Cigarette smoking among Chinese Americans and the influence of linguistic acculturation

Abstract

Less acculturated Chinese Americans experience cultural and language barriers. The present study assessed the relationship between linguistic aspects of acculturation and cigarette smoking among Chinese Americans. A cross-sectional, self-administered survey was administered to a consecutive sample of 541 Chinese American adults (aged 18 years or older) attending four pediatric, medical, or dental practices located in Philadelphia's Chinatown from November 2000 to February 2001. Linguistic acculturation was measured by adapting a reliable and valid acculturation scale developed for Southeast Asians. English and Chinese language proficiency subscales were utilized to analyze the association between language proficiency and current smoking. Whereas 25% of Chinese American men reported current smoking, only 3% of Chinese American women reported current smoking. Chinese American men with lower English proficiency reported significantly higher rates of current smoking compared with Chinese American men with a higher level of English proficiency (33% vs. 18%, p<.01). Less English-proficient Chinese American male smokers were less likely to have received advice from a physician to quit smoking (50% vs. 85%, p=.01). In multivariate analysis, increased English proficiency was associated with decreased odds of current smoking (OR=0.38, 95% CI=0.16-0.89) among Chinese American men after controlling for confounding variables. In conclusion, higher English proficiency was associated with decreased current smoking among Chinese American men. Chinese American men with limited English proficiency should especially be targeted for tobacco control interventions. Further research is needed to assess whether acculturation is associated with smoking among Chinese American women and with use of smoking cessation treatments and services by Chinese American smokers.

Smoking prevalence and correlates among Chinese- and Filipino-American adults: Findings from the 2001 California Health Interview Survey

“…The CHIS finding of 14% current smokers among ChineseAmerican males is closest to the finding of the only other study conducted in California, in which 16.5% of Chinese-American respondents were current smokers [2]. These studies have found that smoking in Chinese-American males was highest among foreign-born as compared to U.S.-born Chinese-Americans, and highest among the more recent immigrants, among those with lowest levels of education and income [2], and among those with low English proficiency [3,7]. CHIS data confirm these findings and suggest that less acculturated Chinese-American males have the greatest need for smoking cessation programs.…”

“…Several surveillance efforts have been conducted in various Chinese-American communities in New York City [17], Chicago's Chinatown [3], Philadelphia's Chinatown [7], Pennsylvania and New Jersey [18,19], and San Francisco [2]. Smoking prevalence among Chinese-American men has ranged in these studies from 34% [3] to 16% [2].…”

“…Two studies found that low English proficiency was a significant predictor of smoking [3,7]. Another study found a higher smoking prevalence among foreign-born Chinese Americans residing in San Francisco than among their U.S.-born peers [2].…”

Review of smoking cessation research among Asian Americans: The state of the research

“…Chen, Unger, Cruz, & Johnson, 1999;Wiecha, Lee, & Hodgkins, 1998), geographical area (e.g., M. S. Chen et al, 1993;Ma et al, 2005;Shelly et al, 2004;Thridandam, Fong, Jang, Louie, & Forst, 1998), and various acculturation factors such as English language fluency (e.g., X. Chen et al, 1999;Fu, Ma, Tu, Siu, & Metlay, 2003;Tang et al, 2005) range from 1.0% to 39.4%. The significance of these findings is that these disaggregated data are more amenable to informing interventions and research on curbing tobacco use among Asian Americans.…”

Heart Disease Prevention Practices among Immigrant Vietnamese Women

“…In a recent review of the smoking literature among Asian Americans, Kim et al 29 report that of five studies that examined the relationship between smoking and acculturation among women, all reported a direct association. [33][34][35][36][37] Our study has several strengths. We used populationbased sampling methods, administered the survey in person, and had a relatively good cooperation rate.…”