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Acculturation & cigarette smoking among Asian-Americans

Institution: University of Southern California
Investigator(s): Xinguang Chen, Ph.D.
Award Cycle: 1997 (Cycle 6) Grant #: 6KT-0191 Award: $244,715
Subject Area: Epidemiology
Award Type: New Investigator Awards
Abstracts

Initial Award Abstract
Cigarette smoking trends and the high level of smoking among Asian-Americans need to be addressed to achieve the State tobacco control objectives. Different sources show that among Asian-Americans, there are about 40% up to 90% current and former smokers, and there are great variations of smoking rates among sub-groups and between sexes. Asian-Americans, as the third largest ethnic group, include 60-80% immigrants from over 15 countries/regions. They speak more than 30 languages and carry with them similar but varied cultural traditions. Most of them have entered the U.S. since 1970, and more than 50% cannot speak English well. These characteristics suggest an urgent need to study Asian-American smoking issues in order to develop focused, culturally appropriate, and empirically based smoking interventions. However, the diverse origins and cultures of these Asian-Americans make it hard to study these problems, and limited research has been done regarding these problems.

This proposed study will be conducted based on data collected through the California Youth Tobacco Survey (1994-97) and the California Tobacco Survey (1990-1997) using advanced analytical methods to examine the following questions:

What are the levels of and differences in tobacco smoking, exposure to environmental tobacco smoke, reception of pro- and anti-tobacco messages, and response to the California Tobacco Control Program among Asian-Americans, and between Asian-Americans and other ethnic groups?

Which are the factors that contribute to smoking behavior, reception of anti- and pro-tobacco messages, exposure to environmental tobacco smoke, and response to the State tobacco control programs among Asian-Americans?

How important are cultural background and acculturation status in determining tobacco smoking, exposure to environmental tobacco smoke, reception of pro- and anti-tobacco messages, and response to the State tobacco control programs among Asian-Americans?

Are there similarities in the relationship between acculturation and smoking across ethnic groups?

The information will be utilized to make recommendations for tobacco control interventions; while they will also aid further scientific research on smoking problems for both Asian-Americans and other ethnic groups.

Final Report
Targeted at Asian Americans in California, the objectives of this project are to describe patterns of cigarette use among them, to identify factors associated with their cigarette smoking behavior, and to test the role of acculturation in their cigarette use in general and by subgroups of Chinese, Filipino, Japanese, and Korean Americans.

Subjects entered this study include 20,482 adolescents (8.7% Asians) from both the California Tobacco Survey (CTS) and the California Youth Tobacco Survey (CYTS) from years 1990 to 1996, and 24,689 adults (6.39% o Asians) from the annual California Adult Tobacco Survey (CATS) from years 1993 to 1998.

Findings from this study indicated that Asian Americans smoked less than subjects from other ethnic minority groups for both adolescents and adults but variation in smoking prevalence within Asian subgroups was greater than between Asian and other ethnic groups. For example 30-day smoking prevalence was 6.9% for Asian American adolescents in general, 2.8% for Chinese, 7.4% for Japanese, 8.3% for Koreans, and 8.6% for Filipinos. The same prevalence was 5.9% for Blacks, 12.6% for Latino/Hispanics, and 16.0% for non-Hispanic whites. The age of smoking initiation was older for Asian Americans than for others. Gender difference in cigarette smoking was greater for Asian Americans than for others. Compared with Asian males, less Asian females reported having smoked cigarettes.

This study further demonstrated that factors associated with cigarette smoking for subjects from other ethnic groups were also associated with cigarette smoking among Asian Americans; these include influences from pro-tobacco media, smoking parents, teachers, siblings, and friends, attitudes/ knowledge/opinions about cigarette smoking, and etc. However, compared with subjects from other ethnic groups, Asian American adolescents tended to be influenced more by smoking parents, and less by smoking siblings/friends and pro-tobacco media.

Detailed analysis in this study suggests that acculturation levels were associated with cigarette for Asian Americans. For example, increase in levels of acculturation was associated with early initiation and current use of cigarettes among Asian American adolescents in general and by ethnic groups of Chinese, Filipino, Japanese, and Korean. Increased level in acculturation was associated with increased hazards of smoking initiation and 30-day smoking prevalence.

When planning, designing, and implementing tobacco control and prevention programs, attentions should be paid to the above issues in order to effectively curb the increasing trends in cigarette smoking for population in general and for Asian Americans in particular.
Publications

Smoking patterns of Asian American youth in California and their relationships with acculturation
Periodical: Journal of Adolescent Health Index Medicus:
Authors: Chen X, Unger JB, Cruz TB, Johnson CA ART
Yr: 1999 Vol: Nbr: Abs: Pg:

Hazards of smoking initiation among Asian American and non-Asian adolescents in California: A survival analysis
Periodical: Journal of Preventive Medicine Index Medicus:
Authors: Chen X, Unger JB ART
Yr: 0 Vol: Nbr: Abs: Pg:

The role of social networks and media receptivity in predicting age of smoking initiation: A proportional hazards model of risk and protective factors
Periodical: Addictive Behaviors Index Medicus:
Authors: Unger JB, Chen X ART
Yr: 0 Vol: Nbr: Abs: Pg: