Perceptions of Asian American men about tobacco cigarette consumption: a social learning theory framework

Social Environmental Influences on Smoking and Cessation: Qualitative Perspectives Among Chinese-Speaking Smokers and Nonsmokers in California

This qualitative study examines the social environmental influences on smoking and cessation from the perspectives of Chinese smokers and household nonsmokers in California. Seven focus groups were conducted with 63 participants. Three culturally influenced levels of potential intervention emerged from constant comparative analysis. At the individual level, participants focused more on irritating odor than health harms of exposure and had inaccurate beliefs about harms of smoking and cessation. At the relational level, peers kept smokers connected to pro-smoking norms. There was conflict in the home about smoking and failed cessation, but smokers recognized the benefits of cessation for family harmony and children's health. Physicians encouraged cessation but this tended to be insufficient to prompt action unless a smoker felt ill. At the societal level, participants recognized changes in social acceptability and environmental regulation of smoking upon immigration. Better implementation of smokefree policies, plus culturally nuanced strategies for equipping both nonsmokers and smokers to become smokefree, are needed.

A Social Network Family-Focused Intervention to Promote Smoking Cessation in Chinese and Vietnamese American Male Smokers: A Feasibility Study

INTRODUCTION

Smoking prevalence is high among limited English-proficient Chinese and Vietnamese American men, who are frequently unmotivated to quit and who underutilize smoking cessation resources. This study applied lay health worker outreach to leverage peer and family networks to promote smoking cessation among these men.

METHODS

We integrated qualitative formative research findings and Social Network Theory to develop a social-network family-focused intervention. In a pilot single-group trial, 15 lay health workers recruited 96 dyads (N = 192, 75% Vietnamese) of Chinese or Vietnamese male daily smokers and their family members and delivered the intervention consisting of two small group education sessions and two individual telephone calls over 2 months.

RESULTS

At baseline, 42% of smokers were at precontemplation. At 3 months following the initiation of the intervention, 7-day and 30-day point prevalence smoking abstinence rates as reported by smokers and independently corroborated by family members were 30% and 24%, respectively. Utilization of smoking cessation resources (medication, quitline, physician's advice) increased from 2% to 60% (P < .001). Findings showed high acceptability of the intervention as it facilitated learning about tobacco-related health risks and cessation resources, and communications between smokers and their families.

CONCLUSIONS

This novel social network family-focused intervention to promote smoking cessation among Chinese and Vietnamese smokers appears to be acceptable, feasible, and potentially efficacious. Findings warrant evaluation of long-term efficacy of the intervention in a larger scale randomized controlled trial.

Working to Eliminate Cancer Health Disparities from Tobacco: A Review of the National Cancer Institute's Community Networks Program

INTRODUCTION

In 2005, the National Cancer Institute funded the Community Networks Program (CNP), which aimed to reduce cancer health disparities in minority racial/ethnic and underserved groups through community-based participatory research, education, and training. The purpose of this study was to describe the CNP model and their tobacco-related work in community-based research, education, and training using a tobacco disparities research framework.

METHODS

We conducted a comprehensive review of the CNP tobacco-related activities including publications, published abstracts, research activities, trainee pilot studies, policy-related activities, educational outreach, and reports produced from 2005-2009. Two authors categorized the tobacco-related activities and publications within the framework.

RESULTS

Although there was no mandate to address tobacco, the CNPs produced 103 tobacco-related peer-reviewed publications, which reflects the largest proportion (12%) of all CNP cancer-related publications. Selected publications and research activities were most numerous under the framework areas "Psychosocial Research," "Surveillance," "Epidemiology," and "Treatment of Nicotine Addiction." Thirteen CNPs participated in tobacco control policymaking in mainstream efforts that affected their local community and populations, and 24 CNPs conducted 1147 tobacco-related educational outreach activities. CNP activities that aimed to build research and infrastructure capacity included nine tobacco-related pilot projects representing 16% of all CNP cancer-related pilot projects, and 17 publications acknowledging leveraged partnerships with other organizations, a strategy encouraged by the CNP.

CONCLUSIONS

The CNP is a promising academic-community model for working to eliminate tobacco-related health disparities. Future efforts may address scientific gaps, consider collaboration across groups, assess the extent of operationalizing community-based participatory research, and improve common tracking measures.

Place matters in perceived tobacco exposure among Korean American young adults: mixed methods approach

A sequential mixed methods study was conducted to identify factors influencing perceived norms about smoking and to examine the association of acculturative contexts and normative beliefs among Korean American young adults (KAYA) who face increased risk of smoking. Content analysis of data from 67 participants in 10 focus groups in 2010 led to the development of an online survey in 2012 (N = 475). KAYA overestimated smoking prevalence, reporting Korean-owned businesses (KOB) as primary places of exposure. Our findings revealed that visits to KOB predicted perceived norms about smoking. Modifying perceptions about social norms and involuntary tobacco exposure may be critical in reducing smoking among KAYA. The study's limitations are noted.

Moderation of gender on smoking and depression in Chinese Americans

This study examined the moderating role of gender in the association between smoking status and depression in a nationwide convenience sample of Chinese American current, former, and never smokers (N=1393). Participants were recruited in smoker-supporter dyads. Multilevel modeling was used to take into account the dyadic nature of the data. Depressive symptoms were measured by a 10-item CES-D (Center of Epidemiological Studies-Depression Scale). Results showed significant effects of smoking status by gender interaction and smoking status on depression after adjusting for acculturation and social support. Among Chinese females, current smokers reported elevated depression level than both former and never smokers. Among Chinese males, current smokers reported more depressive symptoms when compared to former smokers only. Chinese females reported higher depression level than males among current smokers; no gender difference in depression was observed among former or never smokers. The association between smoking and depression is moderated by gender among Chinese Americans where substantial gender difference in smoking prevalence exists. Findings highlight the importance of addressing depression in treating tobacco use among Chinese American smokers, especially among females.

Smoking and the Asian American workforce in the National Latino and Asian American Study

BACKGROUND

Smoking among the Asian American workforce has not been extensively researched. This study examines smoking prevalence among a nationally representative sample of Asian Americans with an emphasis on occupational classification.

METHODS

Cross-sectional data come from the National Latino and Asian American Study. Multivariate logistic regression analyses were used to determine smoking prevalence by occupation, gender, and nativity, among 1,528 participants self-identifying as in the labor force.

RESULTS

Blue collar workers reported the highest smoking prevalence (32%) followed by unemployed (19%), other (17%), service (14%), and white collar (10%). Among both employed males and females, blue collar workers had the highest prevalence (45% and 18%, respectively). By nativity, smoking was highest among blue collar workers for immigrants (25%) and highest among the unemployed for U.S. born (16%). Blue collar employment was significantly associated with being a current smoker (OR = 2.52; 95% CI: 1.23-5.16; P < 0.05) controlling for demographics (e.g., age, gender, ethnic group, nativity, etc.).

CONCLUSIONS

Findings reveal that smoking differs by occupation among Asian Americans. Future research should examine factors explaining differences while considering gender and nativity.

Knowledge of tobacco control policies among U.S. Southeast Asians

Some of the highest smoking rates in the U.S. have been reported among Southeast Asians. The largest numbers of Southeast Asians reside in California. While California has a comprehensive and generally effective tobacco control program, it is unclear how immigrant groups learn of this public health effort. In a study of tobacco norms and practices among two generations of Southeast Asians we collected qualitative data on respondents' knowledge and awareness of tobacco control policies. Data were collected through in-person interviews with 164 respondents aged 15-87, evenly divided by smoking status, gender and generation in the U.S. Due to multiple sources of knowledge, general awareness of tobacco control policies and of secondhand smoke were high among both generations of Southeast Asians and the policies were attributed with changes in smoking behavior. Tobacco control regulations may be an effective means to impact tobacco use among immigrants with limited English proficiency.