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Family Support and Readiness to Consider Smoking Cessation among Chinese and Vietnamese American Male Smokers. J Smok Cessat 2021; 2021. [PMID: 34178159 PMCID: PMC8232893 DOI: 10.1155/2021/6678219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction Smoking prevalence is disproportionately high among Asian American immigrant men with limited English proficiency. Understanding the role of family support may provide insights on culturally acceptable strategies to promote smoking cessation. Aims This study examined how family support was associated with readiness to consider smoking cessation among Chinese and Vietnamese American male daily smokers. Methods We analyzed baseline data (N=340) from a cluster randomized trial of a family-based healthy lifestyle intervention. We assessed the frequency of receiving family support in various forms (encouraging use of cessation resources; praising efforts; checking-in; reminding of familial role). Multiple regression analysis was used to determine associations between family support areas and readiness to consider smoking cessation, controlling for covariates. Results/Findings Reporting a higher frequency of receiving praise and encouragement for one's efforts to quit was positively associated with readiness to consider cessation. Other areas of family support were not significant. Conclusions These findings provide evidence to explore specific areas of family support in enhancing Asian American smokers' readiness to consider cessation. As there is high interest from Asian American family members to support their smokers for quitting, culturally specific and acceptable strategies are needed to promote smoking cessation among Asian Americans.
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Vyas P, Tsoh JY, Gildengorin G, Stewart SL, Yu E, Guan A, Pham A, Burke NJ, McPhee SJ. Disentangling individual and neighborhood differences in the intention to quit smoking in Asian American male smokers. Prev Med Rep 2020; 18:101064. [PMID: 32226728 PMCID: PMC7093831 DOI: 10.1016/j.pmedr.2020.101064] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 01/29/2020] [Accepted: 02/08/2020] [Indexed: 11/22/2022] Open
Abstract
Numerous studies have assessed individual-level factors associated with intention to quit smoking. However, fewer studies have assessed how neighborhood and built environment also contribute towards individual-level behavior. We used baseline data of 340 Chinese and Vietnamese male daily smokers from August 2015 to November 2017 living in the San Francisco Bay Area, who enrolled in a lifestyle intervention trial. The outcome variable was intention to quit in 30 days. To understand the role of contextual factors participants' residential addresses were geocoded, and neighborhood median income, ethnic composition, and tobacco retail density were computed. Individual level analysis suggested that Vietnamese American men had greater intention to quit smoking (OR = 2.90 CI = 1.59, 5.26) in comparison to Chinese Americans. However, after adding neighborhood level factors to the model, no ethnic group difference was observed. Neighborhood household median income (OR = 0.74, CI = 0.64, 0.86) and tobacco retail counts (OR = 0.79, CI = 0.67, 0.94) were negatively associated with intention to quit. Years lived in the U.S. was the only individual level factor associated with intention to quit. By comparing two Asian American groups that live in heterogeneous neighborhoods, we identify key environmental and policy drivers that are associated with quit intention. Future studies aimed at influencing individual-level behavior should take into consideration the neighborhood context and built environment characteristics.
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Affiliation(s)
- Priyanka Vyas
- Center for Tobacco Control Research and Education, University of California, San Francisco, United States
| | - Janice Y. Tsoh
- Center for Tobacco Control Research and Education, University of California, San Francisco, United States
- Department of Psychiatry, University of California, San Francisco, CA, United States
| | - Ginny Gildengorin
- Division of General Internal Medicine, University of California, San Francisco, United States
| | - Susan L. Stewart
- Department of Public Health Sciences, University of California, Davis, United States
| | - Edgar Yu
- Department of Psychiatry, University of California, San Francisco, CA, United States
| | - Alice Guan
- Department of Psychiatry, University of California, San Francisco, CA, United States
| | - Amber Pham
- DePaul University, Chicago, United States
| | | | - Steven J. McPhee
- Division of General Internal Medicine, University of California, San Francisco, United States
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Serious quit attempts and cessation implications for Asian American male smokers. Addict Behav 2020; 100:106129. [PMID: 31627162 PMCID: PMC7354905 DOI: 10.1016/j.addbeh.2019.106129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 09/03/2019] [Accepted: 09/10/2019] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Smoking prevalence remains high among Asian American immigrant men, particularly those with limited English proficiency. Understanding ways to promote serious quit attempts (defined as a quit attempt lasting at least 24 h) could be crucial for reducing tobacco-related health disparities in this population. This study examines correlates of serious past year quit attempts among Chinese and Vietnamese American male daily smokers. METHODS Baseline survey data were collected between 2015 and 2017 from a lifestyle intervention trial (N = 340 Chinese and Vietnamese male daily smokers). Data analysis was conducted in 2019. Multivariable logistic regression analysis was used to identify factors associated with serious past year quit attempts. RESULTS Less than half (43.2%) of the study participants had at least one serious past year quit attempt. Significant correlates of serious quit attempts included utilizing evidence-based methods (OR = 12.83, 95% CI 5.17-31.84) or other methods (OR = 3.92, 95% CI 3.92-13.73) to facilitate quitting compared to those who did not attempt to quit. Also, participants who had a physician encounter in the past year were more likely to have had a serious quit attempt (OR = 2.25, 95% CI 1.12-4.53). Discussing smoking during a past year doctor's visit, however, was not a significant correlate of serious quit attempts. CONCLUSIONS Our findings underscore the importance of promoting the use of smoking cessation resources, and potentially utilizing healthcare encounters to facilitate cessation. Investigations are warranted to understand better how patient-physician interactions can enhance smoking cessation.
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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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Liu Y, Xia Q, Xia J, Zhu H, Jiang H, Chen X, Zheng Y, Zhang F, Li S. The impact of marriage on the overall survival of prostate cancer patients: A Surveillance, Epidemiology, and End Results (SEER) analysis. Can Urol Assoc J 2018; 13:E135-E139. [PMID: 30332597 DOI: 10.5489/cuaj.5413] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Marital status has long been associated with positive patient outcomes in several malignances; however, little is known about its influence on prostate cancer. We analyzed data from the Surveillance, Epidemiology, and End Results (SEER) database to evaluate whether married patients with prostate cancer had a better prognosis than unmarried patients. METHODS We identified 824 554 patients diagnosed with prostate cancer between 1973 and 2012 in the SEER database. Using the Cox proportional hazard models, we analyzed the impact of marital status (single, married, divorced/separated, and widowed) on survival after diagnosis with prostate cancer. Chi-square tests were used to analyze the association between marital status and other variables, and the Kaplan-Meier method was used to estimate survival curves. RESULTS Married men were more likely to be diagnosed with a lower Gleason score and undergo surgery than patients in the other groups (p<0.001). The married group had a lower risk of mortality caused by prostate cancer than the other groups. The five-year survival rate for married patients was higher than that for patients in the other groups. CONCLUSIONS Marital status is a prognostic factor for the survival of prostate cancer patients, as being married was associated with better outcomes.
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Affiliation(s)
- Yu Liu
- Cancer Center, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Hospital of the University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Qi Xia
- Cancer Center, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Hospital of the University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Jianling Xia
- Cancer Center, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Hospital of the University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Hua Zhu
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Haihong Jiang
- Department of Urology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xiangjian Chen
- Department of General Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yuancai Zheng
- Department of Urology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Fangyi Zhang
- Department of Urology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Shi Li
- Department of Urology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
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Joshi S, Jatrana S, Paradies Y. Tobacco smoking between immigrants and non-immigrants in Australia: A longitudinal investigation of the effect of nativity, duration of residence and age at arrival. Health Promot J Austr 2017; 29:282-292. [PMID: 30511489 DOI: 10.1002/hpja.19] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Accepted: 10/16/2017] [Indexed: 11/07/2022] Open
Abstract
ISSUE ADDRESSED Earlier research evidence suggests that there is a difference and over time change in the prevalence of tobacco smoking between immigrants and native-born population. This study investigates the differences in smoking among immigrants from English speaking (ESC) and non-English speaking (NESC) countries relative to native-born (NB) Australians, and how those differences change with duration of residence (DoR) and age at arrival (AA). METHODS Information on 12 634 individuals from the first twelve waves (2001-2012) of Household, Income and Labour Dynamics in Australia (HILDA) longitudinal survey was analysed using multilevel group-mean-centred mixed logistic regression models. Smoking status as an outcome was dichotomized as current vs non-current smokers. RESULTS After adjusting for covariates, relative to native-born respondents, there was no difference in the odds of smoking for English speaking countries immigrants, while immigrants from non-English speaking countries had lower odds of smoking. The smoking prevalence of immigrants from non-English speaking countries converged towards the native-born after 20 years of residence in Australia. The association between duration of residence and smoking was modified by age at arrival, with immigrants (combined ESC and NESC) who arrived as children or adolescents and had lived 20 years or longer were significantly more likely to smoke than native-born Australians. CONCLUSION The results suggest that the initially lower smoking prevalence among non-English speaking countries immigrants converges with that of native-born Australians after twenty years of residence, and immigrants (combined ESC and NESC) who arrived as children or adolescents more than 20 years ago were more likely to be smokers. SO WHAT?: Current health promotion and anti-smoking programs should ensure that immigrants from non-English speaking background have access to education and information about the hazards of tobacco consumptions and are aware of the available smoking cessation services. Efforts to prevent smoking uptake among NESC immigrants and those who arrive as children or adolescents and live longer than 20 years is especially important for tobacco control interventions.
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Affiliation(s)
- Suresh Joshi
- School of Humanities and Social Sciences, Faculty of Arts and Education, Deakin University, Geelong, VIC, Australia
| | - Santosh Jatrana
- Centre for Social Impact Swinburne, Swinburne University of Technology, Hawthorn, Australia
| | - Yin Paradies
- Alfred Deakin Institute for Citizenship and Globalisation, Deakin University, Burwood, VIC, Australia
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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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Tsoh JY, Burke NJ, Gildengorin G, Wong C, Le K, Nguyen A, Chan JL, Sun A, McPhee SJ, Nguyen TT. A Social Network Family-Focused Intervention to Promote Smoking Cessation in Chinese and Vietnamese American Male Smokers: A Feasibility Study. Nicotine Tob Res 2016; 17:1029-38. [PMID: 26180229 DOI: 10.1093/ntr/ntv088] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
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.
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Affiliation(s)
- Janice Y Tsoh
- Department of Psychiatry, University of California San Francisco, San Francisco, CA; Asian American Research Center for Health (ARCH), San Francisco, CA;
| | - Nancy J Burke
- Asian American Research Center for Health (ARCH), San Francisco, CA; Department of Anthropology, History, and Social Medicine, University of California San Francisco, San Francisco, CA
| | - Ginny Gildengorin
- Asian American Research Center for Health (ARCH), San Francisco, CA; Division of General Internal Medicine, University of California San Francisco, San Francisco, CA
| | - Ching Wong
- Asian American Research Center for Health (ARCH), San Francisco, CA; Division of General Internal Medicine, University of California San Francisco, San Francisco, CA
| | - Khanh Le
- Asian American Research Center for Health (ARCH), San Francisco, CA; Division of General Internal Medicine, University of California San Francisco, San Francisco, CA
| | - Anthony Nguyen
- Southeast Asian Community Center (SEACC), San Francisco, CA
| | - Joanne L Chan
- Chinese Community Health Resource Center (CCHRC), San Francisco, CA
| | - Angela Sun
- Asian American Research Center for Health (ARCH), San Francisco, CA; Chinese Community Health Resource Center (CCHRC), San Francisco, CA
| | - Stephen J McPhee
- Asian American Research Center for Health (ARCH), San Francisco, CA; Division of General Internal Medicine, University of California San Francisco, San Francisco, CA
| | - Tung T Nguyen
- Asian American Research Center for Health (ARCH), San Francisco, CA; Division of General Internal Medicine, University of California San Francisco, San Francisco, CA
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Petersen AB, Tsoh JY, Nguyen TT, McPhee SJ, Burke NJ. Suffering in Silence: Impact of Tobacco Use on Communication Dynamics Within Vietnamese and Chinese Immigrant Families. JOURNAL OF FAMILY NURSING 2016; 22:108-132. [PMID: 26717960 PMCID: PMC5714689 DOI: 10.1177/1074840715618194] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The goal of this project was to explore family communication dynamics and their implications for smoking cessation. We conducted 39 in-depth dyadic and individual qualitative interviews with 13 immigrant smoker-family member pairs of Vietnamese ( n = 9 dyads, 18 individuals) and Chinese ( n = 4 dyads, 8 individuals) descent, including seven current and six former smokers and 13 family members. All 13 dyadic and 26 individual interviews were analyzed using a collaborative crystallization process as well as grounded theory methods. We identified three interrelated pathways by which tobacco use in immigrant Vietnamese and Chinese families impacts family processes and communication dynamics. Using a two-dimensional model, we illustrate how the shared consequences of these pathways can contribute to a dynamic of avoidance and noncommunication, resulting in individual family members "suffering in silence" and ultimately smoking being reinforced. We discuss the implications of these findings for development of smoking cessation interventions.
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Affiliation(s)
- Anne Berit Petersen
- 1 University of California, San Francisco, CA, USA
- 2 Loma Linda University, CA, USA
| | | | | | | | - Nancy J Burke
- 1 University of California, San Francisco, CA, USA
- 3 University of California, Merced, CA, USA
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Nguyen T, Kilgore D, Morphew T, Tran J, Berg J, Galant S. The prevalence of asthma risk and contributing factors in underserved Vietnamese children in Orange County, CA. J Asthma 2015; 52:1031-7. [PMID: 26367240 DOI: 10.3109/02770903.2015.1056348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVES Vietnamese constitutes one of the fastest growing minority groups in America, with the largest concentration in Orange County (OC), CA. Yet, there are limited data on the prevalence of asthma in Vietnamese children. Our study evaluated the risk of asthma and key contributing factors among these children living in OC, CA. METHOD Five elementary schools in OC that were predominantly Vietnamese with low socioeconomic status were selected for participation. Validated surveys were sent to parents of all students ages 3-12 in these schools with materials available in English, Vietnamese and Spanish. Surveys included questions to identify the risk of asthma and related key factors. Surveys were completed by parents and returned to schools. RESULTS There were 1530 participants eligible for analysis. Asthma risk was 30.4%, and of these, 22.6% had no prior diagnosis. Contributing factors to identification of those at risk were male gender (p < 0.001), preferred use of the Vietnamese language (p = 0.004), longer duration in the United States (p = 0.019), and smoker in the household (p = 0.015). CONCLUSIONS The prevalence of asthma risk in our community of low socioeconomic status Vietnamese children was found to be higher than commonly appreciated. Furthermore, a considerable number of these children had not been previously diagnosed. Given the limited information in this population, our current findings of asthma risk and key contributing factors could affect health care policies that allow appropriate funding for programs dedicated to asthma care in this and other growing population.
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Affiliation(s)
- Tan Nguyen
- a Department of Family Medicine , University of California , Irvine , CA , USA
| | - David Kilgore
- a Department of Family Medicine , University of California , Irvine , CA , USA
| | | | - Jacqueline Tran
- c Orange County Asian & Pacific Islander Community Alliance , Garden Grove , CA , USA
| | - Jill Berg
- d Program in Nursing Science, University of California , Irvine , CA , USA , and
| | - Stanley Galant
- e CHOC Children's Hospital of Orange County , Orange , CA , USA
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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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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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Webber WL, van Erp B, Stoddard P, Tsoh JY. Determinants of exposure to secondhand smoke among Vietnamese adults: California Vietnamese Adult Tobacco Use Survey, 2007-2008. Prev Chronic Dis 2014; 11:E81. [PMID: 24831285 PMCID: PMC4023674 DOI: 10.5888/pcd11.130327] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Because smoking rates are high among Vietnamese men, we used data from the 2007–2008 California Vietnamese Adult Tobacco Use Survey to estimate secondhand smoke exposure and associated risk factors among Vietnamese nonsmokers. Thirty percent of nonsmokers were exposed to secondhand smoke (SHS) at home, 8% at work, 52% in bars, and 67% on a college campus. At home, odds of SHS exposure were greater for women than for men and for adults aged less than 40 years than for older adults. Odds of SHS exposure were higher for former smokers at work (among employed men) and among men when in bars. Future interventions should consider sex, age, and smoking history in efforts to prevent SHS exposure among Vietnamese adults.
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Affiliation(s)
- Whitney L Webber
- Santa Clara County Public Health Department, 976 Lenzen Ave, San Jose, CA 95126. E-mail:
| | - Brianna van Erp
- Santa Clara County Public Health Department, San Jose, California
| | - Pamela Stoddard
- Santa Clara County Public Health Department, San Jose, California
| | - Janice Y Tsoh
- University of California Department of Psychiatry, San Francisco, California, and Asian American Research Center, San Francisco, California
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Mukherjea A, Wackowski OA, Lee YO, Delnevo CD. Asian American, Native Hawaiian and Pacific Islander tobacco use patterns. Am J Health Behav 2014; 38:362-9. [PMID: 24636032 PMCID: PMC5173306 DOI: 10.5993/ajhb.38.3.5] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To provide a national depiction of Asian American (AA) and Native Hawaiian/Pacific Islander (NHPI) tobacco use and highlight considerations for targeted interventions. METHODS We analyzed data from the 2009-2010 National Adult Tobacco Survey for subgroup differences in prevalence and consumption of various tobacco products. RESULTS Use varies considerably by ethnic subgroups for cigarette smoking (including menthol) and other forms of tobacco. Despite being lighter, less frequent, and seemingly less dependent smokers, AANHPIs had similar quit ratios as non-AANHPIs. CONCLUSIONS AA and NHPI disparities in tobacco use may be due to underutilization of cessation resources, including those for non-cigarette tobacco products, and lack of availability of culturally-appropriate resources. Community-based and regulatory approaches should be employed to reduce use of all tobacco products, especially among high prevalence subgroups.
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Affiliation(s)
- Arnab Mukherjea
- Center for Tobacco Control Research & Education / Division of General Internal Medicine, University of California, San Francisco (UCSF), San Francisco, CA, USA.
| | - Olivia A Wackowski
- Department of Health Education and Behavioral Science, Rutgers School of Public Health, New Brunswick, NJ, USA
| | - Youn Ok Lee
- RTI International, Research Triangle Park, NC, USA
| | - Cristine D Delnevo
- Department of Health Education and Behavioral Science, Rutgers School of Public Health, New Brunswick, NJ, USA
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15
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Tsang IK, Tsoh JY, Wong C, Le K, Cheng JW, Nguyen AN, Nguyen TT, McPhee SJ, Burke NJ. Understanding and use of nicotine replacement therapy and nonpharmacologic smoking cessation strategies among Chinese and Vietnamese smokers and their families. Prev Chronic Dis 2014; 11:E26. [PMID: 24556252 PMCID: PMC3938957 DOI: 10.5888/pcd11.130299] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Introduction Population-based studies have reported high rates of smoking prevalence among Chinese and Vietnamese American men. Although nicotine replacement therapy (NRT) is effective, recommended, and accessible without prescription, these populations underuse NRT for smoking cessation. The aim of this study was to assess understanding and use of NRT and nonpharmacologic treatments among Chinese and Vietnamese American male smokers and their families. Methods In-depth qualitative interviews were conducted with 13 smoker–family pairs, followed by individual interviews with each participant. A total of 39 interviews were conducted in Vietnamese or Chinese, recorded, translated, and transcribed into English for analysis. Results Four themes were identified: use and understanding of NRT, nonpharmacologic strategies, familial and religious approaches, and willpower. Both smokers and their family members believed strongly in willpower and a sense of personal responsibility as the primary drivers for stopping smoking. Lack of these 2 qualities keeps many Chinese and Vietnamese men from using NRT to quit smoking. Those who do use NRT often use it incorrectly, following their own preferences rather than product instructions. Conclusion Our findings indicate the importance of culturally appropriate patient education about NRT. It may be necessary to teach smokers and their families at an individual level about NRT as a complementary approach that can strengthen their resolve to quit smoking. At a community level, public health education on the indication and appropriate use of evidence-based smoking cessation resources, such as NRT, would be an important component of effective tobacco control.
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Affiliation(s)
- Icarus K Tsang
- University of California, San Francisco, San Francisco, California
| | - Janice Y Tsoh
- Department of Psychiatry, University of California San Francisco, 401 Parnassus Ave (0984-TRC), San Francisco, CA 94143. E-mail:
| | - Ching Wong
- University of California, San Francisco, San Francisco, California
| | - Khanh Le
- University of California, San Francisco, San Francisco, California
| | - Joyce W Cheng
- Chinese Community Health Resource Center, San Francisco, California
| | | | - Tung T Nguyen
- University of California, San Francisco, and Asian American Research Center on Health, San Francisco, California
| | - Stephen J McPhee
- University of California, San Francisco, and Asian American Research Center on Health, San Francisco, California
| | - Nancy J Burke
- University of California, San Francisco, and Asian American Research Center on Health, San Francisco, California
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16
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Tong EK, Lew R. Moving communities toward policy change: APPEAL's 4-prong policy change model. Health Promot Pract 2013; 14:29S-35S. [PMID: 23707962 DOI: 10.1177/1524839913484763] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Policy change is recognized for underlying much of the success of tobacco control. However, there is little evidence and attention on how Asian American and Native Hawaiian and Pacific Islander (AA and NHPI) communities may engage in policy change. Challenges for AA and NHPI communities include the racial/ethnic and geographic diversity, and tobacco data accurately representing the communities. Over the past decade, the Asian Pacific Partners for Empowerment, Advocacy and Leadership (APPEAL) has worked to develop and implement policy change for AA and NHPI communities. This article describes APPEAL's 4-prong policy change model, in the context of its overall strategic framework for policy change with communities that accounts for varying levels of readiness and leadership capacity, and targets four different levels of policy change (community, mainstream institution, legislative, and corporate). The health promotion implication of this framework for tobacco control policy engagement is for improving understanding of effective pathways to policy change, promoting innovative methods for policy analysis, and translating them into effective implementation and sustainability of policy initiatives. The APPEAL strategic framework can transcend into other communities and health topics that ultimately may contribute to the elimination of health disparities.
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Affiliation(s)
- Elisa K Tong
- University of California, Davis, Sacramento, CA, USA
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17
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Saw A, Kim J, Lim J, Powell C, Tong EK. Smoking cessation counseling for Asian immigrants with serious mental illness: using RE-AIM to understand challenges and lessons learned in primary care-behavioral health integration. Health Promot Pract 2013; 14:70S-9S. [PMID: 23667056 DOI: 10.1177/1524839913483141] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Engagement in modifiable risk behaviors, such as tobacco use, substantially contributes to early mortality rates in individuals with serious mental illness (SMI). There is an alarmingly high prevalence of tobacco use among subgroups of Asian Americans, such as immigrants and individuals with SMI, yet there are no empirically supported effective smoking cessation interventions that have been tailored to meet the unique cultural, cognitive, and psychological needs of Asian immigrants with SMI. In this article, we share the experiences of clinicians in the delivery of smoking cessation counseling to Asian American immigrants with SMI, in the context of an Asian-focused integrated primary care and behavioral health setting. Through a qualitative analysis of clinician perspectives organized with the RE-AIM framework, we outline challenges, lessons learned, and promising directions for delivering smoking cessation counseling to Asian American immigrant clients with SMI.
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Affiliation(s)
- Anne Saw
- Department of Internal Medicine, University of California, Davis, Sacramento, CA 95817, USA.
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18
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Developing a Multilingual Questionnaire and Surname List to Sample Utah Pacific Islanders. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2013; 19:E25-31. [DOI: 10.1097/phh.0b013e318252ee60] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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19
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Li S, Delva J. Social capital and smoking among Asian American men: an exploratory study. Am J Public Health 2012; 102 Suppl 2:S212-21. [PMID: 22401511 DOI: 10.2105/ajph.2011.300442] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined how different dimensions of social capital (i.e., family and friend connections, neighborhood and family cohesion, family conflict) were associated with smoking behavior among a nationally representative sample of Asian American men and whether the associations varied by ethnic group. METHODS The sample consisted of 998 adult Asian American men who participated in the National Latino and Asian American Survey from 2002 to 2003. We conducted weighted multivariate logistic regressions on data for the sample and for each of 4 ethnic subgroups (Chinese, Vietnamese, Filipino, and Other). RESULTS Vietnamese American men had the highest prevalence of current smoking; Chinese American men, the lowest. After controlling for sociodemographics, socioeconomic status, acculturation, and perceived discrimination, neighborhood cohesion was inversely associated with smoking among Asian American men, and family and friend connections and family cohesion were not. An exception was family cohesion, which was associated with increased odds of smoking among Filipino American men. CONCLUSIONS The relationship between social capital and smoking among Asian American men varied according to specific dimensions of social capital and was ethnicity specific. These findings highlight the need for smoking prevention and cessation interventions to take into consideration the heterogeneity that exists among Asian Americans.
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Affiliation(s)
- Shijian Li
- Center for Study of Asian American Health, School of Medicine, New York University, New York, NY 10016, USA.
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20
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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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21
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Zhu SH, Cummins SE, Wong S, Gamst AC, Tedeschi GJ, Reyes-Nocon J. The effects of a multilingual telephone quitline for Asian smokers: a randomized controlled trial. J Natl Cancer Inst 2012; 104:299-310. [PMID: 22282542 DOI: 10.1093/jnci/djr530] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Although telephone counseling services (quitlines) have become a popular behavioral intervention for smoking cessation in the United States, such services are scarce for Asian immigrants with limited English proficiency. In this study, we tested the effects of telephone counseling for smoking cessation in Chinese-, Korean-, and Vietnamese-speaking smokers. METHODS A culturally tailored counseling protocol was developed in English and translated into Chinese, Korean, and Vietnamese. We conducted a single randomized trial embedded in the California quitline service. Smokers who called the quitline's Chinese, Korean, and Vietnamese telephone lines between August 2, 2004, and April 4, 2008, were recruited to the trial. Subjects (N = 2277) were stratified by language and randomly assigned to telephone counseling (self-help materials and up to six counseling sessions; n = 1124 subjects) or self-help (self-help materials only; n = 1153 subjects) groups: 729 Chinese subjects (counseling = 359, self-help = 370), 848 Korean subjects (counseling = 422, self-help = 426), and 700 Vietnamese subjects (counseling = 343, self-help = 357). The primary outcome was 6-month prolonged abstinence. Intention-to-treat analysis was used to estimate prolonged abstinence rates for all subjects and for each language group. All statistical tests were two-sided. RESULTS In the intention-to-treat analysis, counseling increased the 6-month prolonged abstinence rate among all smokers compared with self-help (counseling vs self-help, 16.4% vs 8.0%, difference = 8.4%, 95% confidence interval [CI] = 5.7% to 11.1%, P < .001). Counseling also increased the 6-month prolonged abstinence rate for each language group compared with self-help (counseling vs self-help, Chinese, 14.8% vs 6.0%, difference = 8.8%, 95% CI = 4.4% to 13.2%, P < .001; Korean, 14.9% vs 5.2%, difference = 9.7%, 95% CI = 5.8% to 13.8%, P < .001; Vietnamese, 19.8% vs 13.5%, difference = 6.3%, 95% CI = 0.9% to 11.9%, P = .023). CONCLUSIONS Telephone counseling was effective for Chinese-, Korean-, and Vietnamese-speaking smokers. This protocol should be incorporated into existing quitlines, with possible extension to other Asian languages.
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Affiliation(s)
- Shu-Hong Zhu
- Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA 92093-0905, USA.
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22
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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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