Smoking Topography in Korean American and White Men: Preliminary Findings

Abstract

Introduction This is the first study of Korean Americans’ smoking behavior using a topography device. Korean American men smoke at higher rates than the general U.S. population. Methods Korean American and White men were compared based on standard tobacco assessment and smoking topography measures. They smoked their preferred brand of cigarettes ad libitum with a portable smoking topography device for 24 hours. Results Compared to White men (N = 26), Korean American men (N = 27) were more likely to smoke low nicotine-yield cigarettes (p < 0.001) and have lower Fagerstrom nicotine dependence scores (p = 0.04). Koreans smoked fewer cigarettes with the device (p = 0.01) than Whites. Controlling for the number of cigarettes smoked, Koreans smoked with higher average puff flows (p = 0.05), greater peak puff flows (p = 0.02), and shorter interpuff intervals (p < 0.001) than Whites. Puff counts, puff volumes, and puff durations did not differ between the two groups. Conclusions This study offers preliminary insight into unique smoking patterns among Korean American men who are likely to smoke low nicotine-yield cigarettes. We found that Korean American men compensated their lower number and low nicotine-yield cigarettes by smoking more frequently with greater puff flows than White men, which may suggest exposures to similar amounts of nicotine and harmful tobacco toxins by both groups. Clinicians will need to consider in identifying and treating smokers in a mutually aggressive manner, irrespective of cigarette type and number of cigarette smoked per day.

Smoking Topography among Korean Smokers: Intensive Smoking Behavior with Larger Puff Volume and Shorter Interpuff Interval

“…The outcome of our study demonstrated similar puff volumes, puff durations, average puff flow rates, and peak flow rates as those obtained from US-dwelling Korean immigrants and American citizens who used the same type of topograph measuring device. However, it also demonstrated that Korean smokers tended to smoke much intensively; the interpuff interval of 8.9 s among Koreans participating in our study was much shorter than that of Americans (25 s) or Korean immigrants living in the USA (13.5 s) [ 8 ].…”

“…An interviewer-administered questionnaire was used to collect information about demographic characteristics (e.g., age, sex, education level, and race/ethnicity), smoking behaviors (self-reported smoking status, daily smoking amount, nicotine dependence based on the Fagerstrom score, cigarette brand name, number of packages smoked daily), and socioeconomic status. A clinical Research Support System (CReSS) pocket device (BORGWALDT, Richmond, VA, USA) was used to collect data containing the distributions of puff volumes, puff durations, and interpuff intervals from cigarette smoking during a 24-hour period, which was used in many previous studies as a valid tool [ 6 , 7 , 8 ]. Urine samples were collected from participants who completed topography analyses and were subjected to measurements of cotinine, OH-cotinine, and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) concentrations using liquid chromatography-tandem mass spectrometry [ 15 ].…”

“…Recently, one study reported that smokers of “ultra-low/low” nicotine-yield cigarettes exhibited 2.7times more intensive smoking behaviors ( p = 0.024) to achieve the same salivary cotinine levels as Japanese smokers of “medium/high” nicotine-yield cigarettes [ 7 ]. In the United States, a study reported that Korean-Americans tended to exhibit higher average puff flows ( p = 0.05), greater peak puff flows ( p = 0.02), and shorter interpuff intervals ( p < 0.001), compared to Americans of Caucasian descent [ 8 ]. Another study found that the higher levels of nicotine metabolites in men relative to women were associated with the puff volumes, as well as the height, weight, and nicotine metabolism of smokers [ 9 ].…”

The use of ambulatory assessment in smoking cessation

“…Smoking topography studies provide useful information on the relationship between smoking behavior and smoking cessation, and topography has been measured in settings outside of the laboratory. Prior work has examined smoking topography in the real world to determine differences in smoking patterns among groups of people (e.g., chippers vs dependent smokers; Brauer, 1996; Korean American vs White men; Chung, Kim, Kini, Fang, Kalman, & Ziedonis, 2015). Research has also shown that self-reported cigarettes smoked per day were not associated with smoking topography patterns in day-to-day life (Hatsukami, Morgan, & Pickens, 1987).…”

A Culturally Adapted Smoking Cessation Intervention for Korean Americans

“…For example, based on the 2009 to 2011 Risk Factor Survey, 36% of Korean men and 11% of Korean women in New York City were smokers, whereas the rates were 19% and 4% for all Asian men and women, respectively, and 14% for the whole city population (Li et al, 2013). Although Korean men smoked fewer cigarettes, they did with greater puff-flows and much shorter intervals than White men (Chung et al, 2015).…”