In the United States, epidemiological evidence suggests that African American adolescents have lower levels of smoking initiation and current smoking than White and Hispanic adolescents (Griesler & Kandel, 1998; Kandel, Kiros, Schaffran, & Hu, 2004). However, smoking rates among African Americans grow and even surpass that of their White counterparts during adulthood (25.6% versus useful site 23.5%; Garrett, Dube, Trosclair, Caraballo, & Pechacek, 2011). Importantly, 68.1% of African American adolescent smokers want to quit, but the actual quit rate is at 8.7% (Centers for Disease Control and Prevention, 2009). Similar disparities exist among Hispanic adolescents; for example, Hispanic adolescents have smoking rates that are as high as or higher than those of White adolescents (Ellickson, Orlando, Tucker, & Klein, 2004), and although smoking rates in White adolescents decreased from 2006 to 2009 (9.

2% to 7.1%), Hispanic adolescents showed trends of increased use in this same time period (10.9% to 11.1%) and exceeded the rates of use among White adolescents (Centers for Disease Control and Prevention, 2009). Less examined but still of considerate concern are smoking behaviors of Asian Americans, American Indians, and Hawaiian/Pacific Islanders. Evidence from the National Youth Tobacco Survey indicates that even though Asian American youth smoke at a lower rate than other minority groups, this rate grows in late adolescence; as 12th graders, 42.5% initiated smoking and 33.0% smoked in the past 30 days; these rates are higher than the rates of other racial/ethnic minority groups (Appleyard, Messeri, & Haviland, 2001).

American Indian youth show high rates tobacco use at an early age; cigarette use is 30.6% in 5th grade, 60.4% in 7th grade, and smokeless tobacco use is 19.0% in 5th grade and 32.6% in 7th grade (Davis, Lambert, Cunningham-Sabo, & Skipper, 1995). In addition to these major ethnic/racial groups, tobacco use behaviors of other minority groups are beginning to be examined. For example, Arab American adolescents are more likely to use other forms of tobacco, such as water pipes compared with non-Arab American adolescents (38% versus 22%; Rice, Weglicki, Templin, Jamil, & Hammad, 2010). These alarming tobacco use incidences and rates among minority adolescents further demonstrate the need to culturally target and tailor tobacco interventions.

Tobacco interventions aimed at adolescents are crucial because smoking is initiated, and progression to regular smoking and nicotine dependence are established in this developmental period. Even smoking an average of two cigarettes per day is predictive of symptoms of nicotine dependence and long-term tobacco use among adolescents (DiFranza et al., 2002). Furthermore, among Brefeldin_A high school students who smoke daily, 60.