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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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2
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Cartujano-Barrera F, Cox LS, Catley D, Shah Z, Alpert AB, Cupertino AP. "I'm a transgender man… I have to quit smoking for treatment and surgery": Describing the experience of a Latino transgender man during his attempt to quit smoking. Explore (NY) 2023; 19:131-135. [PMID: 34823998 PMCID: PMC9110554 DOI: 10.1016/j.explore.2021.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 11/13/2021] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To describe the experience of a Latino transgender man during his attempt to quit smoking using a text messaging intervention. METHODS A Latino transgender man enrolled in a smoking cessation randomized controlled trial for Latino smokers. The participant was randomized to Decídetexto, a smoking cessation mobile intervention. The participant received a 24-week text messaging intervention. We assessed text messaging interactivity with the program, satisfaction, and self-reported abstinence at Week 12 and Month 6. RESULTS During the 24-week intervention period, the participant sent a total of 287 text messages to the program. When analyzing the content of the text messages sent by the participants, four important themes were identified: 1) gender identity, 2) low social support, 3) stressors (e.g., gender dysphoria), and 4) gender affirmation surgery as a reason to quit smoking. At both Week 12 and Month 6, the participant reported being extremely satisfied with the intervention and self-reported cigarette use. CONCLUSION A smoking cessation mobile intervention generated high satisfaction and frequent interactivity among a Latino transgender man. This case report provides important insights into the experience of one Latino transgender man during his attempt to quit smoking. There is an urgent need to develop or adapt existing smoking cessation interventions to better meet the needs of transgender people.
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Affiliation(s)
| | - Lisa Sanderson Cox
- Department of Population Health, University of Kansas Medical Center, Kansas City, Kansas, United States
| | - Delwyn Catley
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, Kansas City, Missouri, United States
| | - Zainab Shah
- Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York, United States
| | - Ash B Alpert
- Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York, United States
| | - Ana Paula Cupertino
- Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York, United States
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3
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Ra CK, Pehlivan N, Kim H, Sussman S, Unger JB, Businelle MS. Smoking prevalence among Asian Americans: Associations with education, acculturation, and gender. Prev Med Rep 2022; 30:102035. [PMID: 36531113 PMCID: PMC9747624 DOI: 10.1016/j.pmedr.2022.102035] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 10/25/2022] [Accepted: 10/27/2022] [Indexed: 11/06/2022] Open
Abstract
There is evidence that smoking prevalence rates are related to acculturation, education, and gender among Asian Americans. However, no studies have examined how smoking rates among Asian Americans vary based on acculturation, education, and gender together. This study used National Health Interview Survey (NHIS) data (2010-2018) to examine cigarette smoking prevalence among Asian American men and women aged 18 and older (N = 14,680). Multivariate logistic regression models were used to estimate associations between educational attainment (i.e., college graduate or higher vs some college or lower), years spent in the United States (U.S.) as a proxy for acculturation (i.e., less than 10 years (less acculturated) vs 10 years or more (more acculturated) vs U.S.-born), and cigarette smoking prevalence across gender controlling for age, marital status, poverty (at/above vs below poverty threshold), country of origin (Chinese vs Filipino vs Asian Indian vs Other Asian), and the survey year. Current smoking prevalence was 9.0 % among all Asian Americans - 5.0 % among women and 13.5 % among men. Among respective gender-specific subgroups, U.S.-born Asian women without a college degree and more acculturated Asian immigrant men without a college degree had the highest odds of smoking (OR: 4.096 [95 % CI: 2.638, 6.360] and 1.462 [95 % CI: 1.197, 1.774], respectively). Findings indicated that less educated U.S.-born Asian women and less educated Asian immigrant men are at greatest risk for smoking. Smoking prevalence among Asian Americans is highly related to acculturation, education, and gender. Findings may inform development of policies and programs that are targeted toward smoking cessation among Asian Americans.
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Affiliation(s)
- Chaelin K. Ra
- Rutgers Cancer Institute of New Jersey, Division of Medical Oncology, Robert Wood Johnson Medical School, Rutgers University, NJ, United States,TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States,Corresponding author
| | - Nazife Pehlivan
- Graduate School of Public Health, Department of Public Health, Seoul National University, Seoul, South Korea
| | - Ho Kim
- Graduate School of Public Health, Department of Public Health, Seoul National University, Seoul, South Korea
| | - Steve Sussman
- Population and Public Health Sciences, Keck School of Medicine, University of Southern California, CA, United States
| | - Jennifer B. Unger
- Population and Public Health Sciences, Keck School of Medicine, University of Southern California, CA, United States
| | - Michael S. Businelle
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States,Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
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4
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Simmons VN, Sutton SK, Medina-Ramirez P, Martinez U, Brandon KO, Byrne MM, Meade CD, Meltzer LR, Brandon TH. Self-help smoking cessation intervention for Spanish-speaking Hispanics/Latinxs in the United States: A randomized controlled trial. Cancer 2021; 128:984-994. [PMID: 34679188 DOI: 10.1002/cncr.33986] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 09/23/2021] [Accepted: 10/04/2021] [Indexed: 11/12/2022]
Abstract
BACKGROUND Hispanic/Latinx smokers living in the United States face unique challenges in quitting smoking. This study evaluated the efficacy of a culturally relevant, Spanish-language, extended self-help smoking cessation intervention among Hispanic smokers. METHODS A 2-arm parallel randomized controlled trial was conducted with Hispanic/Latinx smokers living in the United States who preferred health information in Spanish and smoked 5 or more cigarettes per week. Participants were randomly allocated to receive Libre del Cigarrillo (LDC), which consisted of 11 booklets and 9 pamphlets mailed monthly over 18 months, or the usual care (UC), which was a single Spanish-language self-help booklet from the National Cancer Institute. The primary outcome was self-reported 7-day point prevalence smoking abstinence assessed 6, 12, 18, and 24 months after the baseline. Eight prespecified moderators of the intervention were evaluated. Cost-effectiveness was also evaluated. All statistical tests were 2-sided. RESULTS Data from all participants randomized to LDC (n = 714) or UC (n = 703) were used for analyses after multiple imputation to manage missing data. Generalized estimating equation analyses indicated that LDC abstinence rates were higher (P < .001) across all assessments. Logistic regression analyses revealed that at 24 months, the abstinence rate was greater for LDC (33.1%) than UC (24.3%; odds ratio, 1.54; 95% confidence interval, 1.18-2.02; P = .002). Men exhibited a strong intervention effect at all assessments (P values < .001), whereas the intervention effect for women was observed only at 6 and 12 months (P values < .018). In comparison with UC, the incremental cost per quitter in the LDC arm was $648.43 at 18 months and $683.93 at 24 months. CONCLUSIONS A culturally relevant, Spanish-language intervention was efficacious and cost-effective for smoking cessation. LAY SUMMARY Research is needed to develop interventions for ethnic minority smokers. The aim of the current study was to test a Spanish-language adaptation of a validated and easily implemented self-help smoking cessation intervention in a nationwide randomized controlled trial. The findings demonstrated that the intervention produced greater smoking abstinence in comparison with a standard self-help booklet. Participants also were more satisfied with the intervention, and it was cost-effective. Efforts aimed at promoting tobacco abstinence in this underserved population could have significant public health implications, including potential reductions in cancer health disparities associated with tobacco smoking.
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Affiliation(s)
- Vani N Simmons
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida.,Department of Oncologic Sciences, University of South Florida, Tampa, Florida.,Department of Psychology, University of South Florida, Tampa, Florida
| | - Steven K Sutton
- Department of Oncologic Sciences, University of South Florida, Tampa, Florida.,Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center, Tampa, Florida.,Department of Psychology, University of South Florida, Tampa, Florida
| | | | - Ursula Martinez
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida.,Department of Oncologic Sciences, University of South Florida, Tampa, Florida
| | - Karen O Brandon
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - Margaret M Byrne
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida.,Department of Oncologic Sciences, University of South Florida, Tampa, Florida
| | - Cathy D Meade
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida.,Department of Oncologic Sciences, University of South Florida, Tampa, Florida
| | - Lauren R Meltzer
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - Thomas H Brandon
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida.,Department of Oncologic Sciences, University of South Florida, Tampa, Florida.,Department of Psychology, University of South Florida, Tampa, Florida
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5
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Nguyen P, Schiaffino MK, Lipton BJ. Disparities in self-management outcomes by limited English proficiency among adults with heart disease. Prev Med Rep 2021; 23:101407. [PMID: 34136340 PMCID: PMC8178122 DOI: 10.1016/j.pmedr.2021.101407] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 04/21/2021] [Accepted: 05/08/2021] [Indexed: 01/19/2023] Open
Abstract
There are significant disparities in cardiovascular health outcomes by limited English proficiency (LEP). Self-management plans (SMPs) are associated with better patient outcomes, however little is known about the association of LEP with having an SMP among adults with heart disease. This study examined this association using 2013–2016 California Health Interview Survey data. Among adults that received an SMP, we also examined whether they had a hard copy SMP (print or electronic vs. none), and whether they reported confidence in their ability to manage their heart disease. Our sample included a total of 9102 adults, including 1232 LEP and 7870 English proficient (EP) adults. LEP was associated with significantly lower odds of SMP receipt (Adjusted Odds Ratio [AOR] 0.46, 95% Confidence Interval [CI] 0.31 to 0.68). LEP and EP adults who received an SMP were similarly likely to have a hard copy SMP and report confidence in heart disease management. The finding that LEP adults were less likely than EP adults to receive an SMP may represent a missed opportunity to improve heart health outcomes for this group.
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Affiliation(s)
- Phuong Nguyen
- School of Public Health, San Diego State University, 5500 Campanile Drive, San Diego, CA 92182, USA
| | - Melody K Schiaffino
- School of Public Health, San Diego State University, 5500 Campanile Drive, San Diego, CA 92182, USA.,Center for Health Equity, Education and Research (CHEER), University of California, San Diego, La Jolla, CA, USA
| | - Brandy J Lipton
- School of Public Health, San Diego State University, 5500 Campanile Drive, San Diego, CA 92182, USA.,Center for Health Economics & Policy Studies, San Diego State University, San Diego, CA, USA
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6
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Potter LN, Lam CY, Cinciripini PM, Wetter DW. Intersectionality and Smoking Cessation: Exploring Various Approaches for Understanding Health Inequities. Nicotine Tob Res 2021; 23:115-123. [PMID: 32208484 PMCID: PMC7789945 DOI: 10.1093/ntr/ntaa052] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 03/20/2020] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Many marginalized groups smoke at higher rates and have greater difficulty quitting than less marginalized groups. Most research on smoking cessation inequities has focused on a single sociodemographic attribute (eg, race or socioeconomic status), yet individuals possess multiple attributes that may increase risk. The current study used an intersectionality framework to examine how the interplay between multiple marginalized attributes may impact smoking cessation outcomes. METHODS A diverse sample of 344 adults enrolled in a smoking cessation program and reported on sociodemographic attributes (eg, race/ethnicity, gender, income) and continuous smoking abstinence on their quit date and at 1, 2, and 4 weeks postquit date. A Cox proportional hazard regression model was used to estimate whether intersectional links among race/ethnicity, gender, and income were related to smoking cessation outcomes. RESULTS Lower household income may be related to higher risk of smoking cessation failure. There were no significant interactions among race/ethnicity, gender, and income in predicting relapse. Pairwise intersectional group differences suggested some groups may be at higher risk of relapse. Number of marginalized sociodemographic attributes did not predict relapse. CONCLUSIONS Intersectionality may be a promising framework for addressing health inequities, and may help elucidate how to best design and target intervention efforts for individuals characterized by sociodemographic intersections that concur particularly high risk for poor tobacco cessation outcomes. IMPLICATIONS Despite an overall decline in smoking rates, socioeconomic inequities in smoking prevalence and cancer mortality are widening. Efforts targeting tobacco cessation should incorporate new theory to capture the complex set of factors that may account for tobacco cessation inequities (eg, multiple aspects of identity that may influence access to tobacco cessation treatment and exposure to certain stressors that impede cessation efforts). Intersectionality may be a promising framework for addressing health inequities in tobacco use and cessation and may help elucidate how to best design and target intervention efforts for individuals that concur particularly high risk for poor tobacco cessation outcomes.
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Affiliation(s)
- Lindsey N Potter
- Center for Health Outcomes and Population Equity (HOPE), Huntsman Cancer Institute and Department of Population Health Sciences, University of Utah, Salt Lake City, UT
| | - Cho Y Lam
- Center for Health Outcomes and Population Equity (HOPE), Huntsman Cancer Institute and Department of Population Health Sciences, University of Utah, Salt Lake City, UT
| | - Paul M Cinciripini
- Department of Behavioral Science, Division of Cancer Prevention and Population Sciences, University of Texas MD Anderson Cancer Center, Houston, TX
| | - David W Wetter
- Center for Health Outcomes and Population Equity (HOPE), Huntsman Cancer Institute and Department of Population Health Sciences, University of Utah, Salt Lake City, UT
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7
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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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8
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Shepherd JM, Bakhshaie J, Nizio P, Garey L, Viana AG, Zvolensky MJ. Anxiety symptoms and smoking outcome expectancies among Spanish-speaking Latinx adult smokers: Exploring the role of anxiety sensitivity. J Ethn Subst Abuse 2020; 21:304-324. [DOI: 10.1080/15332640.2020.1759476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
| | | | | | | | | | - Michael J. Zvolensky
- University of Houston, Houston, TX, USA
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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9
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Vinci C, Guo L, Spears CA, Li L, Correa-Fernández V, Etcheverry PE, Lam CY, Hoover DS, Wetter DW. Socioeconomic indicators as predictors of smoking cessation among Spanish-Speaking Mexican Americans. ETHNICITY & HEALTH 2019; 24:841-853. [PMID: 28859518 PMCID: PMC5832556 DOI: 10.1080/13557858.2017.1373074] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 08/21/2017] [Indexed: 05/16/2023]
Abstract
Objective: Smoking-related illnesses are the leading cause of death among Latinos, and within this ethnic group, Mexican Americans are the largest subgroup in the U.S. Understanding the factors associated with successful smoking cessation could inform interventions for this population. Although socioeconomic status (SES) is a powerful predictor of cessation outcomes in the general U.S. population, it has generally been a poor predictor of quitting smoking among Latinos. Within a sample of Spanish-speaking Mexican Americans (n = 199), this study examined a broad array of objective and subjective indicators of SES (i.e. income, education, employment, subjective social status, financial strain, insurance status) as predictors of smoking cessation. Design: Data for the current study came from a longitudinal cohort study examining the pathways linking the social determinants of health with smoking cessation. Generalized estimating equation modeling examined the association of each predictor variable with smoking abstinence across quit day, and the 3 and 26-weeks post-quit time points. Results: Results indicated that both low financial strain and insurance status predicted an increased likelihood of abstinence when controlling for covariates in the intention-to-treat analyses (p = .02 and p = .01, respectively). However, these models only approached significance in the multiple imputation analyses (all ps > .05). Other indicators of SES (i.e. income, education, employment) that have been predictive of cessation in other populations were not predictive of abstinence in this sample. Conclusions: These findings suggest that SES may indeed influence smoking cessation among Spanish-speaking Mexican Americans similarly to its influence in other populations, but that capturing the construct of SES may require assessing a broader range of SES indicators. Specifically, low financial strain and having insurance predicted a greater likelihood of achieving smoking abstinence, whereas other indicators of SES (i.e. income, education) were not predictive.
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Affiliation(s)
- Christine Vinci
- Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Lin Guo
- Corona LLC, Southborough, MA, USA
| | - Claire A. Spears
- Division of Health Promotion & Behavior, Georgia State University, School of Public Health, Atlanta, GA, USA
| | - Liang Li
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Paul E. Etcheverry
- Department of Psychology, Southern Illinois University Carbondale, Carbondale, IL, USA
| | - Cho Y. Lam
- Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Diana S. Hoover
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - David W. Wetter
- Population Health Sciences, University of Utah, Salt Lake City, UT, USA
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10
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Castro Y, Vinci C, Heppner WL, Cano MÁ, Correa-Fernández V, Wetter DW. Revisiting the Relationship Between Acculturation and Smoking Cessation Among Mexican Americans. Ann Behav Med 2019; 53:211-222. [PMID: 29746621 DOI: 10.1093/abm/kay029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND A well-established gender-differentiated association between acculturation and current smoking exists among Latino adults. There are far fewer studies on the potential influence of acculturation on smoking cessation, and extant findings are mixed. PURPOSE Using a multidimensional measure of acculturation, the current study examined the independent and interactive associations of gender and acculturation with smoking cessation among Mexican American smokers engaged in a quit attempt. METHODS Using a latent variable modeling approach to repeated measures analysis, the independent and interaction effects of acculturation in two cultural directions (American and Mexican) were examined for their prospective associations with smoking abstinence. Interactions of acculturation domains with gender were also examined. Acculturation was assessed at baseline and abstinence status was assessed at 3 and 26 weeks post-quit. RESULTS The interaction of American and Mexican cultural identity was significantly associated with smoking abstinence, such that greater American cultural identity was positively associated with abstinence only among those with high Mexican cultural identity. The interaction of English proficiency with gender was significant such that English proficiency was positively associated with abstinence among men but not women. CONCLUSIONS Findings in the cultural identity domain are consistent with a "benefits of biculturalism" perspective, and may be particularly relevant to the adoption of an American cultural orientation among persons with an already-strong heritage-culture orientation. Findings also replicate a gender-differentiated association between acculturation and cessation. Implications for treatment development and future research are discussed.
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Affiliation(s)
- Yessenia Castro
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, TX, USA
| | - Christine Vinci
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Whitney L Heppner
- Department of Psychology, Georgia College and State University, Milledgeville, GA, USA
| | - Miguel Ángel Cano
- Department of Epidemiology, Florida International University, Miami, FL, USA
| | | | - David W Wetter
- Huntsman Cancer Institute and Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
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11
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Pulvers K, Cupertino AP, Scheuermann TS, Sanderson Cox L, Ho YY, Nollen NL, Cuellar R, Ahluwalia JS. Daily and Nondaily Smoking Varies by Acculturation among English-Speaking, US Latino Men and Women. Ethn Dis 2018; 28:105-114. [PMID: 29725195 DOI: 10.18865/ed.28.2.105] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background Higher smoking prevalence and quantity (cigarettes per day) has been linked to acculturation in the United States among Latinas, but not Latino men. Our study examines variation between a different and increasingly important target behavior, smoking level (nondaily vs daily) and acculturation by sex. Methods An online English-language survey was administered to 786 Latino smokers during July through August 2012. The Brief Acculturation Rating Scale for Mexican Americans-II (ARSMA-II) and other acculturation markers were used. Multinomial logistic regression models were implemented to assess the association between smoking levels (nondaily, light daily, and moderate/heavy daily) with acculturation markers. Results Greater ARMSA-II scores (relative risk ratio, RRR=.81, 95% CI: .72-.91) and being born inside the United States (RRR=.42, 95% CI: .24-.74) were associated with lower relative risk of nondaily smoking. Greater Latino orientation (RRR=1.29, 95% CI: 1.11-1.48) and preference for Spanish language (RRR=1.06, 95% CI: 1.02-1.10) and media (RRR=1.12, 95% CI: 1.05-1.20) were associated with higher relative risk of nondaily smoking. The relationship between acculturation and smoking level did not differ by sex. Conclusion This study found that among both male and female, English-speaking Latino smokers, nondaily smoking was associated with lower acculturation, while daily smoking was linked with higher acculturation.
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Affiliation(s)
- Kim Pulvers
- Department of Psychology, California State University San Marcos, San Marcos, CA
| | - A Paula Cupertino
- Center for Cancer Disparities, Hackensack Meridian Health, Hackensack, NJ
| | - Taneisha S Scheuermann
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine, Kansas City, KS
| | - Lisa Sanderson Cox
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine, Kansas City, KS
| | - Yen-Yi Ho
- Department of Statistics, University of South Carolina, Columbia, SC
| | - Nicole L Nollen
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine, Kansas City, KS
| | - Ruby Cuellar
- Department of Psychology, California State University San Marcos, San Marcos, CA
| | - Jasjit S Ahluwalia
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI
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12
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Montgomery L, Mantey DS. Correlates of Blunt Smoking Among African American, Hispanic/Latino, and White Adults: Results From the 2014 National Survey on Drug Use and Health. Subst Use Misuse 2017; 52:1449-1459. [PMID: 28467153 DOI: 10.1080/10826084.2017.1284238] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Blunt use is highly prevalent in the United States and has been associated with several negative health consequences, such as an increased risk for cardiovascular and pulmonary diseases. Although recent studies have identified characteristics (e.g., gender) that are associated with blunt use, it is unclear if these factors correlate with blunt use equally across racial/ethnic groups. METHODS Using cross-sectional data from the 2014 National Survey on Drug Use and Health, this study aimed to determine if demographic, health and substance use correlates of current (i.e., past 30-day) and lifetime blunt use were similar across 37,628 non-Hispanic African American, Hispanic/Latino and non-Hispanic White adults. RESULTS Findings revealed 8.3% of African American, 3.3% of Hispanic/Latino and 2.5% of White adults reported current blunt smoking. Across all racial/ethnic groups, age and current and lifetime cigarette and illicit drug use were associated with current and lifetime blunt use. However, gender, educational level, income, current alcohol use and self-reported health status were differentially associated with current and lifetime blunt use across racial/ethnic groups. Employment status and lifetime depression were not associated with blunt use behaviors among any of the racial/ethnic groups. CONCLUSIONS The relationship between gender, socioeconomic status, alcohol use and self-reported health status and blunt use differs among African American, Hispanic/Latino and White adults. Researchers and providers should consider the heterogeneity in factors that are associated with blunt use when designing prevention and treatment interventions for African American, Hispanic/Latino and White adult blunt smokers.
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Affiliation(s)
- LaTrice Montgomery
- a Addiction Sciences Division , University of Cincinnati College of Medicine , Cincinnati , Ohio , USA
| | - Dale S Mantey
- b University of Texas Health Science Center at Houston, School of Public Health, Austin Campus , Austin , Texas , USA
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Iglesias-Rios L, Bromberg JE, Moser RP, Augustson EM. Food insecurity, cigarette smoking, and acculturation among Latinos: data from NHANES 1999-2008. J Immigr Minor Health 2016; 17:349-57. [PMID: 24306283 DOI: 10.1007/s10903-013-9957-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Prevalence of food insecurity (FI) among Latinos in the United States is almost double the national average. To better understand FI among Latinos, potential risk factors beyond poverty, including acculturation indicators and smoking status, were explored. Cross-sectional data from 6,681 Latino adults from the 1999-2008 National Health and Nutrition Examination Surveys were used. Partial proportional odds (PPO) models were used to estimate associations of FI, including cigarette smoking and acculturation. The PPO models indicated that compared with never smokers, current smokers had significantly higher odds of FI (odds ratios ranged from 1.32 to 1.51 across models). Lower levels of acculturation and poverty and being a younger or middle-aged adult were also significantly associated with FI. Among Latinos, current smoking and low acculturation are important risk factors for FI. Current smoking and low acculturation may exacerbate nutritional deprivation in a population that is already disproportionally affected by poverty and poor health outcomes.
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Affiliation(s)
- Lisbeth Iglesias-Rios
- Tobacco Control Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, MSC 9761, Bethesda, MD, 20892-9761, USA
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14
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Castro Y. Determinants of Smoking and Cessation Among Latinos: Challenges and Implications for Research. SOCIAL AND PERSONALITY PSYCHOLOGY COMPASS 2016; 10:390-404. [PMID: 27672402 DOI: 10.1111/spc3.12256] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Tobacco is a significant burden to individual and public health, and disparities exist among Latino smokers with respect to use and cessation. Although the prevalence of smoking is lower for Latinos than for non-Latino Whites and the general U.S. population, numerous health disparities exist within the population of Latino smokers. Much is known about determinants of smoking and cessation but the vast majority of this knowledge is based on research with non-Latino White smokers. This results in at least two important challenges in tobacco research among Latino smokers: (i) demonstrating the generalizability of known determinants of smoking and cessation, and; (ii) identifying culturally relevant variables that influence smoking and cessation among Latinos. An argument for increased research in these areas is presented with a review of existing research among Latino smokers that demonstrates these needs. Research is summarized that suggests socioeconomic position, depressive symptomatology, physical dependence, and gender function differently as determinants of smoking and cessation among Latinos compared with the general population of smokers. Research is also reviewed that suggests the promise of acculturation, acculturative stress, and discrimination as culturally relevant determinants of smoking and cessation. Research and practice implications are discussed, and specific areas for future research are offered.
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Abraído-Lanza AF, Echeverría SE, Flórez KR. Latino Immigrants, Acculturation, and Health: Promising New Directions in Research. Annu Rev Public Health 2016; 37:219-36. [PMID: 26735431 DOI: 10.1146/annurev-publhealth-032315-021545] [Citation(s) in RCA: 174] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
This article provides an analysis of novel topics emerging in recent years in research on Latino immigrants, acculturation, and health. In the past ten years, the number of studies assessing new ways to conceptualize and understand how acculturation-related processes may influence health has grown. These new frameworks draw from integrative approaches testing new ground to acknowledge the fundamental role of context and policy. We classify the emerging body of evidence according to themes that we identify as promising directions--intrapersonal, interpersonal, social environmental, community, political, and global contexts, cross-cutting themes in life course and developmental approaches, and segmented assimilation--and discuss the challenges and opportunities each theme presents. This body of work, which considers acculturation in context, points to the emergence of a new wave of research that holds great promise in driving forward the study of Latino immigrants, acculturation, and health. We provide suggestions to further advance the ideologic and methodologic rigor of this new wave.
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Affiliation(s)
- Ana F Abraído-Lanza
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY 10032;
| | - Sandra E Echeverría
- Department of Community Health Education, School of Urban Public Health, City University of New York-Hunter College, New York, NY 10035;
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16
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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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17
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Castro Y, Heck K, Forster JL, Widome R, Cubbin C. Social and Environmental Factors Related to Smoking Cessation among Mothers: Findings from the Geographic Research on Wellbeing (GROW) Study. Am J Health Behav 2015; 39:809-22. [PMID: 26450549 DOI: 10.5993/ajhb.39.6.9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES The current study examined associations between race/ethnicity and psychosocial/environmental factors with current smoking status, and whether psychosocial/environmental factors accounted for racial differences in smoking status in a population-based sample of mothers in California. METHODS Cross-sectional data from 542 women with a history of smoking were used. Analyses adjusted for age, partner status, and educational attainment. RESULTS In models adjusted for sociodemographics, black women had significantly lower odds, and Latina immigrants had significantly higher odds of being a former smoker compared to white women. Persons smoking in the home, having a majority of friends who smoke, having perceptions of their neighborhood as being somewhat or very unsafe, and experiencing food insecurity were associated with decreased odds of being a former smoker. When these variables were entered into a single model, only being a Latina immigrant and having a majority of friends who smoke were significantly associated with smoking status. CONCLUSIONS Black women demonstrated a notable disparity compared with white women in smoking status, accounted for by psychosocial/environmental factors. Immigrant Latinas demonstrated notable success in ever quitting smoking. Social networks may be important barriers to smoking cessation among women.
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Affiliation(s)
- Yessenia Castro
- University of Texas at Austin, School of Social Work, Austin, TX, USA
| | - Katherine Heck
- University of California, San Francisco, Department of Family and Community Medicine, San Francisco, CA, USA
| | - Jean L Forster
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Rachel Widome
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Catherine Cubbin
- University of Texas at Austin, School of Social Work, Austin, TX, USA.
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18
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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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Abstract
Research suggests that immigrant enclaves positively influence health behaviors such as tobacco use through supportive social networks and informal social control mechanisms that promote healthy behavioral norms. Yet, the influence of social cohesion and control on tobacco use may depend on smoking-related norms, which can vary by gender. This study examines the influence of neighborhood Latino immigrant enclave status on smoking and cessation among Hispanic men and women. Data from the Los Angeles Family and Neighborhood Survey was combined with census data to assess the relationship between immigrant enclaves, gender, and smoking using multilevel regression. The effect of the Hispanic enclave environment on smoking differed by gender. Living in an enclave had a harmful effect on tobacco use among Hispanic men, marginally increasing the likelihood of smoking and significantly reducing cessation. This effect was independent of neighborhood socioeconomic status, nativity, and other individual demographics. Neighborhood immigrant concentration was not associated with smoking or cessation for Hispanic women. Research, interventions, and policies aimed at reducing smoking among Hispanics may need to be gender responsive to ensure effectiveness as well as health and gender equity.
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Affiliation(s)
- Jennifer Cantrell
- Research & Evaluation Department at the American Legacy Foundation, Washington, DC, USA,
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20
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Wagener TL, Busch AM, Dunsiger SI, Chiang KS, Borrelli B. Changes in risk perception following a smoking cessation intervention: the role of acculturation in a sample of Latino caregivers. J Behav Med 2014; 37:1000-8. [PMID: 24504775 DOI: 10.1007/s10865-014-9554-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Accepted: 01/16/2014] [Indexed: 10/25/2022]
Abstract
The present exploratory study examined the role of acculturation in the perception of the risks of smoking following a smoking cessation induction intervention among Latino caregivers of children with asthma. The sample consisted of 131 Latino smokers (72.9% female; 18.3% born in the U.S.) who were caregivers of a child with asthma. Caregivers were randomized to one of two smoking cessation interventions that were part of a home-based asthma program. Self-report measures of risk-perception were assessed at baseline, end of treatment (2 months after baseline), and 2- and 3-months post-treatment. At baseline, caregivers, regardless of level of acculturation, reported moderate to high levels of concern about the effects of secondhand smoke on their child's health as well as perceived risk regarding the effect of smoking on their own health. However, caregivers who were low in acculturation had a greater increase in concern about the effects of smoking on their child from pre-to post treatment compared to those who were high in acculturation (p = .001). Lastly, level of acculturation moderated the association between caregivers' concern about smoking on their child's health and their motivation to quit smoking (p < .05), but not cessation rates or reduced secondhand smoke exposure (p > .05). Specifically, motivation to quit at 3 months was greater for those with low acculturation. Though exploratory, these findings suggest that risk perception may be more easily influenced in low versus high acculturated populations and this should be considered in the design of clinical interventions and potentially mass media campaigns seeking to influence risk of caregiver behavior on child health with ethnic and racial minorities.
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Affiliation(s)
- Theodore L Wagener
- Section of General & Community Pediatrics, Department of Pediatrics, University of Oklahoma Health Sciences Center, 1200 Children's Ave., Suite 12400, Oklahoma City, OK, 73117, USA,
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21
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Abstract
Higher socioeconomic status smokers are more successful at smoking cessation. Few studies have investigated the prospective association between multiple measures of socioeconomic status and Hispanic smoking cessation. We assessed four measures to examine which predicted smoking cessation. Hispanics without debt had 18.5 times higher odds of 30-day cessation (odds ratio = 18.47, 95% confidence interval = 3.26-104.66, p < .01) and 11-fold increased odds of 7-day point prevalence abstinence (odds ratio = 11.32, 95% confidence interval = 2.45-52.24, p < .01) at 3-month follow-up. Yearly income, education, work status, money to see a doctor, and money for medications were not predictive of smoking cessation. Debt level may better measure socioeconomic inequities by capturing objective and subjective social status associated with Hispanic smoking cessation.
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Affiliation(s)
- Karl Chiang
- Mass Memorial Health Care and The University of Massachusetts Medical School, USA
| | - Belinda Borrelli
- Warren Alpert Medical School at Brown University and The Miriam Hospital
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22
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Castro Y, Businelle MS, Correa-Fernández V, Kendzor DE, Mazas CA, Cofta-Woerpel L, Wetter DW. Associations between indicators of acculturation and tobacco dependence among Spanish-speaking Latino smokers. Addict Behav 2012; 37:1101-8. [PMID: 22688345 DOI: 10.1016/j.addbeh.2012.05.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2012] [Revised: 03/26/2012] [Accepted: 05/15/2012] [Indexed: 10/28/2022]
Abstract
The current study utilized regression analyses to explore the relationships among demographic and linguistic indicators of acculturation, gender, and tobacco dependence among Spanish-speaking Latino smokers in treatment. Additionally, bootstrapping analyses were used to examine the role of dependence as a mediator of the relationship between indicators of acculturation and cessation. Indicators of time spent in the United States were related to indicators of physical dependence. Preferred media language was related to a multidimensional measure of dependence. Gender did not impact the relationships between acculturation indicators and dependence. A multidimensional measure of dependence significantly mediated the relationship between preferred media language and cessation. Future research would benefit from consideration of acculturation and multidimensional measures of dependence when studying smoking cessation among Latinos, and from further examination of factors accounting for relationships among acculturation, dependence, and cessation.
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Heterogeneity in past year cigarette smoking quit attempts among Latinos. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2012; 2012:378165. [PMID: 22675373 PMCID: PMC3362916 DOI: 10.1155/2012/378165] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2011] [Revised: 03/06/2012] [Accepted: 03/06/2012] [Indexed: 12/03/2022]
Abstract
Objective. Examine the association between English language proficiency (ELP) and immigrant generation and having made a cigarette smoking quit attempt in the past 12 months among Latinos. Examine if gender moderates the association between acculturation and quit attempts. Methods. Latino past year smokers from the 2003 and 2006/07 Tobacco Use Supplement to the Current Population Survey were analyzed. Logistic regression was used to examine the association between quit attempt and ELP and immigrant generation, controlling for demographics and smoking characteristics. Results. Latinos with poor ELP were more likely to have made a quit attempt compared to those with good ELP (adjusted odds ratio [AOR] = 1.22, confidence interval [CI]: 1.02–1.46) after controlling for demographic and smoking characteristics. First (AOR = 1.21, CI: 1.02–1.43) and second generation immigrants (AOR = 1.36, CI: 1.12–1.64) were more likely than third generation immigrants to have made a quit attempt in the past 12 months. Conclusion. Quit behaviors are shaped by differences in language ability and generational status among Latinos. This underscores the need to disaggregate Latinos beyond racial/ethnic categories to identify subgroup differences relevant for smoking and smoking cessation behaviors in this population.
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Abstract
Health concerns for Latinos, the largest ethnic minority in the United States, merit attention by policy makers. Given the importance of the Latino population to the economic well-being of the United States, ensuring good health for this group is crucial. Lack of access to health care is the most obvious barrier to maintaining good health for Latinos, but it is not the only important factor. Sociocultural factors, including acculturation, culturally competent health professionals, immigration status, income, and education are also influential to health concerns. Recommendations to decrease health disparities among Latino men include theoretically based health interventions, better integration of research findings, working with local communities, and incorporating Latino masculine values into both health care and health education. Given the importance of the sociocultural factors, the discussion that follows emphasizes these and the interaction of these factors with Latino cultural values.
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Affiliation(s)
- Julie Gast
- Department of Health, Physical Education, and Recreation (JG), Utah State University, Logan, Utah
- Department of Sociology, Social Work, and Anthropology (TP), Utah State University, Logan, Utah
| | - Terry Peak
- Department of Health, Physical Education, and Recreation (JG), Utah State University, Logan, Utah
- Department of Sociology, Social Work, and Anthropology (TP), Utah State University, Logan, Utah
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Delnevo CD, Gundersen DA, Hrywna M, Echeverria SE, Steinberg MB. Smoking-cessation prevalence among U.S. smokers of menthol versus non-menthol cigarettes. Am J Prev Med 2011; 41:357-65. [PMID: 21961462 DOI: 10.1016/j.amepre.2011.06.039] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2011] [Revised: 06/27/2011] [Accepted: 06/28/2011] [Indexed: 11/21/2022]
Abstract
BACKGROUND The Food and Drug Administration currently is assessing the public health impact of menthol cigarettes. Whether menthol cigarettes pose increased barriers to quitting is a critical issue because previous declines in smoking prevalence have stalled. PURPOSE To explore whether menthol cigarette smokers are less likely to quit than non-menthol smokers at the population level and whether this relationship differs by race/ethnicity. METHODS Cross-sectional analyses of the 2003 and 2006/2007 Tobacco Use Supplement to the Current Population Survey were conducted in 2010. Multiple logistic regressions were used to calculate the adjusted odds of cessation for menthol smoking relative to non-menthol smoking. Five different sample restrictions were used to assess the robustness of the findings. RESULTS In the broadest sample restriction, menthol smokers were less likely to have quit smoking (AOR=0.91, 95% CI=0.87, 0.96). This relationship holds among whites (AOR=0.93, 95% CI=0.88, 0.98) and blacks (AOR=0.81, 95% CI=0.67, 0.98). The magnitude of the relationship among Hispanics was similar to that among whites, but differed by Hispanic origin. Among those of Mexican origin, the AOR for menthol smokers was protective but not significant (AOR=1.29, 95% CI=0.99, 1.61), whereas among those of Puerto Rican origin, menthol smokers were less likely to have quit (AOR=0.57, 95% CI=0.37, 0.87). These findings were robust and significant in four of five sample restrictions. CONCLUSIONS Smoking menthol cigarettes is associated with decreased cessation at the population level, and this association is more pronounced among black and Puerto Rican smokers. These findings support the recent calls to ban menthol flavoring in cigarettes.
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Affiliation(s)
- Cristine D Delnevo
- Center for Tobacco Surveillance and Evaluation Research, School of Public Health, University of Medicine and Dentistry of New Jersey, New Brunswick, New Jersey, USA.
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26
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Cox LS, Okuyemi K, Choi WS, Ahluwalia JS. A review of tobacco use treatments in U.S. ethnic minority populations. Am J Health Promot 2011; 25:S11-30. [PMID: 21510783 DOI: 10.4278/ajhp.100610-lit-177] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Tobacco use is the leading preventable cause of disease and death in the United States. Among racial and ethnic minorities, disparities in tobacco use, knowledge of health risks and treatment resources, and access to and utilization of treatment contribute to a disproportionate disease burden from tobacco use. Furthermore, racial and ethnic minorities have been underrepresented within tobacco treatment studies. PURPOSE/OBJECTIVE This paper provides a review of published studies examining tobacco treatment interventions among ethnic and minority populations in the United States. STUDY DESIGN/METHODS Literature searches were used to identify smoking cessation interventions involving racial/ethnic minority populations. Identified studies were published between 1985 and 2009 involving African-American, Latino, Native American, and Asian or Pacific Islander smokers. Studies included in the review (1) targeted one or more ethnic minority group or had at least 10% of study participants from ethnic minority groups and (2) reported abstinence outcomes. RESULTS Sixty-four studies were included in this review. Of studies meeting inclusion criteria, 28 included a primary focus on African-Americans, 10 focused on Latinos, 4 focused on Native Americans, and 3 focused on Asian-American smokers. An additional 19 studies reported samples including participants from more than one minority group. Sample inclusion criteria, intervention content and duration, follow-up, abstinence assessment, and limitations of these studies were reviewed. CONCLUSIONS Individuals from racial and ethnic minority populations are interested in stopping smoking and willing to participate in treatment research. Variations in the content of treatment intervention and study design produced a range of abstinence outcomes across studies. Additional research is needed for all groups, including African-American smokers, and special attention is warranted for Latino, Native American, and Asian groups given the paucity of published studies. Although there were limited evaluations of pharmacotherapy, the existing data support use of pharmacotherapy in addition to counseling for enhancing abstinence outcomes. Further attention to level of individual smoking, variability in smoking patterns, and use of other tobacco products is needed, given known variation within and between racial and ethnic groups. Overall, findings are consistent with recommendations from the 2008 Clinical Practice Guidelines calling for increased research devoted to evaluating and enhancing tobacco use treatment interventions among racial and ethnic minority populations.
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Affiliation(s)
- Lisa Sanderson Cox
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine, Kansas City, Kansas 66160, USA.
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Simmons VN, Cruz LM, Brandon TH, Quinn GP. Translation and adaptation of smoking relapse-prevention materials for pregnant and postpartum Hispanic women. JOURNAL OF HEALTH COMMUNICATION 2011; 16:90-107. [PMID: 21120739 DOI: 10.1080/10810730.2010.529492] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Quitting smoking is one of the most important behavior changes a pregnant woman can make, with health benefits extending beyond pregnancy for the woman and her child. Increasing numbers of pregnant women are quitting smoking; however, the majority resume smoking later in their pregnancy or shortly after giving birth. Previous research has demonstrated the efficacy of self-help smoking relapse-prevention booklets; however, there is a dearth of materials available in Spanish for Hispanic smokers. The goal of the present study was to translate and adapt existing, theoretically based, smoking relapse-prevention materials for pregnant and postpartum Hispanic women. This article describes the transcreation approach used to ensure the Forever Free for Baby and Me booklets were linguistically and culturally relevant for the heterogeneous populations of Hispanic women. The authors conducted multistage formative research to adapt the booklets and modify vignettes and graphics. Compared with previous research conducted with pregnant non-Hispanic women, results revealed the following: (a) a lack of association or concern about smoking and weight gain, (b) the importance of family approval of behavior, and (c) stress related to difficulties surrounding the immigration experience. The authors' qualitative findings confirm and extend past research that has suggested ways to enhance the cultural relevance and acceptability of a health intervention.
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Affiliation(s)
- Vani Nath Simmons
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA.
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