Surveillance of Tobacco Use Among South Asians in the US: Are We Underestimating Prevalence?

Bover-Manderski, Michelle T.; Steinberg, Michael B.; Rahi, Kimberly N.; Banerjee, Smita C.; Delnevo, Cristine D.

doi:10.1007/s10900-016-0226-2

Cited by 13 publications

(10 citation statements)

References 11 publications

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“…While the prevalence of SLT among South Asians in the US is largely unknown and potentially underestimated, often because traditional health surveillance measures for tobacco do not capture traditional Asian products (16), the current published prevalence rates remain high (16)(17)(18)(19). However, a limited number of studies have focused on SLT use among the large South Asian communities in New York City (20)(21)(22), despite some suggestion of its high prevalence (16). In comparison, prevalence of cigarette smoking for the South Asian American population is often low compared to other racial/ethnic groups (23), thus researchers often consider that the risk of certain cancers among this population would also be low.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Correlates of Cultural Smokeless Tobacco Products among South Asian Americans in New York City

et al. 2019

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Despite the high prevalence of smokeless tobacco (SLT) use in South Asia, little is known about the use of cultural smokeless tobacco among South Asians in the United States (US). This study examines the prevalence and correlates of SLT products among South Asians living in New York City (NYC). A total of 602 South Asians living in NYC completed a community health needs and resource assessment and answered questions about the use of SLT. Multivariable logistic regression models were run to examine predictors of SLT use (ever and current use). A total of 28.2% South Asian individuals reported ever use of SLT (35.9% among men and 21.5% among women) and a total of 12.9% reported current use of SLT (16.5% among men and 9.7% among women). Logistic regression models were stratified by sex. Among men, factors associated with ever or current use included: Bangladeshi and Himalayan ethnic subgroup, speaking English very well, attending a religious service a few times a year (ever use only), and current or former cigarette smoking. Among women, factors associated with ever use included: Bangladeshi ethnic subgroup, self-reporting condition of mouth and teeth as fair/poor, and at risk for depression. No factors were significant among women for current use. Overall, prevalence of current and ever use of SLT is high, and important differences exist by sex. Future studies are needed to better

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Section: Introductionmentioning

confidence: 99%

Prevalence and Correlates of Cultural Smokeless Tobacco Products among South Asian Americans in New York City

et al. 2019

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“…8,20 Evidence from a split-sample survey found that the majority of South Asian CST users did not endorse use of smokeless tobacco, but these questions did not ask about CST products. 9 Because most population-based surveys measure the use of cigarettes and other mainstream tobacco products, tobacco use among AIs is likely underestimated because of the neglect of CST. By including CST products, we feel that prevalence estimates from this study will be a truer reflection of AI tobacco use and associated behaviors of current users versus those who have never used.…”

Section: Introductionmentioning

confidence: 99%

“…6 Such CST products are popular among South Asians outside the subcontinent. [7][8][9][10][11][12][13] Smokeless tobacco products are associated with an increased risk of oral cancers and cardiovascular diseases; these preventable conditions may be attributable to CST products as well. 14 The 2009 Global Adult Tobacco Survey has demonstrated that the prevalence of smokeless tobacco in India is higher than the prevalence of smoked products (smokeless tobacco, 23.6% for men and 17.2% for women; cigarettes, 5.3% for men and 0.1% for women; bidis, 9.9% for men and 1.2% for women); higher wealth is associated with cigarette smoking but is inversely associated with smokeless tobacco and bidis.…”

Section: Introductionmentioning

confidence: 99%

Moving toward a true depiction of tobacco behavior among Asian Indians in California: Prevalence and factors associated with cultural smokeless tobacco product use

Mukherjea

Modayil

Tong

2018

Cancer

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BACKGROUND: Asian Indians (AIs) in the United States exhibit disproportionate burdens of oral cancer and cardiovascular disease, which are potentially linked to smokeless tobacco. However, little is known about the use of cultural smokeless tobacco (CST) products in this population. METHODS: California Asian Indian Tobacco Use Survey data from 2004 (n 5 1618) were used to investigate CST prevalence among California's AIs. CST products included paan, paan masala, and gutka. A multivariable logistic regression was conducted to examine factors (socioeconomic status, acculturation measures, and religious affiliation) associated with current CST use versus never use. RESULTS: The current CST prevalence was 13.0% (14.0% for men and 11.8% for women). In contrast, the prevalence of current cigarette use was 5.5% (8.7% for men and 1.9% for women), and the prevalence was lower for cultural smoked tobacco (0.1% for bidis and 0.5% for hookahs). Factors associated with CST use included the following: being male, being 50 years old or older, being an immigrant, speaking an AI language at home, having a higher level of education (adjusted odds ratio [AOR] for high school/some college, 2.6; 95% confidence interval [CI], 1.1-6.5; AOR for college degree or higher, 4.0; 95% CI, 1.7-9.5), having a higher income (AOR for $75,000-$100,000, 2.5; 95% CI, 1.3-4.7; AOR for $100,000, 2.6; 95% CI, 1.4-5.0), identifying as non-Sikh (AOR for Hinduism, 10.0; 95% CI, 6.0-16.5; AOR for other faiths, 10.2; 95% CI, 5.9-17.7), and disagreeing that spiritual beliefs are the foundation of life (AOR, 2.1; 95% CI, 1.2-3.5). CONCLUSIONS: The current CST prevalence is relatively high among California's AIs in comparison with the prevalence of smoking, with narrower differences between sexes. The association with a higher socioeconomic status is contrary to typical cigarette smoking patterns. Acculturation and religious affiliation are important factors associated with current use. Health care providers and policymakers should consider such determinants for targeted interventions. Cancer 2018;124:1607-13.

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“…Tobacco use is common in South Asia; for example, India is the second largest consumer of tobacco in the world [2]. Tobacco consumption in South Asian culture is characterized by the ubiquity of a variety of both smoked and smokeless indigenous and local tobacco products.…”

Section: Introductionmentioning

confidence: 99%

“…In particular, the consumption of smokeless tobacco and areca nut is an integral cultural practice in South Asian countries [7]. These products are becoming more common in the U.S. and can be found in South Asian ethnic enclaves in the U.S. [2]. Particularly, gutka and paan masala are two types of chewing tobacco primarily used among South Asian immigrants in the U.S.…”

Section: Introductionmentioning

confidence: 99%

A qualitative study of gutka and paan masala use among Bhutanese and Burmese migrants in Georgia

Thanh

2020

PLoS ONE

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The city of Clarkston (Georgia) is home to many refugees and immigrants, including Bhutanese and Burmese populations. Use of gutka and paan masala is common in these populations. While gutka and paan masala contain toxic ingredients including carcinogens, little research has examined general use, perceptions of risk, cultural norms, and access to these products among Bhutanese and Burmese populations in the southern U.S. This study uses focus groups and key informant interviews to develop an understanding of gutka and paan masala use among Bhutanese and Burmese refugee populations residing in Clarkston, focusing in particular on knowledge and perceptions of harm, patterns of and reasons for use, access to gutka and paan masala, and resources for cessation and prevention of gutka and paan masala use. We conducted 21 focus groups with Bhutanese and Burmese youths and adults and 11 key informant interviews. We analyzed data using MAXQDA and a grounded theory approach. Emerging themes included mixed understandings of ingredients and harms associated with gutka and paan masala use. The continued use of paan masala was perceived to be due to cultural traditions. Youths, particularly Bhutanese, were perceived as a rising group of users of gutka and paan masala. Widespread availability and accessibility in Clarkston made it easy for both adults and youths to acquire and use gutka and paan masala. Few participants knew about prevention efforts or resources in their communities. In conclusion, culturally-relevant awareness and education programs as well as health promotion materials regarding gutka and paan masala are much needed in Bhutanese and Burmese communities. More regulatory actions are needed, such as better warning signs in businesses to inform customers of ingredients in these products and their health risks, age restrictions on gutka and paan masala purchase, and compliance checks.

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Surveillance of Tobacco Use Among South Asians in the US: Are We Underestimating Prevalence?

Cited by 13 publications

References 11 publications

Prevalence and Correlates of Cultural Smokeless Tobacco Products among South Asian Americans in New York City

Prevalence and Correlates of Cultural Smokeless Tobacco Products among South Asian Americans in New York City

Moving toward a true depiction of tobacco behavior among Asian Indians in California: Prevalence and factors associated with cultural smokeless tobacco product use

A qualitative study of gutka and paan masala use among Bhutanese and Burmese migrants in Georgia

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