Smoking prevalence, according to the study, was higher among men and women born in the United States than among their racial and ethnic counterparts who were immigrants, with larger differences existing between U.S.-born and immigrant women than between U.S.-born and immigrant men. The exceptions were Asian/Pacific Islander men, among whom immigrants had a higher overall rate of smoking.
Furthermore, within immigrant groups there are wide differences depending on country of origin. A Japanese immigrant to the U.S., for example, is more than four times more likely to smoke than an Indian immigrant, yet both are categorized as Asian/Pacific Islanders. A better understanding of such differences, the study concludes, could enhance the development of targeted and culturally sensitive public health smoking prevention programs. The study is published in the April issue of the American Journal of Public Health.
"Analyzing immigrants' smoking rates can reveal their adaptation to the U.S. as well as the effectiveness of smoking regulations and anti-smoking campaigns," said co-author Dowell Myers, Ph.D., director of the Population Dynamics Core at TTURC and the Master of Planning Program at USC's School of Planning, Policy, and Development. "We need to look at the different behaviors that exist not only for Asians and non-Asians, for example, but between Chinese and Koreans, men and women, recent immigrants and those born in the U.S. By understanding these differences, we can develop more effective smoking prevention programs attuned to specific populations."
Highlighting the importance of examining health risk behaviors by immigrant status, the study cited the 2000 Current Population Survey, which showed that approximately 10.4 percent of the total U.S. population was foreign born. For certain racial/ethnic categories, however, the percentage of foreign born was much higher: 61.4% of the Asian population and 39.2% of the Hispanic population, for example.
The study pooled data in the 1995-96 and 1998-99 Tobacco Use Supplements to the Current Population Survey, conducted by the U.S. Census Bureau, to examine smoking prevalence statistics by race/ethnicity, gender, and immigrant status. Smokers were defined as those 15 years or older who had reported smoking at least 100 cigarettes and who smoked every day or some days. They were broadly categorized as U.S- or foreign-born Whites (non-Hispanic), Blacks (non-Hispanic), American Indians, Asian/Pacific Islanders, and Hispanics. Overall, the national smoking prevalence rate was 21.6%, but when disaggregated by immigrant status, the figures showed that native-born survey respondents had a higher rate than foreign born -- 22.6% versus 13.4% -- a pattern that held true across the racial/ethnic categories.
To illustrate the varieties of smoking behaviors within racial/ethnic groups, the study further examined the statistics for immigrants from the top 10 Asian regions of origin according to the CPS data (list descends in order of prevalence): Japan, South Korea, Vietnam, Laos, the Philippines, Cambodia, Taiwan, China, Hong Kong, and India.
While smoking prevalence among Asian/Pacific Island immigrants as a whole was 11.8%, the rates varied from 4.6% for Indian immigrants to 21.4% for Japanese. For male Asian/Pacific Island immigrants, the highest smoking prevalence rate was found among immigrants from South Korea (33.0%) while the lowest rate was recorded for immigrants from India (8.1%). For female Asian/Pacific Island immigrants, the highest smoking prevalence was among women from Japan (16.6%) and lowest, among women immigrating from India (0.9%).
The researchers cautioned that future studies would benefit by including factors such as immigrants' age, period of arrival, and length of U.S. residence, each of which may explain some of the variation in smoking prevalence statistics.
This research was funded by the National Cancer Institute and the National Institute of Drug Abuse and conducted through the Transdisciplinary Tobacco Use Research Center of the University of Southern California.
Kaari Flagstad Baluja, Julie Park and Dowell Myers, Inclusion of immigrant status in smoking prevalence statistics. American Journal of Public Health, Vol. 93, No. 4, April 2003.
Journal
American Journal of Public Health