of cancers that may be caused, in part, by smoking (i.e., cancers of the esophagus and larynx).According to the U.S. Bureau of the Census (1993), there are differences by gender and race in the prevalence of substance abuse. Although much of the literature focuses on the disproportionate number of racial minorities that abuse certain substances, there are other substances that Whites abuse more than do racial minorities. Cultures also vary with respect to the degree that they are willing to acknowledge substance abuse.African Americans tend to become ill from cigarette smoking at younger ages than do Whites, even though they smoke fewer cigarettes per day than do Whites. This seems to be because African Americans prefer menthol cigarettes, which have higher tar and nicotine levels.In 1991, 58.1% of U.S. males and 44.3% of U.S. females reported using alcohol at least once a month, with the total population figure being 50.9%. In terms of race, 52.7% of Whites, 43.7% of African Americans, and 47.5% of Hispanics used alcohol regularly. There is a very high incidence of alcohol abuse among Native Americans (Rowell and Kusterer, 1991). This has been viewed as one effect of a 500-year history of contact with and domination by Europeans. When the use of substances by Native Americans increased in response to disease, genocide, and relocation, the once very clear definitions of acceptable and unacceptable behavior became blurred. Widespread alcohol abuse weakened the concept of personal responsibility. Parents who were abusers found it difficult to hold their children responsible for their own problems with alcohol. A cultural standard of “taking care of one’s own” and not seeking outside professional assistance contributed to a pattern of alcohol and drug use within entire families (Rowell and Kuster, 1991).Marijuana use in 1991, 6.3% of males and 3.4% of females abused marijuana, and 4.5% of Whites, 7.2% of African...
