Differential effects of acculturation on drinking behavior in Chinese- and Korean-American college students

Meta-Analysis on the Relation Between Acculturation and Alcohol Use Among Immigrant Youth

PURPOSE

We empirically examined the relation between acculturation and alcohol use in immigrant youth, with attention to demographic and methodological moderators.

METHODS

We identified 43 studies (38 empirical studies published in peer-reviewed journals and 6 dissertations) yielding 66 independent samples and 118 effect sizes. The total sample size was 61,851 immigrant youth from birth to 25 years of age (M = 937.14, standard deviation = 1,271.24) with a mean age of 15.50 years (standard deviation = 2.46).

RESULTS

The average effect size for the fixed effects model was .04 with a 95% confidence interval of .03-.05, which was significantly different from zero (p < .001). The average effect size for the random effects model was .05 with a 95% confidence interval of .02-.08, which was significantly different from zero (p = .002). Location of the study, age of participants, type of measurements used to assess acculturation and alcohol use, and publication year were significant moderators.

CONCLUSIONS

This meta-analytic review supported the immigrant paradox in which acculturation puts immigrant youth at risk for alcohol use. Several demographic and methodological factors also moderated this relation in a significant way. Important implications are discussed.

Exploring second generation Korean American alcohol use through church-based participatory research: A rapid ethnographic assessment in Los Angeles, California, United States

The prevalence of heavy drinking is high among Korean Americans (KAs), but alcohol treatment utilisation is low. Korean American drinking behaviours may be attributable to the Korean drinking culture. However, relatively little research has been conducted to explore this narrative. The aim of this paper was to examine the social and cultural contexts of drinking and help-seeking behaviours among second generation KAs. In 2016, we conducted a rapid ethnographic assessment (REA) in partnership with a Korean American church in Los Angeles. The REA involved participant observation and ten unstructured interviews. We used constructivist grounded theory to analyse the themes emerging from field notes and interview transcripts. Respondents perceived the existence of a Korean drinking culture in the United States that has been passed down from prior generations and preserved in ethnic enclaves. This Korean drinking culture was marked by festive occasions with heavy drinking, but the extent to which respondents adopted this drinking culture may have depended on their ethnic identities and connections to the community. For many second generation KAs, identity and community were tied to religious life. We found that KAs perceived professional treatment and recovery resources to be underutilised. We offer insights about church-based participatory research as an approach to studying drinking among KAs.

Longitudinal Change in Alcohol Use and Motivations for Drinking Among Asian American College Students

BACKGROUND

Asian Americans are understudied in the literature on alcohol, due to data limitations and the perception that they are at low risk for alcohol misuse. Yet, certain subpopulations-such as college students-may be at higher risk. The current study examined longitudinal change in alcohol use and motivations for drinking among Asian American students. We tested for differences by nativity status, ethnic origin, and gender and examined whether motivations covaried with alcohol use.

METHODS

Asian American first-year college students (N = 199, 45.7% female, 37.7% foreign-born) attending a US university were identified through stratified random sampling using registrar information. For 7 consecutive semesters, students completed online surveys about their behaviors and beliefs.

RESULTS

Multilevel models demonstrated that alcohol use and alcohol-related motivations increased over time. US-born students consistently consumed more alcoholic drinks, reached higher peak drinking levels, and drank more frequently than foreign-born students; however, motivations did not differ by nativity status. Chinese American students consumed less alcohol, drank less, and were more motivated to avoid alcohol-related consequences than students of other/multiple heritage ethnic origins. Each motivation subscale was associated with alcohol use at the between-person level. Likewise, within-person variability in motivations was linked to variability in drinking across semesters. Controlling for other motivations, drinking for fun emerged as the strongest correlate of alcohol use variability.

CONCLUSIONS

Alcohol misuse was highest among US-born students and those with higher motivations for drinking. Furthermore, alcohol use varied in tandem with motivations, suggesting that motivations may be a useful intervention target among this population.

Risk Factors Related to Binge Drinking

The characteristics of and risk factors associated with binge drinking among South Korean and American adolescents were identified in this study. Data on adolescents in the 9th to 12th grades were extracted from two nationwide data sets: the Korea Youth Risk Behavior Web-based Survey System and the U.S. Youth Risk Behavior Surveillance System. Binge drinking was observed among 16% of American adolescents during the past month and among 11.6% of Korean adolescents during the past year. For adolescents from both countries, the following seven similar significant factors were associated with binge drinking: female gender, higher grade, fighting-related injury experience, current cigarette smoking, preteen smoking initiation, participation in team sports, and depression. Among Korean adolescents, higher or lower level of academic achievement and inadequate sleep were additional unique factors associated with binge drinking. These results could be useful for developing interventions for adolescents engaging in binge drinking in both countries.

Ethnic Drinking Culture, Acculturation, and Enculturation in Relation to Alcohol Drinking Behavior Among Marriage-Based Male Immigrants in Taiwan

Drinking behavior among immigrants could be influenced by drinking-related cultural norms in their country of origin and host country. This study examined the association of ethnic drinking culture, acculturation, and enculturation with alcohol drinking among male immigrants in Taiwan. This cross-sectional survey recruited 188 male immigrants. Ethnic drinking culture was divided into dry and wet according to per capita alcohol consumption and abstinent rate in the countries of origin in reference to that in Taiwan. A scale, Bidimensional Acculturation Scale for Marriage-Based Immigrants, was developed to measure acculturation (adaptation to the host culture) and enculturation (maintenance of the original culture). Drinking patterns (abstinent, low-risk drinking, and hazardous drinking) were determined by scores on the Alcohol Use Disorder Identification Test. There was a significant interaction between ethnic drinking culture and enculturation/acculturation on drinking patterns. Multinomial logistic regression models identified that for those from dry ethnic drinking cultures, a high level of acculturation was associated with increased low-risk drinking, while a high level of enculturation was associated with decreased low-risk drinking. For those from wet ethnic drinking cultures, a low level of acculturation and high level of enculturation were associated with increased hazardous drinking. High family socioeconomic status was associated with increased drinking, while perceived insufficient family income was positively associated with hazardous use. To prevent hazardous use of alcohol, health education should be targeted at immigrant men who drink, especially among those who have economic problems, are from wet ethnic drinking cultures, and demonstrate low adaptation to the host culture.

Prospective Effects of Parenting on Substance Use and Problems Across Asian/Pacific Islander and European American Youth: Tests of Moderated Mediation

OBJECTIVE

Parental warmth and knowledge are protective factors against substance use, whereas parental psychological control is a risk factor. However, the interpretation of parenting and its effects on developmental outcomes may vary cross-culturally. This study examined direct and indirect effects of three parenting dimensions on substance use across Asian/Pacific Islander (API) and European Americans.

METHOD

A community sample of 97 API and 255 European Americans were followed from Grades 6 to 12. Participants reported on parenting in Grade 7, academic achievement and externalizing behaviors in Grades 7 and 8, and substance use behaviors in Grades 7, 9, and 12.

RESULTS

Direct effects of parenting were not moderated by race. Overall, mother psychological control was a risk factor for substance use problems in Grade 9, whereas father knowledge was protective against alcohol use in Grade 9, substance use problems in Grades 9 and 12, and alcohol dependence in Grade 12. Moderated mediation analyses indicated significant mediational links among European Americans only: Mother knowledge predicted fewer externalizing problems in Grade 8, which in turn predicted fewer substance use problems in Grades 9 and 12. Father warmth predicted better academic achievement in Grade 8, which in turn predicted fewer substance use problems in Grades 9 and 12, as well as alcohol and marijuana dependence in Grade 12.

CONCLUSIONS

Better academic achievement and fewer externalizing behaviors explain how positive parenting reduces substance use risk among European Americans. Promoting father knowledge of adolescents' whereabouts can reduce substance use risk among both European and API Americans.

Acculturative stress as a moderator of the effect of drinking motives on alcohol use and problems among young adults

BACKGROUND

Research has demonstrated a strong relationship between drinking motives and alcohol use among young adult populations. Further, there is substantial evidence of the association between psychosocial stressors and greater alcohol consumption. In the present study, we examined whether acculturative stress would moderate the relationship between major drinking motives and alcohol use behaviors and alcohol-related problems, and whether this relationship differs by racial/ethnic group.

METHOD

Six hundred diverse undergraduate students (mean age=21.50, SD=2.46; 82.8% female; 40.2% White/Caucasian) completed a series of measures, including demographic information, alcohol use/alcohol problems, and acculturative stress.

RESULTS

Findings showed varying patterns in the moderating effect of acculturative stress on the relationship between drinking motives and alcohol consumption and alcohol-related problems, particularly for self-identified Hispanic, Black, and Asian students. Stronger drinking motives were associated with greater alcohol consumption and alcohol-related problems, and this relationship was stronger among Asian and Hispanic students who reported higher levels of acculturative stress. For Black students, greater acculturative stress was observed to weaken the relationship between coping, enhancement, and conformity motives and alcohol drinking frequency.

CONCLUSIONS

Results are discussed in terms of incorporating acculturative stress in the development of tailored alcohol use interventions for vulnerable young adults, such as certain ethnic minority and immigrant groups. Clinical implications include screening for acculturative stress in primary care and counseling centers and early intervention programs to identify young adults who may be at-risk for or currently experiencing alcohol problems.

Gene-by-Environment Interactions on Alcohol Use Among Asian American College Freshmen

OBJECTIVE

Among northeast Asians, the variant aldehyde dehydrogenase allele, ALDH2*2 (rs671, A/G, minor/major), has been inversely associated with alcohol dependence. The strength of the associations between ALDH2*2 and drinking behaviors depends on the developmental stage, the phenotype studied, and other moderating variables. This study examined ALDH2 gene status as a moderator of the associations between parental drinking, peer drinking, and acculturation with alcohol use among 222 Chinese American and Korean American college freshmen.

METHOD

Negative binomial regressions were used to test the main and interactive effects of ALDH2 with contextual factors on alcohol frequency (drinking days) and quantity (drinks per drinking day) in the past 3 months.

RESULTS

ALDH2*2 was associated with more subjective flushing symptoms and longer length of flushing but was unrelated to both alcohol frequency and quantity. Peer drinking was positively associated with both alcohol frequency and quantity, but neither was moderated by ALDH2. We observed a nonsignificant trend for the interaction between parental drinking and ALDH2 on alcohol frequency, where parental drinking was positively associated with alcohol frequency only among participants with ALDH2*2. We found a significant interaction between acculturation and ALDH2 on alcohol frequency, where acculturation was positively associated with alcohol frequency only among those with ALDH2*2. Exploratory analyses stratified by Asian ethnic subgroup indicated that this interaction was driven primarily by the Korean subsample.

CONCLUSIONS

Parental drinking and acculturation may facilitate more frequent drinking among those who have more intense reactions to alcohol (i.e., those with ALDH2*2) during the transition from high school to college.

Differences in alcohol use patterns between adolescent Asian American ethnic groups: Representative estimates from the National Survey on Drug Use and Health 2002-2013

OBJECTIVE

Studies have suggested that alcohol use prevalence is increasing among Asian American adolescents and there may be significant differences between specific adolescent Asian American ethnicities.

METHOD

Data from the National Survey on Drug Use and Health (2002-2013) were used to estimate prevalence of alcohol use (lifetime, past-month, past-year) and problem (binge drinking, alcohol use disorder [AUD], and early initiation of use) outcomes among adolescent Asian American ethnicities.

RESULTS

Filipino Americans had the highest prevalence of lifetime (29.3%) and past-month (10.3%) use; Korean Americans had the highest prevalence of past-year use (22.7%). Asian Indian Americans had the lowest prevalence of all three use indicators: 14.6%, 11.9%, and 4.9% for lifetime, past-year, and past-month, respectively. Korean Americans had the highest prevalence of binge drinking (5.4%), Filipino Americans had the highest prevalence of AUD (3.5%), and Vietnamese Americans had the highest prevalence of early initiation of use (13.5%). Asian Indian Americans had the lowest prevalence for all three alcohol problem indicators: 2.6%, 1.0%, and 4.9% for binge drinking, AUD, and early initiation of use, respectively.

CONCLUSIONS

Prevalence estimates of alcohol outcomes among Korean, Japanese, and Filipino American adolescents were high and similar to other racial groups that are often considered higher risk racial groups. Estimates among large subgroups with low alcohol use prevalence, Chinese and Asian Indian Americans, may mask high rates among other Asian ethnicities when alcohol use estimates are presented among Asians overall. When feasible, researchers should present alcohol use estimates disaggregated by specific Asian American ethnicities and investigate differences in risk factors across groups.

The Associations Between Forced Sex and Severe Mental Health, Substance Use, and HIV Risk Behaviors Among Asian American Women

We examined the association between forced sex history and mental health, sexual health, and substance use among Asian American women ( n = 720); 14.3% of our sample ( n = 103) reported forced sex experiences. Multiple logistic regression analyses revealed that participants with forced sex histories were 2-8 times more likely to have higher rates of mental health problems, HIV risk behavior, and substance use. Qualitative analysis was used to supplement the quantitative results and give depth to our findings. Our results suggest that interventions for Asian American women who experienced forced sex should integrate mental health, substance use, and sexual health treatments.

Genetic and Environmental Predictors of Alcohol Use in Asian American Young Adults

OBJECTIVE

Among Asian American young adults, variations in alcohol-metabolizing genes (i.e., aldehyde dehydrogenase [ALDH2] and alcohol dehydrogenase [ADH1B]) are protective, whereas Korean ethnicity, family history of alcohol problems (FH), and acculturation represent risk factors for alcohol misuse. This study aims to integrate these genetic and environmental factors in a sample of Asian Americans expressing a wide range of alcohol use behaviors and problems.

METHOD

Participants were 97 Asian American young adults (42% female) recruited as heavy and light drinkers (n = 49 and 48, respectively). Participants completed the Alcohol Use Disorders Identification Test, Timeline Followback, Vancouver Acculturation Index, and Family Tree Questionnaire. All participants provided buccal cell samples for DNA analysis.

RESULTS

Family history-positive (FH+) subjects reported greater alcohol use than family history-negative (FH-) subjects. A FH × ALDH2 interaction was observed such that FH- subjects demonstrated no ALDH2 effect, yet in FH+ subjects, the ALDH2*2 genotype was associated with increased alcohol use. A significant main effect of acculturation was also moderated by FH such that the positive association between acculturation and alcohol use was greater among FH+ subjects and, in particular, among FH+ men.

CONCLUSIONS

Although preliminary, these results suggest that the potential protective effects conferred by ALDH2 and ADH1B are moderated by FH, such that a positive FH appeared to abolish the protective effect of these genes. Further, acculturation was associated with greater alcohol use in FH+ subjects only. If replicated in larger samples, these data suggest that alcohol-metabolism genes may not be protective in the context of high environmental risk.

Under-Researched Demographics: Heavy Episodic Drinking and Alcohol-Related Problems Among Asian Americans

Asian Americans represent the fastest- growing population in the United States (Le 2010). At the same time, there is evidence that problematic drinking rates are increasing among young-adult Asian Americans (Grant et al. 2004). Accordingly, it is essential to understand the etiological determinants and mechanisms of risk that may help explain this growth in problematic alcohol use among this group. The high prevalence of the ALDH2*2 and ADH1B*2 alleles in a large percentage of Asian subgroups has been studied as a potential protective factors against alcohol abuse, yet some individuals who possess these genes still engage in problematic alcohol use (Wall et al. 2001). Other social and psychological factors may account for this discrepancy. Thus, some factors, such as negative physiological alcohol expectancies, are protective against alcohol abuse in this population (Hendershot et al. 2009). Sociocultural factors such as acculturation and nativity also may help explain drinking patterns among this group. The literature suggests that vast and significant within-group differences exist among Asian Americans, such that individuals who were born in the United States and/or are more acculturated are at elevated risk for alcohol abuse and related problems (Hahm et al. 2003). Differences also have been observed among Asian-American ethnic subgroups, with some groups (e.g., Japanese, Korean, and multi-Asian Americans) reporting higher rates of drinking compared with others (e.g., Chinese and Vietnamese Americans) (Iwamoto et al. 2012). Furthermore, Asian Americans who report higher levels of depressive symptoms, psychological distress, and perceived discrimination seem to be at a heightened risk for abusing alcohol (Iwamoto et al. 2011a; Nishimura et al. 2005; Yoo et al. 2010). Finally, an emerging body of research examining gender-relevant factors, including feminine and masculine norms, may help explain within-group differences among Asian-American women and men. Thus, traditional norms that may directly pertain to hyperfemininzed Asian-American women, including modesty and sexual fidelity, may protect against heavy episodic drinking (Young et al. 2005). Conversely, the risk for heavy episodic drinking may be enhanced in men who strive to demonstrate traditional notions of masculinity through risk-taking and endorsement of playboy norms (Iwamoto et al. 2010). Although this review has illustrated the contemporary state of research on alcohol use among Asian Americans, it also highlights the significant limitations in this literature. Many of the studies reviewed here have used cross-sectional data, which do not allow researchers to infer causality between the various sociocultural factors and problematic alcohol use. One way of addressing this gap in the existing literature may be to implement longitudinal designs to further understand how the temporal relationship between sociocultural factors, including acculturation and gender norms, may impact alcohol use and alcohol-related problem trajectories. There also is a pressing need to develop greater understanding of within-group differences among U.S.-born and foreign-born Asian Americans as well as among as specific ethnic groups. To date, epidemiological research has largely neglected to examine these significant discrepancies. Given the growing prevalence of alcohol use and alcohol-related problems among Asian-American women (Grant et al. 2004; Iwamoto et al. 2010), studies also should focus on this group and explore how the intersection of gender and culture may influence alcohol use. Finally, the majority of research on this population has been conducted in college samples; therefore, it is important to also examine community samples, including U.S.-born young adults who are not attending college and older adult Asian-American populations.

Understanding differences in alcohol consumption and depressed mood between U.S.- and foreign-born Asian and Caucasian college students

The number and proportion of foreign-born individuals in the U.S. population has increased in recent decades. From 1970 to 2007, the foreign-born population more than tripled to approximately 37 million (U.S. Census Bureau, 1997 , 2008 ). Foreign-born students are a key subpopulation of college students. About 23% of U.S. undergraduate college students in 2007-2008 were either born outside of the United States (10%) or were children of at least one first-generation immigrant parent (13%; National Center for Education Statistics, U.S. Department of Education [NCES], 2012 ). Asian students constitute the majority (30%) of foreign-born undergraduates. Although foreign-born Asian students compose nearly one-quarter of the college population, limited research has examined how rates of alcohol use and depression differ between foreign-born and U.S.-born Asian college students (Gonzalez, Reynolds, & Skewes, 2011 ; Ralston & Palfai, 2012 ). The limited research is worrisome given their increasing rates of college enrollment (U.S. Census Bureau, 2011 ), alcohol consumption (Aud, Fox, & KewalRamani, 2010 ), alcohol abuse and dependence (Grant et al., 2004 ), and underutilization of mental health services (U.S. Department of Health and Human Services, 2001 ). Collectively, these factors point to the need for further research tailored to Asian college drinkers.

Ethnic drinking cultures, gender, and socioeconomic status in Asian American and Latino drinking

BACKGROUND

Heterogeneity in drinking across national groups is well documented, but what explains such heterogeneity is less clear. To improve understanding of the underlying cultural conditions that may lead to diverse drinking outcomes, we investigate whether 3 dimensions of ethnic drinking culture (EDC)-alcohol consumption level, drinking prevalence, and detrimental drinking pattern (DDP) in the country of origin (COO)-are significantly associated with alcohol consumption in Asian Americans and Latina/os, and whether the associations vary by gender and socioeconomic status (SES) as assessed by educational level.

METHODS

A nationally representative sample of 1,012 Asian American and 4,831 Latino adults extracted from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions data was used. A series of multiple logistic and linear regression models were fitted separately for Asian Americans and for Latinos. Analyses were also stratified by gender and educational level.

RESULTS

Overall, the associations between EDC variables and drinking outcomes were more pronounced for all Asian Americans than for all Latina/os, for males than for females among Asian Americans, and for Latinas than for Latinos. In analyses simultaneously stratifying on gender and education level, however, there was a clear pattern of COO DDP associated with heavier drinking and alcohol consumption volume only for Latinos without a college degree.

CONCLUSIONS

Ethnic drinking cultures may influence drinking in Asian American and Latino subgroups, albeit to a varying degree. Low-SES Latinos may be at disproportionate risk of harmful drinking patterns pervasive in their COO. Future research might investigate the complex interplay between socioeconomic disadvantage and cultural conditions to inform targeted interventions for subgroups at high risk of alcohol-related harms.

Predicting Alcohol Misuse Among College Students in the US and South Korea

This study examines contributing factors of alcohol misuse among college students in South Korea and the U.S. Exploratory factor analyses (EFA) on measurements of alcohol expectancy, alcohol efficacy, and accommodation resulted in social and personal causes for alcohol misuse. Social causes alone predicted alcohol misuse for both countries. Social factors constituted a much stronger predictor of alcohol misuse among South Korean students than among American students. Practical implications for effective deterrence of student binge drinking are discussed.

Asian American problem drinking trajectories during the transition to adulthood: ethnic drinking cultures and neighborhood contexts

OBJECTIVES

We aimed to identify problem drinking trajectories and their predictors among Asian Americans transitioning from adolescence to adulthood. We considered cultural and socioeconomic contextual factors, specifically ethnic drinking cultures, neighborhood socioeconomic status, and neighborhood coethnic density, to identify subgroups at high risk for developing problematic drinking trajectories.

METHODS

We used a sample of 1333 Asian Americans from 4 waves of the National Longitudinal Study of Adolescent to Adult Health (1994-2008) in growth mixture models to identify trajectory classes of frequent heavy episodic drinking and drunkenness. We fitted multinomial logistic regression models to identify predictors of trajectory class membership.

RESULTS

Two dimensions of ethnic drinking culture-drinking prevalence and detrimental drinking pattern in the country of origin-were predictive of problematic heavy episodic drinking and drunkenness trajectories. Higher neighborhood socioeconomic status in adolescence was predictive of the trajectory class indicating increasing frequency of drunkenness. Neighborhood coethnic density was not predictive of trajectory class membership.

CONCLUSIONS

Drinking cultures in the country of origin may have enduring effects on drinking among Asian Americans. Further research on ethnic drinking cultures in the United States is warranted for prevention and intervention.

Differences in Substance Use and Substance Use Risk Factors by Asian Subgroups

The present study examined differences in lifetime use and initiation of substance use and associated risk factors for alcohol, cigarettes, and marijuana among seven subgroups of Asian American (AA) adolescents: Chinese, Filipino, Indian, Japanese, Korean, Vietnamese, and Mixed heritage Asian. Sixth and 7th grade AA adolescents in Southern California were surveyed five times over three academic years. We examined subgroup differences in (1) lifetime alcohol, cigarette, and marijuana use assessed at baseline, (2) initiation of each substance over three years, and (3) baseline individual (positive and negative expectancies about substances, resistance self-efficacy, and intentions to use), family (closest adult and older sibling substance use), and school factors (perceived peer use). Although there was considerable heterogeneity in lifetime substance use and initiation rates, subgroup differences were not statistically significant (ps > .20). Significant subgroup differences existed for negative expectancies about use, perceived peer use, and close adult alcohol and cigarette use (ps < .05). Specifically, Vietnamese and Japanese adolescents had the lowest negative expectancies about cigarettes and marijuana, respectively. Vietnamese adolescents reported the highest levels of perceived peer cigarette use. Mixed-heritage adolescents reported the highest frequency of alcohol and cigarette use by their closest adult. Although no differences in substance use rates were observed, these findings are an important first step in understanding heterogeneity in AA adolescents' risk for substance use and initiation.

Does diversity matter? The need for longitudinal research on adolescent alcohol and drug use trajectories

The existing research aimed at understanding alcohol and drug (AOD) use patterns from early to late adolescence typically does not examine samples with substantial racial and ethnic diversity. This is a critical research gap because studies have suggested that non-white adolescents often have worse health outcomes compared to white adolescents, even with less AOD use. In this paper, we discuss the need for future research on this topic, given demographic shifts in the racial and ethnic composition of the USA. We also outline how this research can provide information on what periods might be most relevant for each racial/ethnic group, and suggest measures that epidemiological studies on early substance use should assess to capture the underlying cultural, acculturation, psychosocial, and contextual factors that explain racial/ethnic differences in AOD trajectories.

The role of immigration status in heavy drinking among Asian Americans

We examined the role of Asian Americans' immigration status in their heavy drinking, using a national sample of 3,574 Asian American adults during 2008 to 2011 when surveyed by the National Health Interview Survey. Our results, with relevant social structural factors controlled, show that U.S.-born Asian Americans exhibited the highest heavy-drinking levels, followed by long-time-resident Asian immigrants, then recent-resident Asian immigrants (our three main subsamples). The higher heavy-drinking levels characterizing U.S.-born Asians who were male and younger, as compared to immigrant Asians who were male and younger, helped explain differential heavy-drinking levels across subsamples. The study's limitations are noted.

Association between Acculturation and Binge Drinking among Asian-Americans: Results from the California Health Interview Survey

Objective. Evaluate the association between acculturation and binge drinking among six Asian-American subgroups. Methods. A cross-sectional analysis of public access adult portion of 2007, 2009, and 2011/2012 California Health Interview Survey data was conducted. Univariate and multivariable logistic regression analyses were utilized with any binge drinking in the past year as the outcome variable and language spoken at home and time in USA as proxy measures of acculturation. Results. A total of 1,631 Asian-Americans (N = 665,195) were identified as binge drinkers. Binge drinking was positively associated with being first generation South Asian (OR = 3.05, 95% CI = 1.55, 5.98) and monolingual (English only) Vietnamese (OR = 3.00; 95% CI = 1.58, 5.70), especially among females. Other factors associated with increased binge drinking were being female (Chinese only), not being current married (South Asian only), and being an ever smoker (all subgroups except South Asians). Conclusion. First generation South Asians and linguistically acculturated Vietnamese, especially females, are at an increased risk of binge drinking. Future studies and preventive measures should address the cultural basis of such health risk behaviors among Asian-American adults.

Exploring relationships between facets of self-esteem and drinking behavior among diverse groups of young adults

Theory and empirical evidence suggest that North American-based measures of self-esteem, which measure individualistic positive self-regard, may be less applicable to Eastern cultures. In the present exploratory study, we examined how different conceptualizations of self-esteem, as measured by the Rosenberg Self-esteem Scale and the Collective Self-esteem (CSE) Scale, predicted drinking behavior among three groups of American college students (N=326) with varying ethnicities: White, Korean, and Chinese/Taiwanese. Hierarchical negative binomial regression was employed to evaluate these relations. Ethnic identity was controlled for in all analyses. Findings indicated that while global self-esteem was positively associated with drinking for the whole sample, ethnicity moderated this relationship such that global self-esteem was related to drinking for White participants but not for their Chinese/Taiwanese counterparts. In addition, while CSE did not associate with drinking for the whole sample, effects emerged for specific ethnicities. Specifically, private CSE was associated with less drinking for Korean and Chinese/Taiwanese participants. Depending on specific Asian ethnicity, public CSE served as a risk (Korean participants) or a protective factor (Chinese/Taiwanese participants) for drinking. Findings suggest that above and beyond ethnic identity, differential relationships between facets of self-esteem and drinking behavior may exist among White, Korean, and Chinese/Taiwanese young adults. Intervention and prevention programs should develop strategies to help Chinese/Taiwanese and Korean American young adults cultivate protective factors within domains of CSE.

The relation between acculturation and alcohol consumption patterns among older Asian and Hispanic immigrants

This study examines the relation between acculturation and alcohol consumption patterns among older Asian and Hispanic immigrants in the state of California. Data were obtained from the 2009 California Health Interview Survey and included Asian (n = 1264) and Hispanic (n = 571) adults aged 60 and older who were born outside of the US. Outcome variables included presence of past year alcohol consumption, past year binge drinking, and number of binge drinking days. Acculturation was measured with items pertaining to English use and proficiency. Hierarchical multiple or logistic regression analyses were conducted separately for each racial/ethnic group and each dependent variable. Alcohol consumption was found in less than half of the sample for both Asians (43.2%) and Hispanics (39.2%). Binge drinking was found in 3.1% of Asians and 8.4% of Hispanics. Acculturation was significantly related to past year alcohol consumption for Hispanics, past year binge drinking for Asians, and binge drinking days for Asians, such that higher level of acculturation predicted a greater likelihood of alcohol consumption but decreased likelihood of binge drinking and fewer binge drinking days. The results indicate that acculturation may be related to alcohol consumption patterns for older immigrants. This suggests future needs to develop an in-depth understanding of the health behaviors of these immigrant elderly groups.

The relationship between collective self-esteem, acculturation, and alcohol-related consequences among Asian American young adults

We examined the relationship between collective self-esteem (i.e., the value one places on being part of a collective group), acculturation, and alcohol-related consequences in a sample of 442 Asian American young adults. We found that membership self-esteem and public collective self-esteem interacted with acculturation such that low levels of both predicted greater rates of consequences. Participants with lower acculturation and greater private collective self-esteem experienced more alcohol consequences. This study suggests that differential aspects of collective self-esteem may serve as protective or risk factors for Asian American young adults depending on degree of acculturation.

Differences in the prevalence rates and correlates of alcohol use and binge alcohol use among five Asian American subpopulations

BACKGROUND

This study (1) estimated the prevalence of alcohol and binge alcohol use among adult Asian Americans by sub-ethnicity; (2) examined alcohol drinking patterns among these subpopulations; and (3) investigated sub-ethnic differences in characteristics associated with alcohol and binge alcohol use.

METHOD

Data from 8900 Asian Americans aged 18 or older who participated in the 2002-2008 National Surveys on Drug Use and Health (NSDUHs) were analyzed. Descriptive analyses and multivariate logistic regression modeling were applied.

RESULTS

Korean Americans (51.8%) and Japanese Americans (49.7%) reported higher rates of past-month alcohol use than Chinese Americans (42.0%), Filipino Americans (37.9%), and Asian Indian Americans (34.0%). Korean Americans (24.6%) reported the highest rate of past-month binge alcohol use, followed by Filipino Americans (14.5%), Japanese Americans (14.2%), Asian Indian Americans (10.1%), and Chinese Americans (8.1%). Among these examined Asian Americans, foreign-born Chinese, Filipino, and Asian Indian Americans were less likely to have past-month alcohol use than their corresponding U.S. born counterparts; and only foreign-born Asian Indian Americans were less likely to have past-month binge alcohol use than their U.S. born counterparts. Males were 3-5 times more likely to have binge alcohol use than females among examined Asian American subpopulations except for Korean Americans. Korean Americans were more likely to have binge alcohol use than the other examined sub-ethnic Asian Americans.

CONCLUSIONS

Adult Asian Americans are heterogeneous in sociodemographic characteristics and alcohol and binge alcohol use. These differences suggest the need for sub-ethnically specific prevention and treatment programs for alcohol use problems among Asian American subpopulations.

Self-determination, perceived approval, and drinking: differences between Asian Americans and Whites

The present research assessed racial differences in the associations among controlled orientation, injunctive norms, and increased drinking by White and Asian American college students. Previous research has noted racial differences in drinking, but reasons have not been considered in the context of individual differences in self-determination or responses to social influences. The authors evaluated perceived parental and peer injunctive norms as mediators of the relationship between controlled orientation and number of drinks consumed per week. The association between controlled orientation and drinking was further expected to be moderated by race. This study consisted of 534 White and 198 Asian American participants who had at least one heavy drinking episode in the month prior to assessment. Participants completed self-report measures assessing self-determination, perceived parental/peer injunctive norms, and drinking. Results indicated that peer injunctive norms served as a mediator between controlled orientation and greater number of drinks consumed per week for Whites only. Although Asian Americans were significantly higher in controlled orientation than Whites, they drank less and perceived their peers to be less approving of drinking. In contrast, Whites who were high in controlled orientation viewed their friends as being significantly more approving of alcohol and consumed significantly more drinks per week. Results provide unique considerations for understanding cultural differences in drinking among White and Asian American young adults.

Binge drinking and alcohol-related problems among U.S.-born Asian Americans

Binge drinking (five drinks or more in a 2-h sitting for men or four or more drinks in a 2-h sitting for women) and alcohol-related problems are a growing problem among Asian American young adults. The current study examines the sociocultural (i.e., generational status and ethnic identity) determinants of binge drinking and alcohol-related problems across U.S.-born, young-adult, Asian American ethnic groups. Data were collected from 1,575 Asian American undergraduates from a public university in Southern California. Chinese Americans consisted of the largest Asian ethnicity in the study, followed by Vietnamese, Filipino, Korean, South Asian, Japanese, Multi-Asian, and "other Asian American." Participants completed a web-based assessment of binge drinking, alcohol-related problems, ethnic identity, descriptive norms (i.e., perceived peer drinking norms), and demographic information. An analysis of variance was used to determine potential gender and ethnic differences in binge drinking and alcohol-related problems. Negative binomial regression was selected to examine the relationship between the predictors and outcomes in our model. There were no gender differences between Asian American men and women in regards to binge drinking; however, men reported more alcohol-related problems. Japanese Americans reported the highest number of binge-drinking episodes and alcohol-related problems, followed by Filipino and Multi-Asian Americans (e.g., Chinese and Korean). Living off-campus; higher scores in descriptive norms; Greek status; and belonging to the ethnic groups Japanese, Filipino, Multi-Asian, Korean, and South Asian increased the risk of engaging in binge drinking. Quantity of alcohol consumed, Greek status, gender, Filipino, South Asian, other Asian, and lower ethnic identity scores were related to alcohol-related problems. Using one of the largest samples collected to date on sociocultural determinants and drinking among U.S.-born Asian American young adults, the findings highlight the significant variability in drinking patterns among Asian American ethnic groups.

Examining the relationships between acculturation orientations, perceived and actual norms, and drinking behaviors of short-term american sojourners in foreign environments

As little research has examined factors influencing increased and heavy drinking behavior among American sojourners abroad, this study was designed to examine how acculturation orientations (i.e., separation versus assimilation), host country per capita drinking rates, and perceptions about the drinking behavior among other sojourners and natives in the host country predicted alcohol risk abroad. A sample of 216 American college students completing study abroad programs completed a pre-abroad questionnaire to document their pre-abroad drinking levels, followed by a post-return questionnaire to assess drinking while abroad, acculturation orientations and perceived norms of drinking behavior within the foreign environment. A dichotomous variable was created to compare United States (U.S.) per capita drinking rates with those of the host country. Hierarchical repeated-measures ANOVAs examined the changes in drinking from pre-abroad to abroad levels. Participants studying in countries with higher drinking rates than the U.S. and those with higher perceptions about the drinking behavior in the country increased their drinking to a greater extent. Those with higher separation acculturation orientations and greater perceptions drank at heavier levels while abroad. Participants with a greater assimilation orientation and higher perceptions about native drinking, as well as those with a greater separation orientation and higher perceptions about other students' alcohol use drank the heaviest while abroad. These findings have implications for future preventive work with American students and other sojourning groups to promote pre-abroad knowledge of more accurate drinking norms and greater engagement in the culture to potentially prevent increased and heavier drinking.

Ethnic drinking cultures and alcohol use among Asian American adults: findings from a national survey

AIMS

To investigate the influence of ethnic drinking cultures on alcohol use by Asian Americans and how this influence may be moderated by their level of integration into Asian ethnic cultures.

METHODS

A nationally representative sample of 952 Asian American adults extracted from the Wave 2 National Epidemiologic Survey of Alcohol and Related Conditions data was used. Multiple logistic and linear regression models were fitted, some of which were stratified by nativity.

RESULTS

Controlling for financial stress, discrimination and demographic variables, a hypothesized, positive relationship between ethnic drinking cultures and alcohol outcomes held for most drinking outcomes. A hypothesis on the moderating effect of integration into ethnic cultures indicated by ethnic language use was supported for US-born Asian Americans.

CONCLUSION

Ethnic drinking cultures may significantly influence alcohol use by Asian Americans. The influence of ethnic drinking cultures may be conditioned by the degree of integration into the ethnic cultures. To inform alcohol interventions for reducing harmful and hazardous alcohol use among immigrants, future research needs to explore the cultural and social processes occurring in immigrant communities that might significantly influence drinking.

Differences in the drinking behaviors of Chinese, Filipino, Korean, and Vietnamese college students

OBJECTIVE

This study examined alcohol drinking behaviors across ethnic subgroups of Asian college students by gender, foreign-born status, and college-related living arrangements.

METHOD

Univariate and ordinal logistic regression analyses were employed to explore male and female Asian subgroup differences in alcohol drinking behaviors. The sample included 753 male and female undergraduates between the ages of 18 and 27 years who self-identified as Chinese, Filipino, Korean, or Vietnamese and who varied in their foreign-born status. Participants completed a self-administered questionnaire on their alcohol drinking practices.

RESULTS

Ordinal regression analysis assessed risks for increased consumption and found that Korean and Filipino students reported higher levels of alcohol consumption compared with other Asian subgroups. Students living in on-campus dormitories and in off-campus apartments reported higher alcohol consumption than did those living at home. Being born in the United States was a significant predictor of higher levels of alcohol consumption for women but not for men.

CONCLUSIONS

Results of this study indicate the need for campus alcohol education and prevention programs capable of responding to specific Asian subgroup needs.