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. 1999 Dec;8(4):402–410. doi: 10.1136/tc.8.4.402

Is acculturation a risk factor for early smoking initiation among Chinese American minors? A comparative perspective

X Chen 1, J Unger 1, C Johnson 1
PMCID: PMC1759739  PMID: 10629247

Abstract

OBJECTIVE—To determine the extent to which Chinese American and white minors differ in age of smoking initiation, and to determine the effect of acculturation on smoking initiation.
DESIGN—Cross-sectional telephone surveys.
SETTING—Stratified random samples of the state of California, United States.
SUBJECTS—347 Chinese American and 10 129 white adolescents aged 12 through 17 years, from the California Tobacco Survey (1990-93) and the California Youth Tobacco Survey (1994-96).
OUTCOME MEASURES—Hazards (risk) of smoking initiation by age, smoking initiation rate, cumulative smoking rate, mean age of smoking initiation, and acculturation status.
STATISTICAL METHODS—Life table methods, proportional hazards models, and χ2 tests.
RESULTS—The risk of smoking initiation by age among Chinese American minors was about a third of that among white minors. The risk for Chinese Americans continued to rise even in later adolescence, in contrast to that for whites, which slowed after 15 years of age. Acculturation was associated significantly with smoking onset among Chinese Americans. Acculturation, smoking among social network members, attitudes toward smoking, and perceived benefits of smoking were associated with the difference in hazards of smoking onset between Chinese American minors and their white counterparts.
CONCLUSIONS—Chinese American adolescents had a lower level and a different pattern of smoking onset than white adolescents. Levels of acculturation and other known risk factors were associated with the hazards of smoking initiation among Chinese American minors and with the difference in smoking initiation between the Chinese and white adolescents. Tobacco prevention policies, strategies, and programmes for ethnically diverse populations should take acculturation factors into account.


Keywords: acculturation; Chinese Americans; smoking initiation; adolescence

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Selected References

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  1. Bal D. G., Kizer K. W., Felten P. G., Mozar H. N., Niemeyer D. Reducing tobacco consumption in California. Development of a statewide anti-tobacco use campaign. JAMA. 1990 Sep 26;264(12):1570–1574. [PubMed] [Google Scholar]
  2. Chen X., Unger J. B., Cruz T. B., Johnson C. A. Smoking patterns of Asian-American youth in California and their relationship with acculturation. J Adolesc Health. 1999 May;24(5):321–328. doi: 10.1016/s1054-139x(98)00118-9. [DOI] [PubMed] [Google Scholar]
  3. Chen X., Unger J. B. Hazards of smoking initiation among Asian American and non-Asian adolescents in California: a survival model analysis. Prev Med. 1999 Jun;28(6):589–599. doi: 10.1006/pmed.1999.0487. [DOI] [PubMed] [Google Scholar]
  4. Deyo R. A., Diehl A. K., Hazuda H., Stern M. P. A simple language-based acculturation scale for Mexican Americans: validation and application to health care research. Am J Public Health. 1985 Jan;75(1):51–55. doi: 10.2105/ajph.75.1.51. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Douglas S., Hariharan G. The hazard of starting smoking: estimates from a split population duration model. J Health Econ. 1994 Jul;13(2):213–230. doi: 10.1016/0167-6296(94)90024-8. [DOI] [PubMed] [Google Scholar]
  6. Dusenbery L., Epstein J. A., Botvin G. J., Diaz T. The relationship between language spoken and smoking among Hispanic-Latino youth in New York City. Public Health Rep. 1994 May-Jun;109(3):421–427. [PMC free article] [PubMed] [Google Scholar]
  7. Elder J. P., Edwards C. C., Conway T. L., Kenney E., Johnson C. A., Bennett E. D. Independent evaluation of the California Tobacco Education Program. Public Health Rep. 1996 Jul-Aug;111(4):353–358. [PMC free article] [PubMed] [Google Scholar]
  8. Engels R. C., Knibbe R. A., Drop M. J. Inconsistencies in adolescents' self-reports of initiation of alcohol and tobacco use. Addict Behav. 1997 Sep-Oct;22(5):613–623. doi: 10.1016/s0306-4603(96)00067-6. [DOI] [PubMed] [Google Scholar]
  9. Epstein J. A., Botvin G. J., Dusenbury L., Diaz T., Kerner J. Validation of an acculturation measure for Hispanic adolescents. Psychol Rep. 1996 Dec;79(3 Pt 1):1075–1079. doi: 10.2466/pr0.1996.79.3.1075. [DOI] [PubMed] [Google Scholar]
  10. Escobedo L. G., Anda R. F., Smith P. F., Remington P. L., Mast E. E. Sociodemographic characteristics of cigarette smoking initiation in the United States. Implications for smoking prevention policy. JAMA. 1990 Sep 26;264(12):1550–1555. [PubMed] [Google Scholar]
  11. Flint A. J., Yamada E. G., Novotny T. E. Black-white differences in cigarette smoking uptake: progression from adolescent experimentation to regular use. Prev Med. 1998 May-Jun;27(3):358–364. doi: 10.1006/pmed.1998.0299. [DOI] [PubMed] [Google Scholar]
  12. GORDON T. Mortality experience among the Japanese in the United States, Hawaii, and Japan. Public Health Rep. 1957 Jun;72(6):543–553. [PMC free article] [PubMed] [Google Scholar]
  13. Gillmore M. R., Catalano R. F., Morrison D. M., Wells E. A., Iritani B., Hawkins J. D. Racial differences in acceptability and availability of drugs and early initiation of substance use. Am J Drug Alcohol Abuse. 1990;16(3-4):185–206. doi: 10.3109/00952999009001583. [DOI] [PubMed] [Google Scholar]
  14. Gilpin E. A., Pierce J. P. Trends in adolescent smoking initiation in the United States: is tobacco marketing an influence? Tob Control. 1997 Summer;6(2):122–127. doi: 10.1136/tc.6.2.122. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Graham J. W., Johnson C. A., Hansen W. B., Flay B. R., Gee M. Drug use prevention programs, gender, and ethnicity: evaluation of three seventh-grade Project SMART cohorts. Prev Med. 1990 May;19(3):305–313. doi: 10.1016/0091-7435(90)90030-n. [DOI] [PubMed] [Google Scholar]
  16. Heath A. C., Cates R., Martin N. G., Meyer J., Hewitt J. K., Neale M. C., Eaves L. J. Genetic contribution to risk of smoking initiation: comparisons across birth cohorts and across cultures. J Subst Abuse. 1993;5(3):221–246. doi: 10.1016/0899-3289(93)90065-j. [DOI] [PubMed] [Google Scholar]
  17. Johnson C. A., Pentz M. A., Weber M. D., Dwyer J. H., Baer N., MacKinnon D. P., Hansen W. B., Flay B. R. Relative effectiveness of comprehensive community programming for drug abuse prevention with high-risk and low-risk adolescents. J Consult Clin Psychol. 1990 Aug;58(4):447–456. doi: 10.1037//0022-006x.58.4.447. [DOI] [PubMed] [Google Scholar]
  18. Klonoff E. A., Landrine H. Acculturation and cigarette smoking among African American adults. J Behav Med. 1996 Oct;19(5):501–514. doi: 10.1007/BF01857681. [DOI] [PubMed] [Google Scholar]
  19. Landrine H., Richardson J. L., Klonoff E. A., Flay B. Cultural diversity in the predictors of adolescent cigarette smoking: the relative influence of peers. J Behav Med. 1994 Jun;17(3):331–346. doi: 10.1007/BF01857956. [DOI] [PubMed] [Google Scholar]
  20. Li X., Fang X., Stanton B. Cigarette smoking among Chinese adolescents and its association with demographic characteristics, social activities, and problem behaviors. Subst Use Misuse. 1996 Apr;31(5):545–563. doi: 10.3109/10826089609045826. [DOI] [PubMed] [Google Scholar]
  21. Marin G., Perez-Stable E. J., Marin B. V. Cigarette smoking among San Francisco Hispanics: the role of acculturation and gender. Am J Public Health. 1989 Feb;79(2):196–198. doi: 10.2105/ajph.79.2.196. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Marmot M. G., Syme S. L. Acculturation and coronary heart disease in Japanese-Americans. Am J Epidemiol. 1976 Sep;104(3):225–247. doi: 10.1093/oxfordjournals.aje.a112296. [DOI] [PubMed] [Google Scholar]
  23. Mavreas V., Bebbington P., Der G. The structure and validity of acculturation. Analysis of an acculturation scale. Soc Psychiatry Psychiatr Epidemiol. 1989 Sep;24(5):233–240. doi: 10.1007/BF01788964. [DOI] [PubMed] [Google Scholar]
  24. Moeschberger M. L., Anderson J., Kuo Y. F., Chen M. S., Jr, Wewers M. E., Guthrie R. Multivariate profile of smoking in Southeast Asian men: a biochemically verified analysis. Prev Med. 1997 Jan-Feb;26(1):53–58. doi: 10.1006/pmed.1996.9993. [DOI] [PubMed] [Google Scholar]
  25. Popham W. J., Potter L. D., Hetrick M. A., Muthén L. K., Duerr J. M., Johnson M. D. Effectiveness of the California 1990-1991 tobacco education media campaign. Am J Prev Med. 1994 Nov-Dec;10(6):319–326. [PubMed] [Google Scholar]
  26. Robertson S. B., Jackson C. Initiation of cigarette smoking among children with and without learning disabilities. J Dev Behav Pediatr. 1996 Aug;17(4):248–252. [PubMed] [Google Scholar]
  27. Wiecha J. M. Differences in patterns of tobacco use in Vietnamese, African-American, Hispanic, and Caucasian adolescents in Worcester, Massachusetts. Am J Prev Med. 1996 Jan-Feb;12(1):29–37. [PubMed] [Google Scholar]
  28. Wolff C. B., Portis M. Smoking, acculturation, and pregnancy outcome among Mexican Americans. Health Care Women Int. 1996 Nov-Dec;17(6):563–573. [PubMed] [Google Scholar]

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