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Environmental contexts of smoking for Southeast Asians

Institution: Pacific Institute for Research and Evaluation
Investigator(s): Juliet Lee,
Award Cycle: 2004 (Cycle 13) Grant #: 13RT-0058H Award: $726,834
Subject Area: Epidemiology
Award Type: Research Project Awards

Initial Award Abstract
This study investigates the relationship between the social environment and smoking among Southeast Asians in California urban areas. Of U.S. states, California is home to the largest number of Southeast Asians. Although as many as 35-70% of Southeast Asians in the U.S. may smoke, there is evidence that smoking decreases among this population with increasing time in the U.S. Changes in immigrants’ tobacco use have been attributed to “acculturation.” Acculturation is a type of social change wherein people experience large-scale changes in values, beliefs and practices resulting from the meeting of two or more differing worldviews. For immigrants, these changes are usually understood to result from living in a different social environment. The precise relationship between changes in socio-cultural context and changes in tobacco use, however, remains unclear. This study proposes that tobacco use is a social practice, that changes in tobacco use reflect immigrants’ changing relationship to their social environment, and that these relationships vary by generation and gender. Through in-depth interviews with 120 male and female Laotians and Cambodians in the San Francisco Bay Area representing two generations in the U.S., together with ethnographic observations of Southeast Asian public gatherings, this three-year study will specifically investigate:

• Inter-generational variation in the social meanings of smoking. The study will compare the social meaning of smoking for first and second generation Southeast Asians and for males and females by identifying categories such as ethnic identity, educational achievement, life aspirations, gender identity, and peer and family relations, and how these relate to smoking.

• Inter-generational variation in knowledge of and attitudes towards smoking. The study will assess Southeast Asians’ awareness of and attitudes towards smoking, such as: health risks related to smoking; the role of tobacco use in family, peer, school and neighborhood environments; environmental tobacco control policies such as workplace and school smoking restrictions; and second-hand smoke. These attitudes will then be compared by generation and gender.

• Inter-generational variation in smoking behaviors. The study will identify variations in smoking practices which may result from the different socio-cultural environments within which first and second generation Southeast Asians develop smoking habits. Potential variations may occur in relation to age of onset; social contexts of tobacco use; attempts to quit smoking; female smoking; smoking in public; and home smoking policies.

As such, the study addresses TRDRP research priorities in several areas: 1) The study will gather information on the smoking practices of understudied populations, in this case four subgroups of Southeast Asians for whom there is little to no information: Laotians, Cambodians, second-generation youth and women; 2) The study addresses gender-based differences in smoking by comparing tobacco use for Southeast Asian women and men; 3) The study addresses environmental factors that influence the initiation of tobacco use. The findings derived from this study may result in the design of tobacco prevention programs which more closely address young Southeast Asians’ social realities, as well as enhanced support for cessation and harm reduction efforts among this underserved California population. The study may additionally contribute to a better understanding of the relationship between smoking and social change processes for U.S. immigrants in general.