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Lee ARS, Rodriquez EJ, Gallo LC, Giachello AL, Isasi CR, Perreira KM, Daviglus ML, Kaplan RC, Talavera GA, Pérez-Stable EJ, Oren E. Acculturation level and change in cigarette consumption behaviors among diverse Hispanics/Latinos: the Hispanic Community Health Study/Study of Latinos. Ann Epidemiol 2023; 84:33-40. [PMID: 37164291 PMCID: PMC11027575 DOI: 10.1016/j.annepidem.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 04/24/2023] [Accepted: 05/05/2023] [Indexed: 05/12/2023]
Abstract
PURPOSE To study associations between language acculturation level and changes in cigarette consumption among the diverse and growing U.S.-based Hispanic/Latino population and inform culturally tailored smoking prevention and cessation strategies. METHODS In the Hispanic Community Health Survey/Study of Latinos cohort, we used cigarette consumption behaviors at baseline (2008-2011) and follow-up (2014-2017) and a modified Short Acculturation Scale for Hispanics (SASH) language subscale to measure associations of language acculturation (unidimensional) with changes in cigarette consumption and quitting rates. Weighted multivariable linear and logistic regressions were stratified by daily (n = 1397) and nondaily (n = 633) smoking, and either sex, educational attainment, or migration status. RESULTS Smokers at baseline (n = 2030) on average were aged 42 years old (SE = 0.5) with a mean SASH-language score of 2.3 (SE = 0.1; range = 1-5), indicating more Spanish language use. Among male daily smokers, we observed increases in smoked cigarettes-per-day (CPD) with unit increases in SASH-language score (1.08, 95% CI: 0.24-1.92). Associations with acculturation trended toward greater increases in CPD and lower odds of quitting as educational attainment increased. CONCLUSIONS Language acculturation level is an important determinant for increased smoking behaviors, particularly among men. Our findings are significant in informing smoking reduction programs for the Hispanic/Latino population.
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Affiliation(s)
- Adrienne R S Lee
- School of Public Health, Division of Epidemiology, San Diego State University, 5500 Campanile Drive, San Diego, CA 92182; Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093.
| | - Erik J Rodriquez
- Division of Intramural Research, National Heart, Lung, and Blood Institute, 10 Center Drive, Room 9D58, Bethesda, MD
| | - Linda C Gallo
- Department of Psychology, San Diego State University, 5500 Campanile Drive, San Diego, CA 92182
| | - Aida L Giachello
- Department of Preventive Medicine, Northwestern University, 680 N Lake Shore Dr, Chicago, IL 60611
| | - Carmen R Isasi
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461
| | - Krista M Perreira
- Department of Social Medicine, University of North Carolina at Chapel Hill, 333 S. Columbia Street, Chapel Hill, NC 27599
| | - Martha L Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, 1819 W. Polk Street, Chicago, IL 60612
| | - Robert C Kaplan
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461; Public Health Sciences Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, Seattle, WA 98109
| | - Gregory A Talavera
- Department of Psychology, San Diego State University, 5500 Campanile Drive, San Diego, CA 92182
| | - Eliseo J Pérez-Stable
- Division of Intramural Research, National Heart, Lung, and Blood Institute, 10 Center Drive, Room 9D58, Bethesda, MD; Office of the Director, National Institute on Minority Health and Health Disparities, National Institutes of Health, 6707 Democracy Boulevard, Bethesda, MD 20892
| | - Eyal Oren
- School of Public Health, Division of Epidemiology, San Diego State University, 5500 Campanile Drive, San Diego, CA 92182
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Gousse Y, Wilson TE, McFarlane D, Browne RC, Fraser M, Yusim D, Stewart M, Salifu MO, Joseph MA. HIV Testing Correlates: U.S. and Foreign Born High-Risk Black Heterosexual Men. J Immigr Minor Health 2021; 23:1145-1151. [PMID: 33507520 PMCID: PMC9796172 DOI: 10.1007/s10903-021-01140-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2021] [Indexed: 12/30/2022]
Abstract
In the U.S., Black men are disproportionately affected by HIV, with some of the highest HIV incidence rates and lowest rates of HIV testing. We examined correlates of HIV testing and knowledge among participants of the Barbershop Talk with Brothers (BTWB) project, an HIV prevention program targeting high-risk sexual behaviors among Black heterosexual men in Brooklyn, New York. Specifically, we examined differences between U.S. vs. foreign-born status and HIV testing rates, HIV knowledge, and socio-demographic factors. Of the 855 men included, the mean age was 33 years and 35.0% were foreign-born. Lifetime HIV testing was reported at 84%, with greater proportion of U.S. vs foreign-born men reporting lifetime (88.6% vs. 75.0%) and recent testing (68.6% vs. 51.0%), p < 0.001. Among foreign-born men, recent HIV testing was associated with lower stigma and greater HIV transmission knowledge than those un-tested. The authors recommend tailored approaches to increasing HIV testing in Black communities, based on nativity and social factors.
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Affiliation(s)
- Yolene Gousse
- Department of Pharmacy Administration and Public Health, St. John’s University, Queens, NY, USA,Brooklyn Health Disparities Center, Brooklyn, NY, USA,Department of Pharmacy Administration and Public Health, Dr. Andrew J. Bartilucci Center, St. John’s University, 8000 Utopia Parkway, New York, NY 11439, USA
| | - Tracey E. Wilson
- Brooklyn Health Disparities Center, Brooklyn, NY, USA,Department of Community Health Sciences, School of Public Health, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Davin McFarlane
- Brooklyn Health Disparities Center, Brooklyn, NY, USA,Special Treatment and Research Program, College of Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | | | - Marilyn Fraser
- Brooklyn Health Disparities Center, Brooklyn, NY, USA,Arthur Ashe Institute for Urban Health, Brooklyn, NY, USA
| | - Diana Yusim
- Baystate Medical Center, Springield, MA, USA
| | - Mark Stewart
- Brooklyn Health Disparities Center, Brooklyn, NY, USA,School of Graduate Studies, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Moro O. Salifu
- Brooklyn Health Disparities Center, Brooklyn, NY, USA,Division of Nephrology, Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Michael A. Joseph
- Brooklyn Health Disparities Center, Brooklyn, NY, USA,Department of Epidemiology and Biostatistics, School of Public Health, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
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Examining the Associations Between Immigration Status and Perceived Stress Among HIV-Infected and Uninfected Women. J Community Health 2019; 43:1172-1181. [PMID: 29926272 DOI: 10.1007/s10900-018-0537-6] [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: 10/28/2022]
Abstract
Stress is associated with poor mental and physical health outcomes. In the United States (U.S.), little is known about perceived stress and associated factors among HIV-infected and immigrant women. Here, we examine these associations within a sample of 305 HIV-infected and uninfected, U.S.-born and non-U.S.-born women who were part of the Women's Interagency HIV Study (WIHS) at three sites (New York, Chicago, and Los Angeles). Perceived stress was measured using the 10-item Perceived Stress Scale (PSS-10); HIV infection was serologically confirmed, and nativity status was self-reported. Bivariate and multivariable logistic regression were used to identify associations with perceived stress. The majority of participants were U.S.-born (232, 76.1%) and were HIV-infected (212, 68.5%). Mutlivariable analyses found the odds of perceived stress to be lower for those employed [adjusted odds ratio (AOR) = 0.31, 95% confidence interval (CI) = (0.15-0.63)], with high levels of social support (AOR = 0.45, 95% CI 0.26-0.79), and HIV-infected (AOR = 0.44, 95% CI 0.24-0.79). Perceived stress was positively associated with living in unstable housing (AOR = 2.54, 95% CI 1.17-5.51). Here, immigration status was not associated with perceived stress. We identified stress to be higher among women who were unemployed, unstably housed, or who had low social support. Community-based programs should tailor interventions to include stress reduction strategies for participants with identified risk factors to improve mental and physical health outcomes.
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Pagano A, Gubner N, Le T, Guydish J. Cigarette smoking and quit attempts among Latinos in substance use disorder treatment. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2018; 44:660-667. [PMID: 29333890 DOI: 10.1080/00952990.2017.1417417] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Differences in tobacco use behaviors have been identified between Latinos and non-Latino whites in the general US population. Little is known about cigarette smoking and quitting behaviors of Latinos in treatment for substance use disorders (SUDs), who represent two major tobacco-vulnerable groups. OBJECTIVES To compare, in a national sample of persons enrolled in SUD treatment, demographic, drug use, and smoking and quitting prevalence and behaviors between Latinos and non-Latino whites. METHODS We surveyed 777 SUD treatment clients, sampled from 24 clinics selected at random from the National Institute on Drug Abuse Clinical Trials Network (Latino client n = 141; 40% female). We then conducted univariate and multivariate analyses to identify correlates of smoking behaviors by Latino/non-Latino white ethnicity. RESULTS Latinos' smoking prevalence resembled that of non-Latino whites (78.7% vs. 77.4%). In regression analyses, Latino smokers (n = 111) tended to smoke fewer cigarettes per day (CPD) than non-Latino white smokers (n = 492); were more often nondaily smokers and menthol smokers; more often reported a smoking quit attempt in the last year; and tended to report higher numbers of past-year quit attempts. Among Latino smokers, those with less education and those reporting opioids as their primary drug of use reported higher CPD. CONCLUSIONS Latinos in SUD treatment are at equally high risk of being current heavy smokers as compared to non-Latino whites in SUD treatment. At the same time, Latinos in SUD treatment exhibit ethnic-specific smoking and quitting behaviors that should be considered when designing smoking interventions for this group.
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Affiliation(s)
- Anna Pagano
- a Prevention Research Center , Pacific Institute for Research and Evaluation , Oakland , CA , USA
| | - Noah Gubner
- b Philip R. Lee Institute for Health Policy Studies, University of California San Francisco , San Francisco , CA , USA
| | - Thao Le
- b Philip R. Lee Institute for Health Policy Studies, University of California San Francisco , San Francisco , CA , USA
| | - Joseph Guydish
- b Philip R. Lee Institute for Health Policy Studies, University of California San Francisco , San Francisco , CA , USA
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Merzel CR, Isasi CR, Strizich G, Castañeda SF, Gellman M, Maisonet Giachello AL, Lee DJ, Penedo FJ, Perreira KM, Kaplan RC. Smoking cessation among U.S. Hispanic/Latino adults: Findings from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Prev Med 2015; 81:412-9. [PMID: 26515291 PMCID: PMC6391117 DOI: 10.1016/j.ypmed.2015.10.006] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 10/14/2015] [Accepted: 10/17/2015] [Indexed: 10/22/2022]
Abstract
This paper examines patterns of smoking cessation among Hispanics/Latinos with particular attention to gender, acculturation, and national background. Data are from the Hispanic Community Health Study/Study of Latinos, a population-based study of 16,415 non-institutionalized Hispanics/Latinos ages 18-74 from a stratified random sample of households in Chicago, Miami, the Bronx, and San Diego. Face-to-face interviews, in English or Spanish, were conducted from 2008 to 2011. Findings are based on 6398 participants who reported smoking at least 100 cigarettes in their lifetime. Associations with smoking cessation outcomes were assessed in bivariate and multivariable analyses. Findings indicate that approximately equal proportions of men and women were former smokers. There was little difference by gender in socioeconomic characteristics associated with smoking cessation. Both men and women who lived in households with smokers were less likely to be abstinent. Multivariable analysis indicated that the likelihood of quitting varied by national background primarily among men, however, Puerto Rican and Cuban smokers of both genders were the least likely to successfully quit smoking. Among women, but not men, younger and more socially acculturated individuals had lower odds of sustaining cessation. Over 90% of female and male former smokers reported quitting on their own without cessation aids or therapy. The results suggest that many Hispanics/Latinos are self-motivated to quit and are able to do so without clinical assistance. Heterogeneity in smoking behaviors among Hispanics/Latinos should be taken into account when developing and delivering smoking cessation interventions and public health campaigns.
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Affiliation(s)
- Cheryl R Merzel
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, United States.
| | - Carmen R Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, United States
| | - Garrett Strizich
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, United States
| | - Sheila F Castañeda
- Institute for Behavioral and Community Health, Graduate School of Public Health, San Diego State University, United States
| | - Marc Gellman
- Department of Psychology, University of Miami, United States
| | - Aida L Maisonet Giachello
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, United States
| | - David J Lee
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, United States
| | - Frank J Penedo
- Department of Medical Social Science, Feinberg School of Medicine, Northwestern University, United States
| | - Krista M Perreira
- Department of Public Policy, University of North Carolina Chapel Hill, United States
| | - Robert C Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, United States
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Abstract
Socially and culturally embedded norms regarding smoking may be one pathway by which individuals adopt smoking behaviors. However, few studies have examined if social norms operate in young adults, a population at high risk of becoming regular smokers. There is also little research examining correlates of social norms in populations with a large immigrant segment, where social norms are likely to differ from the receiving country and could contribute to a better understanding of previously reported acculturation-health associations. Using data from a nationally representative sample of young adults in the United States reached via a novel cell-phone sampling design, we explored the relationships between acculturation proxies (nativity, language spoken and generational status), socioeconomic position (SEP), smoking social norms and current smoking status among Latinos 18-34 years of age (n = 873). Specifically, we examined if a measure of injunctive norms assessed by asking participants about the acceptability of smoking among Latino co-ethnic peers was associated with acculturation proxies and SEP. Results showed a strong gradient in smoking social norms by acculturation proxies, with significantly less acceptance of smoking reported among the foreign-born and increasing acceptance among those speaking only/mostly English at home and third-generation individuals. No consistent and significant pattern in smoking social norms was observed by education, income or employment status, possibly due to the age of the study population. Lastly, those who reported that their Latino peers do not find smoking acceptable were significantly less likely to be current smokers compared to those who said their Latino peers were ambivalent about smoking (do not care either way) in crude models, and in models that adjusted for age, sex, generational status, language spoken, and SEP. This study provides new evidence regarding the role of social norms in shaping smoking behaviors among Latino young adults and suggests distinct influences of acculturation proxies and socioeconomic condition on smoking social norms in this population.
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Incidence of non-small-cell lung cancer among California Hispanics according to neighborhood socioeconomic status. J Thorac Oncol 2013; 8:287-94. [PMID: 23399956 DOI: 10.1097/jto.0b013e31827bd7f5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Lung cancer incidence is associated with markers of lower socioeconomic status (SES) in whites, blacks, and Asians but with markers of higher SES in Hispanics. The magnitude and etiology of this positive gradient in Hispanics remain undefined. We examined non-small-cell lung cancer (NSCLC) incidence and ever-smoking rates among California Hispanics according to measures of SES. METHODS We computed neighborhood (n)SES-specific incidence rates by sex and race or ethnicity for 74,179 NSCLC cases in the California Cancer Registry, 1998-2002. Associations between nSES and NSCLC incidence were examined, using incidence rate ratios and linear trend tests, and stratified by age, stage, and histology. Ever-smoking rates among Hispanics were obtained from California Health Interview Survey 2001 data, and odds ratios for ever-smoking were calculated for measures of SES and acculturation. RESULTS Compared with the lowest nSES quintile, the NSCLC incidence in the highest quintile was 1.86 and 1.18 times higher for Hispanic women and men, respectively. The positive nSES gradients remained significant for all ages, stages, and nonsquamous histologies in women, and only for older age, local or regional stages, and adenocarcinoma histology in men. Ever-smoking rates were associated with English-speaking households and U.S.-born status for Hispanic women and low education and U.S.-born status for Hispanic men. CONCLUSIONS For California Hispanics, higher nSES was strongly associated with increased NSCLC incidence in women, but weakly associated in men, and ever-smoking rates were strongly correlated with increased acculturation. This finding may portend an increasing burden of NSCLC in Hispanic women, given future trends in acculturation and SES.
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