Effect of American acculturation on cigarette smoking behavior among six major Asian American subpopulations in California

Purpose To investigate the moderating effect of acculturation and other individual characteristics on smoking behavior and examine the gender-specific prevalence of cigarette smoking among six major Asian American subpopulations in California. Methods Using data from the 2001 California Health Interview Survey, we examined smoking prevalence among 5,265 Asian American adults, age 18 to 85 years, who reported being from 1 of the 6 major Asian American subpopulations in the California region. Level of U.S. acculturation was measured by five index variables: country of birth, parentsʹ country of birth, languages spoken at home, years lived in the U.S., and frequency of eating tomatoes prepared in a quintessential American fashion. Multinomial logistic regression methods were used to estimate gender-specific rates of current and past cigarette smoking and its determinants. Results After adjusting for possible confounding due to age, education level, marital status, alcohol consumption, health care access, and health insurance status, we found that American acculturation level was negatively correlated with menʹs current smoking rates but positively correlated with womenʹs current smoking rates. Overall, highly acculturated men and least acculturated women had the lowest current smoking rates. Current cigarette smoking prevalence rates were higher among men of Korean, Vietnamese, and Filipino background as compared to California men in general. Rates for men of Japanese, Chinese, and South Asian background were, in contrast, lower. As expected, smoking rates for women in all six subpopulations were lower than that seen among men. Conclusion Tobacco use among Asian Americans is not uniformly low. Some subpopulations have relatively higher rates of use. Most troubling, the process of acculturation to living in the U.S. appears to disadvantage Asian American women. Comprehensive, community-based, culturally-tailored, and language-specific smoking control programs are urgently needed to reduce the high prevalence of cigarette smoking among some subpopulations of Asian American men and reverse the increasing trend of cigarette smoking among Asian American women.