Hazards of Smoking Initiation among Asian American and Non-Asian Adolescents in California: A Survival Model Analysis

Background. Information about the risk of smoking initiation among whites, African Americans, and Latino Americans has provided an important informa tion base for smoking prevention programs among ado lescents from these ethnic backgrounds. Unfortu nately, there is a lack of such information for Asian Americans, a fast-growing ethnic minority group with much internal diversity. Method. This study used cross-sectional data from 20,482 subjects 12–17 years of age, randomly sampled in California, to describe and compare the risk of smoking initiation for adolescents by age among Asian Ameri can and other non-Asian ethnic groups, using survival analysis. Computer-aided telephone interview tech niques were used in data collection. Result. The risk of early smoking initiation among Asian American adolescents is about a third of that of Caucasians. However, the risk among Asian Americans continues to increase throughout adolescence, while the same risk among Caucasians and African Ameri cans plateaus around 14–15 years of age. Significant differences in the levels and patterns of smoking initia tion among Asian American subgroups were observed, with Chinese Americans showing the lowest risk of smoking initiation and Filipino Americans the highest, Japanese and Korean Americans being in-between. Conclusion. Asian American adolescents may be es pecially at risk of smoking initiation later in adoles cence, even though they are at lower risk early in ado lescence. Smoking prevention programs for Asian Americans should continue throughout adolescence and early adulthood.