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Thompson CL, Buchanan AH, Myers R, Weinberg DS. Integrating primary care, shared decision making, and community engagement to facilitate equitable access to multi-cancer early detection clinical trials. Front Oncol 2024; 13:1307459. [PMID: 38486933 PMCID: PMC10937460 DOI: 10.3389/fonc.2023.1307459] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 12/06/2023] [Indexed: 03/17/2024] Open
Abstract
Effective implementation of cancer screening programs can reduce disease-specific incidence and mortality. Screening is currently recommended for breast, cervical, colorectal and lung cancer. However, initial and repeat adherence to screening tests in accordance with current guidelines is sub-optimal, with the lowest rates observed in historically underserved groups. If used in concert with recommended cancer screening tests, new biospecimen-based multi-cancer early detection (MCED) tests could help to identify more cancers that may be amendable to effective treatment. Clinical trials designed to assess the safety and efficacy of MCED tests to assess their potential for reducing cancer mortality are needed and many are underway. In the conduct of MCED test trials, it is crucial that participant recruitment efforts successfully engage participants from diverse populations experiencing cancer disparities. Strategic partnerships involving health systems, clinical practices, and communities can increase the reach of MCED trial recruitment efforts among populations experiencing disparities. This goal can be achieved by developing health system-based learning communities that build understanding of and trust in biomedical research; and by applying innovative methods for identifying eligible trial patients, educating potential participants about research trials, and engaging eligible individuals in shared decision making (SDM) about trial participation. This article describes how a developing consortium of health systems has used this approach to encourage the uptake of cancer screening in a wide range of populations and how such a strategy can facilitate the enrollment of persons from diverse patient and community populations in MCED trials.
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Affiliation(s)
- Cheryl L. Thompson
- Penn State Cancer Institute, Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, United States
| | - Adam H. Buchanan
- Department of Genomic Health, Geisinger, Danville, PA, United States
| | - Ronald Myers
- Division of Population Science Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, United States
| | - David S. Weinberg
- Department of Medicine, Fox Chase Cancer Center, Philadelphia, PA, United States
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Akiki Z, Saadeh D, Haddad C, Sacre H, Hallit S, Salameh P. Knowledge and attitudes toward cigarette and narghile smoking among previous smokers in Lebanon. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:14100-14107. [PMID: 32037494 DOI: 10.1007/s11356-020-07763-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 01/15/2020] [Indexed: 06/10/2023]
Abstract
To evaluate the proportions of current cigarette smokers (CCS) and current narghile smokers (CNS) as well as previous cigarette smokers (PCS) and previous narghile smokers (PNS) and to assess smoking knowledge and attitudes toward supporting smoking ban or cessation among previous compared with current smokers. This cross-sectional study took place between May and December 2018, and enrolled a sample of 1598 exclusive cigarette smokers (ECS) and 2091 exclusive narghile smokers (ENS), representative of all Lebanese governorates. A questionnaire designed specifically for this study was used to collect data. Among ECS, 45.2% were CCS and 54.8% were PCS. Among ENS, 83.5% were CNS and 16.5% were PNS. Higher age (adjusted odds ratio (aOR) (95% confidence interval (CI)) = 1.02 (1.01; 1.03)), higher knowledge (1.05 (1.02; 1.08)), and attitude scores (1.11(1.09; 1.13)) were significantly associated with higher odds of being PCS. Higher age (1.02 (1.01; 1.03)), being employed (1.32 (1.004; 1.72)), higher knowledge (1.04 (1.02; 1.07)), and attitude scores (1.09 (1.07; 1.12)) were significantly associated with higher odds of being PNS. Previous smokers have higher knowledge and better attitude toward supporting smoking cessation compared with current smokers. A better knowledge along with effective interventions, might lead to a positive attitude toward supporting smoking ban or smoking cessation among the general population.
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Affiliation(s)
- Zeina Akiki
- INSPECT- LB: Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie, Beirut, Lebanon.
- Faculty of Public Health, Lebanese University, Fanar, Lebanon.
- Faculty of Nursing and Health Sciences, Notre Dame Louaize University, Barsa, Lebanon.
- Faculty of Health Sciences, University of Balamand, Koura, Lebanon.
| | - Danielle Saadeh
- INSPECT- LB: Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie, Beirut, Lebanon
- Faculty of Public Health, Lebanese University, Fanar, Lebanon
- CERIPH, Center for Research in Public Health, Pharmacoepidemiology Surveillance Unit, Faculty of Public Health, Lebanese University, Fanar, Lebanon
| | - Chadia Haddad
- Institut d'Epidémiologie et de Neurologie Tropicale, UMR 1094, Neuroépidémiologie Tropicale, Université de Limoges, GEIST, 87000, Limoges, France
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
| | - Hala Sacre
- INSPECT- LB: Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie, Beirut, Lebanon
- Drug Information Center, Order of Pharmacists of Lebanon, Beirut, Lebanon
| | - Souheil Hallit
- INSPECT- LB: Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie, Beirut, Lebanon.
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
| | - Pascale Salameh
- INSPECT- LB: Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie, Beirut, Lebanon
- Faculty of Medicine, Lebanese University, Beirut, Lebanon
- Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
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Roods K, Jasek J, Farley SM. Recent Survey Findings on Smoking and Cessation Behaviors Among Asians in New York City. J Community Health 2019; 44:1141-1149. [PMID: 31278604 DOI: 10.1007/s10900-019-00695-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Cigarette smoking has declined among New York City (NYC) adults since 2002, but research has shown that NYC tobacco control policies may be less impactful among Asian communities, particularly Chinese. In order to better target this subgroup, we explored smoking and cessation behaviors among Chinese-speaking Asian smokers compared with English-speaking Asian smokers and all other smokers. We used combined 2015-2016 data from the NYC Community Health Survey (CHS), an annual dual landline/cellphone survey of about 9000 adults to analyze smoker demographics, and 2010-2012 and 2016 CHS samples to compare quit attempts, advice, and aids used among Asian smokers who took the survey in Chinese, Asian smokers who took the survey in English and all other smokers at two points in time. We used multivariable logistic regression to compare outcomes between groups. In 2015-2016, English-speaking Asians (11.2%, p = .004) and all other adults (13.6%, p = .029) were less likely to be current smokers compared with Chinese-speaking Asians (16.9%). In 2010-2012 there was no difference in odds of current smoking by race/interview language, while in 2016 the odds of smoking among English-speaking Asians and all other respondents were 51% and 32% lower, respectively, than Chinese-speaking Asians. Odds of NRT use did not differ in 2010-2012 but in 2016 odds of NRT use among all other smokers were 2.63 times higher than among Chinese-speaking Asian smokers. Results indicate the need for tailored smoking cessation programs towards Chinese-speaking Asian smokers to encourage NRT use, reduce cigarette consumption, and decrease disparities.
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Affiliation(s)
- Kristi Roods
- New York City Department of Health and Mental Hygiene, 42-09 28th Street, WS 11-150, Long Island City, NY, 11101, USA
| | - John Jasek
- New York City Department of Health and Mental Hygiene, 42-09 28th Street, WS 11-150, Long Island City, NY, 11101, USA.
| | - Shannon M Farley
- New York City Department of Health and Mental Hygiene, 42-09 28th Street, WS 11-150, Long Island City, NY, 11101, USA
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Vu M, Escoffery C, Srivanjarean Y, Do E, Berg CJ. Acculturation and Exposure to Secondhand Smoke in the Home Among Vietnamese Immigrants in Metropolitan Atlanta. J Immigr Minor Health 2019; 22:580-587. [PMID: 31154544 DOI: 10.1007/s10903-019-00906-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study represents the first effort to examine associations between various measures of acculturation and past 30-day secondhand smoke (SHS) exposure among Vietnamese-Americans in metro-Atlanta, one of the areas with the highest number of Vietnamese-Americans in the U.S. Survey data of 96 Vietnamese-American nonsmoking adults attending health fairs/programs hosted by community-based organizations (2017-2018) were analyzed. Acculturation-related predictors included Vancouver Acculturation Index, language fluency, years in the U.S., and area-level proportion of Asian residents. The sample was an average 37.49 years old and 65.3% female; the average number of years in the U.S. was 18.17 years. Past 30-day SHS exposure was reported by 21.9%. In multiple logistic regressions, the only variable associated with SHS exposure was the number of years living in the U.S. [OR = 0.91, CI = (0.85-0.99), p = 0.02]. Newly-immigrated Vietnamese-Americans have increased SHS exposure risk. Education about smoke-free policies and harmful effects of SHS may benefit this population.
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Affiliation(s)
- Milkie Vu
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, GCR 521, Atlanta, GA, 30322, USA.
| | - Cam Escoffery
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, GCR 521, Atlanta, GA, 30322, USA
- Winship Cancer Institute, Emory University, Atlanta, GA, USA
| | | | - Elizabeth Do
- Center for Pan Asian Community Services, Atlanta, GA, USA
| | - Carla J Berg
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, GCR 521, Atlanta, GA, 30322, USA
- Winship Cancer Institute, Emory University, Atlanta, GA, USA
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Lee SR, Cho AR, Lee SY, Cho YH, Park EJ, Kim YJ, Lee JG. Secondhand smoke knowledge, sources of information, and associated factors among hospital staff. PLoS One 2019; 14:e0210981. [PMID: 30668578 PMCID: PMC6342318 DOI: 10.1371/journal.pone.0210981] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 01/05/2019] [Indexed: 11/25/2022] Open
Abstract
Purpose To evaluate knowledge of secondhand smoke (SHS) risks, sources of information, and associated factors and behaviors among hospital staff. Methods We conducted a cross-sectional survey using a 40-item self-administered questionnaire among 328 employees at a university hospital. The questions on representative diseases related to SHS were used to measure the degree of knowledge of SHS. Multiple regression analysis was used to determine the correlation between SHS knowledge scores and variables. Results Females had better SHS knowledge scores than males, regardless of smoking status (p<0.05). SHS knowledge was positively correlated with cessation education in males, non-smokers, and the total sample (β = 3.950, 2.356, and 2.684, respectively, p<0.05). It was correlated with the experience of any SHS exposure-related symptoms in males, non-smokers, and the total sample (β = 3.950, 2.356, and 2.684, respectively, p<0.05) and discomfort when exposed to SHS in non-smokers and the total sample (β = 0.670 and 0.821, respectively, p<0.05). Conclusion SHS knowledge is high among females, when hospital staff are educated about SHS risks, and when they have experienced any SHS exposure-related symptoms or felt uncomfortable when exposed to SHS. SHS risk education is an effective tool to increase SHS knowledge in hospital staff.
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Affiliation(s)
- Sae Rom Lee
- Family Medicine Clinic, and Research Institute of Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - A-ra Cho
- Family Medicine Clinic, and Research Institute of Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Sang Yeoup Lee
- Family Medicine Clinic, and Research Institute of Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
- Department of Medical Education, Pusan National University School of Medicine, Yangsan, Republic of Korea
- * E-mail:
| | - Young Hye Cho
- Family Medicine Clinic, and Research Institute of Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Eun Ju Park
- Family Medicine Clinic, and Research Institute of Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Yun Jin Kim
- Department of Family Medicine, Pusan National University School of Medicine, Yangsan, Republic of Korea
| | - Jeong Gyu Lee
- Department of Family Medicine, Pusan National University School of Medicine, Yangsan, Republic of Korea
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Lim KH, Lim HL, Teh CH, Kee CC, Heng PP, Cheah YK, Ghazali SM. Secondhand smoke (SHS) exposure at home and at the workplace among non-smokers in Malaysia: Findings from the Global Adult Tobacco Survey 2011. Tob Induc Dis 2018; 16:49. [PMID: 31516446 PMCID: PMC6659505 DOI: 10.18332/tid/95188] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 08/23/2018] [Accepted: 09/17/2018] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Understanding the prevalence of secondhand smoke (SHS) exposure and the associated factors is beneficial for the formulation of effective measures to reduce exposure to SHS. The purpose of this study was to determine SHS exposure at home and workplace, and its associated factors among non-smoker Malaysian adults. METHODS Data were extracted from the Global Adult Tobacco Survey-Malaysia (GATS-M) that involved a representative sample of 5112 Malaysian adults. Logistic regression analyses were performed to examine the association between SHS exposure, sociodemographic factors, knowledge on the danger of SHS, and smoking restrictions at home and at work among non-smokers. RESULTS Among non-smoker Malaysians, age ≥15 years, 27.9% (equivalent to approximately 4.21 million non-smokers) and 33.9% (equivalent to approximately 1.37 million non-smokers) reported that they were exposed to SHS at home and the workplace, at least once a month, respectively. Women (AOR=2.12, 95% CI: 1.61-2.78), young individuals (AOR=3.06, 95% CI: 1.48-6.33), Malays (AOR=2.39, 95% CI: 1.56-3.64) or other Bumiputra ethnic groups (AOR=2.40, 95% CI: 1.39-4.19) and those who worked as other than government employees were more likely to report SHS exposure at home (non-government employee: AOR=1.88, 95% CI: 1.06-3.36). Respondents with a total smoking restriction at home did not report any SHS exposure at home. Similarly, those whose workplace had smoking restrictions were less likely to report SHS exposure at the work compared to their counterparts whose workplace had partial (AOR=3.08, 95% CI: 1.84-5.15) or no smoking restrictions (AOR=15.33, 95% CI: 6.75-34.86). CONCLUSIONS A substantial proportion of Malaysian adults were exposed to SHS at home and at work. The findings emphasize the need for policies on smoking restrictions at work and the need to promote the adoption of a completely smoke-free home, among the Malaysian population.
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Affiliation(s)
| | - Hui Li Lim
- Hospital Sultan Haji Ahmad Shah, Pahang, Malaysia
| | | | | | - Pei Pei Heng
- Institute for Medical Research, Kuala Lumpur, Malaysia
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Saw A, Tang H, Tsoh JY, Chen MS, Tong EK. Non-smoker assertive behaviour against smoke exposure: Chinese and Korean American non-smokers. Drug Alcohol Rev 2017; 36:779-787. [PMID: 28439993 PMCID: PMC5656557 DOI: 10.1111/dar.12557] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 03/03/2017] [Accepted: 03/16/2017] [Indexed: 11/28/2022]
Abstract
INTRODUCTION AND AIMS Non-smokers' assertive behaviour towards smokers by asking them not to smoke is important in promoting smoke-free environments. Korean and Chinese Americans come from countries where most women are non-smokers and assertive behaviour may not be prevalent but may increase after migration because of social-ecological factors. This study assessed the extent to which Korean and Chinese American non-smokers ask someone not to smoke and associated factors. DESIGN AND METHODS The 2003 California Chinese American and Korean American Tobacco Use Surveys were analysed. Multivariate logistic regression analyses examined factors related to non-smoker self-reports that they asked someone not to smoke within the past year. RESULTS About 40% reported past-year assertive behaviour against smoking, with higher rates among Koreans than Chinese (60.4% vs. 34.5%), those living with smokers (63.5%), ever exposed with a smoke-free home rule (62.3%), recently exposed at work without a smoke-free work policy (67.6%) and regularly exposed at other locations (52.3%). In combined multivariate analyses of both ethnic groups, assertive behaviour was associated with individual factors (single vs. married; tobacco exposure knowledge), family factors (living with smokers, exposed at home despite a smoke-free rule), community factors (exposed at work with no smoke-free policy, exposed at other locations) and cultural factors (Korean vs. Chinese ethnicity; lower acculturation). DISCUSSION AND CONCLUSIONS Chinese and Korean American non-smokers report assertive behaviour against smoking, which is associated with social-ecological factors. Results help identify target groups and strategies for future intervention, including the need to implement or enforce smoke-free environments and promote empowerment. [Saw A, Tang H, Tsoh JY, Chen MS Jr, Tong EK. Non-smoker assertive behaviour against smoke exposure: Chinese and Korean American non-smokers.
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Affiliation(s)
- Anne Saw
- Department of Psychology, DePaul University, Chicago, USA
| | - Hao Tang
- Genetic Disease Screening Program, California Department of Public Health, Richmond, USA
| | - Janice Y. Tsoh
- Department of Psychiatry, University of California, San Francisco, USA
| | - Moon S. Chen
- Department of Internal Medicine, University of California Davis, Sacramento, USA
| | - Elisa K. Tong
- Department of Internal Medicine, University of California Davis, Sacramento, USA
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Involuntary Tobacco Smoking Exposure Among Korean American Emerging Adults: A Qualitative Study. J Immigr Minor Health 2016; 19:733-737. [PMID: 27053068 DOI: 10.1007/s10903-015-0318-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
High smoking prevalence among Korean American (KA) males place KA family members and co-workers at an elevated risk of involuntary tobacco smoke exposure (ITSE). KA emerging adults (EAs) face an additional risk of ITSE by their peers, as emerging adulthood is associated with increased smoking. This paper explores health behaviors, attitudes and beliefs of ITSE among KAEA. Qualitative data analysis was conducted on transcripts from ten focus groups (N = 67). Themes related to attitudes and perceptions of ITSE were identified: high level of cultural tolerance, lack of knowledge/insufficient information, perceived benign health effects, and perceived hopelessness/indifference. Themes related to culturally-held beliefs include: tolerance of male family smokers, allowance of indoor smoking and misconceptions of practices perceived to minimize ITSE. The dissemination of culturally relevant ITSE information is needed in KA communities. Failure to implement indoor smoking bans in ethnic enclaves calls for increased enforcement of regulations by public health officials.
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Tong EK, Fagan P, Cooper L, Canto M, Carroll W, Foster-Bey J, Hébert JR, Lopez-Class M, Ma GX, Nez Henderson P, Pérez-Stable EJ, Santos L, Smith JH, Tan Y, Tsoh J, Chu K. Working to Eliminate Cancer Health Disparities from Tobacco: A Review of the National Cancer Institute's Community Networks Program. Nicotine Tob Res 2015; 17:908-23. [PMID: 26180215 PMCID: PMC4542844 DOI: 10.1093/ntr/ntv069] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2014] [Accepted: 03/13/2015] [Indexed: 12/29/2022]
Abstract
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.
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Affiliation(s)
- Elisa K Tong
- Department of Internal Medicine, University of California, Davis, Sacramento, CA;
| | - Pebbles Fagan
- Cancer Prevention and Control Program, University of Hawaii Cancer Center, Honolulu, HI
| | | | - Maria Canto
- Center for Research Capacity Building, National Institute of General Medical Sciences, Bethesda, MD
| | - William Carroll
- Department of Surgery, University of Alabama at Birmingham, Birmingham, AL
| | | | - James R Hébert
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC
| | | | - Grace X Ma
- Department of Public Health, Temple University, Philadelphia, PA
| | | | - Eliseo J Pérez-Stable
- Department of Internal Medicine, University of California, San Francisco, San Francisco, CA
| | | | | | - Yin Tan
- Department of Public Health, Temple University, Philadelphia, PA
| | - Janice Tsoh
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA
| | - Kenneth Chu
- Formerly National Cancer Institute's Center to Reduce Cancer Health Disparities (retired), Bethesda, MD
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Mao A, Bottorff JL, Oliffe JL, Sarbit G, Kelly MT. A qualitative study of Chinese Canadian fathers' smoking behaviors: intersecting cultures and masculinities. BMC Public Health 2015; 15:286. [PMID: 25879194 PMCID: PMC4379716 DOI: 10.1186/s12889-015-1646-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 03/16/2015] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND China is home to the largest number of smokers in the world; more than half of the male population smoke. Given the high rates of Chinese immigration to Canada and the USA, researchers have explored the effect of immigration on Chinese smokers. Reduced tobacco use among Chinese immigrants has been reported in the United States; however, little is known about the social factors underlying men's smoking practices in settings where tobacco control measures have denormalized smoking, and in the context of fatherhood. The purpose of this Canada-based study was to explore the smoking-related experiences of immigrant Chinese fathers. METHODS In this qualitative study, semi-structured telephone interviews were conducted with 22 Chinese Canadian fathers who smoked or had recently quit smoking, and had at least one child under the age of five years old. RESULTS The Chinese fathers had dramatically changed their smoking patterns due to concern for their children's health and social norms and restrictions related to smoking in Canada. The facilitators and barriers for men's smoking were intertwined with idealized masculine provider and protector roles, and diverse Canadian Chinese cultural norms related to tobacco use. CONCLUSIONS The findings have implications for the development of future smoking cessation interventions targeting Chinese Canadian immigrant smokers as well as smokers in China.
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Affiliation(s)
- Aimei Mao
- Kiang Wu Nursing College of Macau, Est. Repouso No.35, R/C, Macau, China.
| | - Joan L Bottorff
- School of Nursing and Institute for Healthy Living and Chronic Disease Prevention, University of British Columbia, 3333 University Way, Kelowna, BC, Canada.
- Faculty of Health Sciences, Australian Catholic University, Melbourne, VIC, Australia.
| | - John L Oliffe
- School of Nursing, University of British Columbia, 302 6190 Agronomy Rd, Vancouver, BC, Canada.
| | - Gayl Sarbit
- Institute for Healthy Living and Chronic Disease Prevention, University of British Columbia, 3333 University Way, Kelowna, BC, Canada.
| | - Mary T Kelly
- Institute for Healthy Living and Chronic Disease Prevention, University of British Columbia, 3333 University Way, Kelowna, BC, Canada.
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Understanding socio-cultural influences on smoking among older Greek-Australian smokers aged 50 and over: facilitators or barriers? A qualitative study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:2718-34. [PMID: 25739006 PMCID: PMC4377928 DOI: 10.3390/ijerph120302718] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Revised: 02/18/2015] [Accepted: 02/25/2015] [Indexed: 02/05/2023]
Abstract
Smokers of all ages can benefit by quitting, but many smokers continue to smoke. Older Greek-Australian smokers, one of the largest ethnic groups in Australia, have higher rates of smoking than other groups of older Australians. This qualitative study aimed to explore older Greek-Australians’ views about socio-cultural influences on their smoking. A snowball sampling technique was used to identify twenty Greek–Australian smokers (12 males and eight females), aged ≥ 50 years. They were recruited through the Greek Orthodox Community Center of South Australia (GOCSA). Qualitative data were collected using semi-structured face-to-face interviews. The audio-taped interviews were translated and transcribed, and then analysed using content analysis. Results suggested that smoking was considered as the “norm” by older Greek-Australian smokers. There were four groups embedded in the participants’ social networks that were reported to be important in relation to either encouraging smoking or, smoking abstinence. These support groups included: family members, friends, the Greek community, and physicians. Smokers’ family members (brothers) and friends were identified as facilitators of smoking whereas non-smoker family members (children and spouses) were reported as providing barriers to smoking. Different approaches were used by supporter groups to assist smokers to quit smoking—both planned and unplanned. Knowledge, planning of social and cultural supports, and addressing barriers to smoking cessation are a important part of health planning for older Greek-Australians. Social norms, including those arising from social interactions, and predisposing traits can influence smoking behaviour. Addressing the specific barriers to smoking cessation of older Greek-Australians is critical to addressing the risk for chronic disease in this group.
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Sa J, Seo DC, Nelson TF, Lohrmann DK. Cigarette smoking among Korean international college students in the United States. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2013; 61:454-467. [PMID: 24152023 DOI: 10.1080/07448481.2013.832253] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVE AND PARTICIPANTS This study explored (1) the prevalence of cigarette smoking among South Korean international college students in the United States, (2) differences in smoking between on- and off-campus living arrangements, and (3) predictors of an increase in smoking over time in the United States METHODS An online survey was completed by 1,201 students at 52 4-year US universities (34% response rate). RESULTS The overall smoking prevalence was 43.5%. The smoking rate (29.0%) of female students was higher than that (4%) of female college students in South Korea. Sex, living place, living situation, length of stay as a student in the United States, home smoking rules, campus-wide tobacco-free policies, and levels of acculturative stress, anxiety, and depression were significantly associated with an increase in smoking (p < .05). CONCLUSIONS Given the high smoking prevalence among the South Korean students on US college campuses, targeted prevention efforts for these students may be warranted.
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Affiliation(s)
- Jaesin Sa
- a Department of Exercise Science , University of Maryland Eastern Shore , Princess Anne , Maryland
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Koch-Weser S, Liang S, Grigg-Saito D, Toof R. Health Behaviors Among Cambodian Adults in Lowell, Massachusetts. J Immigr Minor Health 2012; 14:823-30. [DOI: 10.1007/s10903-012-9620-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Kim SS, Kim SH, Ziedonis D. Tobacco dependence treatment for Korean Americans: preliminary findings. J Immigr Minor Health 2012; 14:395-404. [PMID: 21785963 DOI: 10.1007/s10903-011-9507-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The study was conducted to examine the relative effectiveness of cognitive behavior therapy with a cultural tailoring intervention compared to brief medication management. The study used a two-arm randomized controlled trial in which participant assignment was stratified by gender. The intervention condition received eight weekly 40-min individualized counseling sessions of culturally tailored cognitive behavior therapy, while the control condition received eight weekly 10-min individualized counseling sessions of medication management. Both conditions received nicotine patches for 8 weeks. Data were collected at baseline and at four follow-up points (one and 4 weeks, and three and 6 months post-quit). Treatment outcomes were presented as an intention-to-treat analysis. Thirty Korean immigrants participated in the study. At 6-month follow-up, 57.1% of participants in the intervention and 18.8% of participants in the control had 7-day point prevalence abstinence (odds ratio = 5.8, 95% confidence interval = 1.12-26.04, P = 0.04). Participants' self-reported abstinence was biochemically verified with exhaled carbon monoxide and salivary cotinine levels. A combination of the culturally tailored cognitive behavior therapy and nicotine replacement therapy had a better treatment outcome compared to brief medication management. The promising result suggests a need to further test the intervention in larger samples and longer follow-up assessments before it can be adapted in clinical settings.
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Affiliation(s)
- Sun S Kim
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA.
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Kim SS, Nguyen HL, Le TH. Culture and smoking among Vietnamese Americans in central Massachusetts. J Transcult Nurs 2012; 23:151-8. [PMID: 22294338 DOI: 10.1177/1043659611434060] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The study was conducted (a) to assess use of any smoking cessation medications, (b) to identify factors associated with smoking, and (c) to assess knowledge of the health effects of smoking and attitudes toward smoking and seeking help for quitting among Vietnamese Americans. This is a descriptive study conducted with a nonrepresentative sample of 163 Vietnamese Americans. Current and former smokers constituted 24.4% and 25.6% of men and 1.2% and 3.5% of women, respectively. Of 20 current smokers, 17 (85%) reported use of cessation medications in their past quit attempts. Acculturation was the only significant correlate of ever smoking (vs. never smoking) in multivariate logistic regression analyses. Men who were less acculturated had more than 5 times the odds of being ever smokers (odds ratio = 5.33, 95% confidence interval = 1.37-20.78) compared with more acculturated men. Most participants had correct knowledge of the health effects of smoking regardless of age, education level, and smoking status. Attitudes toward smoking differed by age and education level but not by smoking status. Nurses working with Vietnamese Americans should be aware of the high rate of smoking among male immigrants and provide smoking cessation interventions.
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Affiliation(s)
- Sun S Kim
- University of Massachusetts Medical School, 365 Plantation St., Worcester, MA 01652, USA.
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Bhanji S, Andrades M, Taj F, Khuwaja AK. Factors related to knowledge and perception of women about smoking: a cross sectional study from a developing country. BMC WOMENS HEALTH 2011; 11:16. [PMID: 21605469 PMCID: PMC3123283 DOI: 10.1186/1472-6874-11-16] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/31/2010] [Accepted: 05/24/2011] [Indexed: 11/19/2022]
Abstract
Background Smoking rates among women are currently low, but they are the fastest growing segment of cigarette smoking population in developing countries. We aimed to assess the knowledge and perceptions towards smoking and to identify the factors related with level of knowledge and perceptions among adult women in urban slums. Methods This was a cross sectional study conducted on 250 adult (≥18 years of age) women attending primary care clinics in three slums of Karachi, Pakistan. A pre-tested and structured, interviewer administered questionnaire was used for data collection. Factors associated with level of understanding about smoking were analyzed with chi-square test. Results Most of the women knew that smoking has adverse effects on women and children's health but the knowledge of specific health effects was limited. About one third of the women knew that active smoking can cause lung disease, but only a small percentage (7%) knew that it could lead to heart disease. None of the women were aware that smoking contributes to infertility and osteoporosis. A small proportion of women were aware that smoking can lead to low birth weight (7%), congenital anomalies (5%) and less than 1% of women knew that it contributes to pregnancy loss, still birth and preterm delivery. The understanding of passive smoking affecting children's lung was low (20%) and a similar proportion voiced concern about the bad influence of maternal smoking on children. Educated women had better knowledge of health effects of smoking. Education was associated with having better knowledge about effects on women health in general (p = 0.02) and specific effects like lung (p = 0.03) and reproductive health effects (p < 0.001). Education was also associated with knowledge regarding effects on fetus (p < 0.001) and children (p < 0.005). Although most of the women disliked being around smokers, more than one third thought that smoking decreases boredom (39%), tension (38%) and also helps to relax (40%). A large proportion (48%) of women had the misconception that smoking helps to reduce weight. Conclusions This study reveals that women are aware of the general ill effects of smoking but fail to identify smoking to be associated with female maladies particularly those who were illiterate and had lower levels of education. Understanding and attitudes needs to be improved by increasing health awareness and education of women in these urban communities with special emphasis on the effects of smoking on women's health.
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Affiliation(s)
- Seema Bhanji
- Department of Family Medicine, The Aga Khan University, Stadium Road, PO Box 3500, Karachi-74800, Pakistan
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Tsoh JY, Tong EK, Gildengorin G, Nguyen TT, Modayil MV, Wong C, McPhee SJ. Individual and family factors associated with intention to quit among male Vietnamese American smokers: implications for intervention development. Addict Behav 2011; 36:294-301. [PMID: 21177041 DOI: 10.1016/j.addbeh.2010.11.009] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2010] [Revised: 11/10/2010] [Accepted: 11/20/2010] [Indexed: 10/18/2022]
Abstract
Smoking prevalence among Vietnamese American males remains higher than the U.S. general population. This study examined the associations of individual and family factors with quit intention among Vietnamese male smokers in California to guide intervention development to reduce their smoking prevalence. Data for Vietnamese male current smokers (n=234) in the 2008 California Vietnamese Adult Tobacco Use Survey (N=1101 males) were analyzed to describe quit intention and previous quit attempts. One-third of Vietnamese male smokers (33%) had no intention to quit at any time, 36% intended to quit soon (in the next 30 days), and 31% intended to quit later (beyond the next 30 days). Half (51.7%) of the sample was in "precontemplation," indicating no intention to quit within 6 months. Many (71%) had made a serious quit attempt in the past year, but 68% of those who tried to quit used no cessation assistance. Multivariate logistic regression adjusting for age, depression, smoking intensity, nicotine dependence, health knowledge, children in the household and home smoking ban revealed that having smoking-related family conflicts and a quit attempt in the past year with or without assistance were independently associated with an intention to quit either in the next 30 days or later. Higher education was associated with no intention to quit. Findings underscore the importance of designing strategic interventions that meet the needs of smokers at both individual and family levels to promote quit intention and to facilitate successful quitting in this population.
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Kim S, Wipfli H, Navas-Acien A, Dominici F, Avila-Tang E, Onicescu G, Breysse P, Samet JM. Determinants of Hair Nicotine Concentrations in Nonsmoking Women and Children: A Multicountry Study of Secondhand Smoke Exposure in Homes. Cancer Epidemiol Biomarkers Prev 2009; 18:3407-14. [DOI: 10.1158/1055-9965.epi-09-0337] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Tong EK, Tang H, Tsoh J, Wong C, Chen MS. Smoke-free policies among Asian-American women: comparisons by education status. Am J Prev Med 2009; 37:S144-50. [PMID: 19591754 PMCID: PMC3992924 DOI: 10.1016/j.amepre.2009.05.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2008] [Revised: 03/03/2009] [Accepted: 05/05/2009] [Indexed: 11/29/2022]
Abstract
BACKGROUND California has significantly decreased racial/ethnic and educational disparities in smoke-free home and indoor work policies. California's ethnic-specific surveys present an opportunity to disaggregate data and examine the impact of California's smoke-free social norm campaign for Asian-American women. METHODS The California Tobacco Use Surveys for Chinese Americans and Korean Americans were conducted in 2003 and analyzed in 2008 to compare women with lower ( RESULTS Lower-educated and higher-educated women had similar proportions of smoke-free policies at home (58%) or indoor work (90%). However, lower-educated women were more likely than higher-educated women to report anyone ever smoking at home (OR=1.62, 95% CI=1.06, 2.48, p=0.03) and exposure during the past 2 weeks at an indoor workplace (OR=2.43, 95% CI= 1.30, 4.55, p=0.005), even after controlling for ethnicity, smoke-free policy, knowledge about the health consequences of secondhand smoke exposure, and acculturation. There was no interaction between education and knowledge about secondhand smoke health harms. CONCLUSIONS The intended consequences of California's tobacco-control efforts have resulted in similar rates of smoke-free policies at home and in indoor work environments among Asian-American women across educational levels. However, an unintended consequence of this success is a disparity in enforcement by educational status, with lower-educated Asian-American women reporting greater smoke exposure despite similar rates of knowledge about the health consequences of secondhand smoke exposure. Besides establishing policies, lower-educated Asian-American women may need to be empowered to assert and enforce their right to smoke-free environments.
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Affiliation(s)
- Elisa K Tong
- Department of Internal Medicine, University of California, Davis, California, USA.
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Battle RS, Lee JP, Antin TMJ. Knowledge of tobacco control policies among U.S. Southeast Asians. J Immigr Minor Health 2009; 12:215-20. [PMID: 19495979 DOI: 10.1007/s10903-009-9265-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
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.
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Giuliani KKW, Mire OA, Jama S, Dubois DK, Pryce D, Fahia S, Ehrlich LC. Tobacco use and cessation among Somalis in Minnesota. Am J Prev Med 2008; 35:S457-62. [PMID: 19012839 DOI: 10.1016/j.amepre.2008.09.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2008] [Revised: 08/06/2008] [Accepted: 09/03/2008] [Indexed: 10/21/2022]
Abstract
BACKGROUND Somalis compose the largest African refugee group living in the U.S., with more than 10,330 primary arrivals in fiscal year 2006 alone. Half of all Somalis in the U.S. live in Minnesota. Although tobacco use is a considerable problem among Somalis, especially among men, little research has examined factors affecting tobacco use and cessation. METHODS A sequential exploratory design informed the overall study methodology. Key informant interviews (n=20) and focus group discussions (13 groups; n=91) were conducted with Somali adults and youth in the fall of 2006 and the summer of 2007, respectively. Participants were asked about tobacco-use prevalence, prevention, and cessation, and the marketing of tobacco. RESULTS Perceived prevalence of tobacco use by Somalis is high at 50%. The main reason for initiating tobacco use was the influence of friends or peer pressure and included other social factors. Prevention and cessation messages suggested by participants include medical advice, education on the negative health effects of tobacco use, religion, and the support of family and friends. Barriers to cessation include lack of insurance coverage, lack of knowledge on where to find assistance, and lack of cessation support groups. Severe social stigma for Somali female smokers poses specific challenges to prevention and intervention efforts. Water-pipe smoking is perceived to be prevalent, particularly among female youth. CONCLUSIONS Somalis view tobacco use as an important issue in their community. Religious and social support and demographically targeted approaches should be key factors in creating effective prevention and cessation programs and must address water-pipe smoking.
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Tong EK, Nguyen TT, Vittinghoff E, Pérez-Stable EJ. Smoking behaviors among immigrant Asian Americans: rules for smoke-free homes. Am J Prev Med 2008; 35:64-7. [PMID: 18541178 PMCID: PMC2441880 DOI: 10.1016/j.amepre.2008.03.024] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2007] [Revised: 01/23/2008] [Accepted: 03/13/2008] [Indexed: 10/22/2022]
Abstract
BACKGROUND Higher acculturation is associated with Asian-American smoking prevalence decreasing in men and increasing in women. Asian immigrants in California are significantly more likely than their counterparts in Asia to have quit smoking. Smoke-free environments may mediate this acculturation effect because such environments are not widespread in Asia. METHODS In 2006, Asian-American current and former smokers were analyzed using the 2003 California Health Interview Survey. A multivariate logistic regression analysis examined how the interaction between having a smoke-free-home rule and immigrating to the U.S. is associated with status as a former smoker and lighter smoking. RESULTS For recent Asian immigrants (<10 years in the U.S.) and longer-term residents (born/>or=10 years in the U.S.), having a smoke-free-home rule was associated with status as a former smoker (OR 14.19, 95% CI=4.46, 45.12; OR 3.25, 95% CI=1.79, 5.90, respectively). This association was stronger for recent immigrants (p=0.02). Having a smoke-free-home rule was associated with lighter smoking only for longer-term residents (OR 5.37, 95% CI=2.79, 10.31). CONCLUSIONS For Asian Americans, smoke-free-home rules are associated with status as a former smoker, particularly among recent immigrants, and lighter smoking in long-term residents. Interventions encouraging Asian Americans to adopt smoke-free-home rules should be evaluated.
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Affiliation(s)
- Elisa K Tong
- Division of General Internal Medicine, University of California Davis, Davis, California, USA
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