics relative to non-Hispanic whites. Using the National Health Interview Survey smoking supplements from 1987-2004, I find that the mortality burden of cigarette smoking is substantially larger among whites than among Hispanic subgroups. Smoking explains more than two-thirds of the advantage for Mexican-Americans and 50%-75% for other Hispanics. Smoking also accounts larger differences at lower levels of education, especially for Mexican-Americans. For both Hispanic subgroups, low mortality related to cigarette smoking is the main reason for adult survival advantage relative to non-Hispanic whites.