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CORK Bibliography: Asian Americans

46 citations. January 2009 to present

Prepared: September 2011

Antin TMJ; Moore RS; Lee JP; Satterlund TD. Law in practice: Obstacles to a smokefree workplace policy in bars serving Asian patrons. Journal of Immigrant and Minority Health 12(2): 221-227, 2010. (32 refs.)

The California smokefree workplace ordinance (AB13) has been well-received, even in bars where deeply established traditions of smoking may exist. However, a closer investigation of bars where indoor smoking persists revealed that bar workers in some ethnic minority communities continue to be exposed to secondhand smoke in their workplaces. To identify sociocultural factors that may impede the adoption of AB13, the researchers conducted 150 observations and 29 patron and staff interviews in 50 California bars serving Asian patrons in Los Angeles and San Francisco counties. Observers witnessed indoor smoking in 82% of the bars. Interviews revealed that social relationships, social interactions, and a tendency to avoid confrontation complicated the positive reception of AB13 within these bars. Accounting for sociocultural factors provides a nuanced understanding of the challenges involved in implementing tobacco control policy in such diverse settings and may allow for culturally appropriate tobacco policy development and implementation in other jurisdictions.

Ayers JW; Chambers CD; Hofstetter CR; Hughes SC; Reyes WD; Kang SW et al. Cultural and social network predictors of drinking among Korean American women. Alcohol 45(1): 89-97, 2011. (42 refs.)

This study estimated the association of cultural and social mechanisms with Korean American women's drinking behaviors. Data were drawn from telephone interviews with 591 Korean women selected from a random sample of households in California with Korean surnames during 2007. About 62% of eligible respondents completed the interview. Respondents reported any lifetime drinking (yes/no), drinking volume (typical number of drinks consumed on drinking days), level of acculturation, and described their social network by assessing who encouraged or discouraged drinking (drinking support) or drank (drinking models). Multivariable regressions were used for analyses. About 70% (95% confidence interval [95%CI], 67, 74) of Korean American women reported any lifetime drinking and current drinkers drank 1.18 (95%CI: 1.07, 1.28) drinks on drinking days. Acculturation was not significantly associated with any lifetime drinking or drinking volume, whereas models and support for drinking were statistically significantly associated with a higher probability of any lifetime drinking and drinking more on drinking days. Each additional encourager, or one or fewer discourager, for drinking in women's social networks was associated with a 2% (95%CI: 1, 3) higher probability of any lifetime drinking and drinking 0.25 (95%CI: -0.53, 1.18) more drinks on drinking days. Each additional drinker in women's networks was associated with a 4% (95%CI: 1, 8) higher probability of any lifetime drinking and drinking 0.26 (95%CI: -0.05, 0.60) more drinks on drinking days. Korean American women's drinking appears to be strongly related to their social networks, although how women take on traits of their new environment was not.

Barnes PM; Adams PF; Powell-Griner E. QuickStats: Percentage of Adults Aged �18 Years Who Were Current Cigarette Smokers, by Race/Ethnicity --- National Health Interview Survey, United States, 2004--2008. MMWR. Morbidity and Mortality Weekly Review 59(11): 340, 2010. (1 refs.)

During 2004--2008, 20.5% of adults aged �18 years were current cigarette smokers. American Indian /Alaska Native adults (32.7%) were most likely to currently smoke cigarettes, and Asian adults (10.4%) were least likely to be current smokers.

Public Domain

Barry DT; Steinberg MA; Wu R; Potenza MN. Differences in characteristics of Asian American and white problem gamblers calling a gambling helpline. CNS Spectrums 14(2): 83-91, 2009. (39 refs.)

Introduction: The characteristics of Asian American and white problem gamblers using a gambling helpline were examined to identify race-related differences. Methods: Logistic regression analyses were conducted on data obtained from callers to a gambling helpline serving southern New England in 2000-2003, inclusive. Results: Of the 144 phone calls used in the analyses, 72 were from Asian American callers and 72 were from white callers who were matched on gender, education, income, marital/cohabitation status, and age. Race-related differences were observed in forms of gambling problems, psychiatric problems secondary to gambling, substance use problems, and family history. Asian American gamblers were more likely to report suicide attempts related to gambling and problems with non-strategic gambling. White gamblers were more likely to report both casino and non-casino gambling problems and personal and familial alcohol use problems. High proportions of both groups reported problems with strategic gambling, gambling-related anxiety, family and financial problems secondary to gambling, financial debt, daily tobacco use, and a family history of problem gambling. Conclusion: Race-related differences should be considered in optimizing prevention and treatment strategies related to problem gambling.

Battle RS; Lee JP; Antin TMJ. Knowledge of tobacco control policies among US Southeast Asians. Journal of Immigrant and Minority Health 12(2): 215-220, 2010. (33 refs.)

Some of the highest smoking rates in the U. S. have been reported among Southeast Asians. The largest numbers of Southeast Asians reside in California. While California has a comprehensive and generally effective tobacco control program, it is unclear how immigrant groups learn of this public health effort. In a study of tobacco norms and practices among two generations of Southeast Asians we collected qualitative data on respondents' knowledge and awareness of tobacco control policies. Data were collected through in-person interviews with 164 respondents aged 15-87, evenly divided by smoking status, gender and generation in the U.S. Due to multiple sources of knowledge, general awareness of tobacco control policies and of secondhand smoke were high among both generations of Southeast Asians and the policies were attributed with changes in smoking behavior. Tobacco control regulations may be an effective means to impact tobacco use among immigrants with limited English proficiency.

Brown LM; Gridley G; Wu AH; Falk RT; Hauptmann M; Kolonel LN et al. Low level alcohol intake, cigarette smoking and risk of breast cancer in Asian-American women. Breast Cancer Research and Treatment 120(1): 203-210, 2010. (40 refs.)

Studies have shown that breast cancer incidence rates among Asian migrants to the United States approach US incidence rates over several generations, implicating potentially modifiable exposures such as moderate alcohol use that has been linked to excess breast cancer risk in other populations. The goal of this study was to investigate the effect of alcohol intake, primarily low levels, on breast cancer risk in Asian-American women and explore whether smoking and alcohol contributed to the breast cancer incidence rates observed among Asian migrants to the United States. Study subjects in this population-based case-control study included 597 incident cases of breast cancer of Chinese, Japanese, and Filipino ethnicity living in San Francisco-Oakland, Los Angeles, and Oahu, Hawaii, and 966 population controls frequency matched on age, ethnicity, and area of residence. The fraction of smokers and drinkers was significantly higher in women born in Western compared with Eastern countries. However, breast cancer risk was not significantly associated with smoking (odds ratio (OR) = 1.2, 95% confidence interval (95% CI) = 0.9-1.6) or alcohol drinking (OR = 0.9, 95% CI = 0.7-1.1) in this population of low consumers of alcohol (median intake among drinkers in grams per day was 0.48 for cases and 0.40 for controls). These data suggest that low alcohol intake is not related to increased breast cancer risk in Asian-American women and that neither alcohol nor cigarette use contributed to the elevated risks in Asian-American women associated with migration patterns and Westernization.

de Castro AB; Garcia G; Gee GC; Tsai JHC; Rue T; Takeuchi DT. Smoking and the Asian American workforce in the National Latino and Asian American Study. American Journal of Industrial Medicine 53(2, Special Issue): 171-178, 2010. (46 refs.)

Background: Smoking among the Asian American workforce has not been extensively researched. This study examines smoking prevalence among a nationally representative sample of Asian Americans with an emphasis on occupational classification. Methods: Cross-sectional data come form the National Latino and Asian American Study. Multivariate logistic regression analyses were used to determine smoking prevalence by occupation, gender and nativity, among 1,528 participants self identifying as in the labor force. Results Blue collar workers reported the highest smoking prevalence (32%)followed by unemployed (19%), other (17%), service (14%), and white collar (10%). Among both employed males and females, blue collar workers had the highest prevalence (45% and 18%, respectively). By nativity smoking was highest among blue collar workers for immigrants (25%) and highest among the unemployed for U.S. born (16%). Blue collar employment was significantly, associated with being a current smoker (OR = 2.52; 95% CI: 1.23-5.16: P < 0.05) controlling for demographics (e.g., age, gender, ethnic group, nativity, etc.). Conclusions: Findings reveal that smoking differs by occupation among Asian Americans. Future research should examine factors explaining differences while considering gender and nativity.

Fang L; Schinke SP; Cole KCA. Preventing substance use among early Asian-American adolescent girls: Initial evaluation of a web-based, mother-daughter program. Journal of Adolescent Health 47(5): 529-532, 2010. (10 refs.)

Purpose: This study examined the efficacy and generalizability of a family-oriented, web-based substance use prevention program to young Asian-American adolescent girls. Methods: Between September and December 2007, a total of 108 Asian-American girls aged 10-14 years and their mothers were recruited through online advertisements and from community service agencies. Mother-daughter dyads were randomly assigned to an intervention arm or to a test-only control arm. After pretest measurement, intervention-arm dyads completed a 9-session web-based substance use prevention program. Guided by family interaction theory, the program aimed to improve girls' psychological states, strengthen substance use prevention skills, increase mother-daughter interactions, enhance maternal monitoring, and prevent girls' substance use. Study outcomes were assessed using generalized estimating equations. Results: At posttest, relative to control-arm girls, intervention-arm girls showed less depressed mood; reported improved self-efficacy and refusal skills; had higher levels of mother-daughter closeness, mother-daughter communication, and maternal monitoring; and reported more family rules against substance use. Intervention-arm girls also reported fewer instances of alcohol, marijuana, and illicit prescription drug use, and expressed lower intentions to use substances in the future. Conclusions: A family-oriented, web-based substance use prevention program was efficacious in preventing substance use behavior among early Asian-American adolescent girls.

Fazio A; Joe-Laidler K; Moloney M; Hunt G. Gender, sexuality, and ethnicity as factors of club-drug use among Asian Americans. Journal of Drug Issues 40(2): 405-432, 2010. (83 refs.)

This article examines the relationship between substance use and gender, sexuality, ethnicity, and nativity among 250 Asian American youths involved in the dance club/rave scene. We find distinct patterns of drug use differing by country of origin and ethnicity. However, contrary to some literature we do not find significant differences corresponding to immigration status, or number of years in the U.S. The most significant differences between subgroups are related to gender and sexuality: male respondents consume more drugs, more frequently than female respondents, and non-heterosexual respondents consume more than heterosexual respondents, with differing patterns for men's' and women's sexual subgroups. There were also significant gender and sexuality differences with respect to the contexts in which respondents consume drugs, with the most significant differences being between heterosexual and non-heterosexual men. As we discuss, these findings illustrate the need for further investigation of drug-use patterns of gender and sexuality within Asian American communities.

Frojd S; Ranta K; Kaltiala-Heino R; Marttunen M. Associations of social phobia and general anxiety with alcohol and drug use in a community sample of adolescents. Alcohol and Alcoholism 46(2): 192-199, 2011. (55 refs.)

Aims: This study explores whether associations between anxiety and alcohol and other substance use are already evident in middle adolescence, and whether general anxiety or symptoms of social phobia affect continuity of frequent alcohol use, frequent drunkenness and cannabis use. Methods: Data from the Adolescent Mental Health Cohort Study, a school-based Finnish survey among adolescents aged 15-16 years at baseline, was utilized to assess prevalence, incidence and continuity of symptoms of social phobia, general anxiety, frequent alcohol use, frequent drunkenness and cannabis use (which in this context was smoked 'hashish' of unknown constituency), and the associations between the substance use variables and the anxiety variables in 2-year follow-up. Results: Anxiety preceded substance use while no reciprocal associations were observed. Depression mediated the associations between anxiety and substance use. Symptoms of social phobia did not elevate the incidence of substance use, but general anxiety did. Frequent drunkenness was less significantly associated with anxiety than the other two substance use variables. Co-morbid general anxiety increased the persistence of frequent alcohol use while co-morbid social phobia decreased its persistence. Continuity of frequent drunkenness and cannabis use were unaffected by co-morbid anxiety. Conclusions: General anxiety in middle adolescence places adolescents at risk for concurrent and subsequent substance use. The risk may, however, be associated with co-morbid depression. Social phobia in middle adolescence may protect from substance use. Adolescents with internalizing symptoms may need guidance in coping with the symptoms even if the symptoms do not fulfil the criteria of mood or anxiety disorder.

Goebert D; Nishimura S. Comparison of substance abuse treatment utilization and preferences among Native Hawaiians, Asian Americans and Euro Americans. Journal of Substance Use 16(2): 161-170, 2011. (49 refs.)

Use and preferences for substance abuse treatment can vary by ethnicity. However, little is known about use and preferences among Native Hawaiians and Asian Americans. Interviews from 192 admitted multi-ethnic residents from two treatment facilities in Hawaii were conducted. More similarities than differences were found. The most utilized treatments were Alcoholics Anonymous and the emergency department, with no significant ethnic differences. However, Native Hawaiians and Asian Americans were significantly less likely to have spoken to a mental health provider about alcohol problems (32%%, 39%%, respectively vs. 69%% of Euro Americans) and to have seen a physician for a drinking-related problem (21%% of Native Hawaiians and 19%% of Asian Americans vs. 41%% of Euro Americans). Native Hawaiians were significantly more likely to consider marriage counselling to be an effective form of treatment (33%% vs. 11%% of Asian Americans and 9%% of Euro Americans). Implications for substance abuse treatment are discussed. The findings suggest that it is important to integrate the field of substance abuse in multiple systems; including substance abuse, medical, criminal, social service and community settings to ensure treatment preferences are met. Ethnic differences may also have implications for expanding and tailoring services.

Happell B; Platania-Phung C; Gruenert S. Rates of alcohol usage among Vietnamese Australian communities: A literature review. (review). Journal of Substance Use 15(4): 246-256, 2010. (33 refs.)

Census data indicates a steady increase in the number of Vietnamese people migrating to Australia. Despite this there is a paucity of research examining alcohol usage within this community. A review of the literature was undertaken to examine the prevalence of alcohol use, related harms, and health service use. Vietnamese Australians were found to consume alcohol at a rate lower than that of Australians in general. However, the relevant research may not be generalizable, alcohol usage and associated harms may be under-reported, and prevalence rates contradicted the breadth and frequency of harms reported. These issues are discussed.

Hendershot CS; Neighbors C; George WH; McCarthy DM; Wall TL; Liang TB et al. ALDH2, ADH1B and alcohol expectancies: Integrating genetic and learning perspectives. Psychology of Addictive Behaviors 23(3): 452-463, 2009. (82 refs.)

The present study evaluated associations of ALDH2 and ADH1B genotypes with alcohol expectancies and drinking behavior in a sample of Asian American young adults. In addition to assessing global alcohol expectancies, the authors developed a measure of physiological expectancies to evaluate an expectancy phenotype specific to the mechanism by which ALDH2 and ADH1B variations presumably influence drinking behavior. Compared with individuals with the ALDH2*1/*1 genotype, those with the ALDH2*2 allele reported greater negative alcohol expectancies, greater expectancies for physiological effects of alcohol and lower rates of alcohol use. ADH1B was not associated with alcohol expectancies or drinking behavior. Hierarchical models showed that demographic factors, ALDH2 genotype, and expectancy variables explained unique variance in drinking outcomes. Mediation tests showed significant indirect effects of ALDH2 on drinking frequency and peak lifetime consumption through expectancies. These results provide support for influences of genetic factors and alcohol sensitivity on alcohol-related learning and suggest the importance of developing biopsychosocial models of drinking behavior in Asian Americans.

Hofstetter CR; Ayers JW; Irvin VL; Sim DEK; Hughes SC; Reighard F et al. Does church participation facilitate tobacco control? A report on Korean immigrants. Journal of Immigrant and Minority Health 12(2): 187-197, 2010. (76 refs.)

Background: This study explores hypotheses linking church attendance to smoking prevalence, cessation, exposure to environmental tobacco smoke (ETS), and household smoking bans among Korean immigrants in California. Methods: Data were drawn from telephone interviews with Korean adults (N = 2085) based on a probability sample during 2005-2006 in which 86% of those contacted completed interviews. Results: Koreans who reported that they had attended church were less likely to be current smokers and to be exposed to ETS, and more likely to have quit smoking and to have a complete smoking ban than non-attenders after statistical controls for behavioral covariates. Discussion: Whether or not participants reported attending church was associated with increased tobacco control practices. Public health interventions may profit by seeking to expand cooperation with religious congregations to facilitate efforts to promote healthy lifestyles among immigrant populations beyond the influences of church attendance.

Hu SHS; Pallonen UE; Meshack AF. The impact of immigration status on tobacco use among Chinese-American adults in Texas. Journal of Immigrant and Minority Health 12(2): 206-214, 2010. (42 refs.)

Objectives: This study analyzed the impact of immigration status on current tobacco use among adult Chinese-Americans living in Texas. Methods A survey was administered in Chinese and English in 2004 to assess tobacco use among Chinese-American adults using a stratified probability sample from two large metropolitan areas in Texas. Data were adjusted for unequal probability of selection and weighted to provide state-wide estimates for Chinese-Americans in Texas. Results The study sample was comprised of 1,054 Chinese-American adults. The overall current smoking rate was 11.1% with men's rates much higher (16.1%) than women's (6.7%). Lower household income and education increased smoking among males but more educated females had a tendency to smoke more. Although overall smoking rate among Chinese-Americans was significantly lower than the general Texas population (20.6%), smoking rate among recent immigrant men (<5 years in the U.S.) was alarmingly higher (28.0%). U.S.-born Chinese-American men's smoking rate (25.0%) is similar to that of their U.S.-born counterparts (23.7%). U.S.-born Chinese-American men initiated smoking 4 years earlier (13.8 years) than their immigrant counterparts. Conclusions: Although Chinese-Americans in Texas had overall lower smoking rates than the general population, the high smoking rates among recently immigrated men emphasize the need for cessation activities targeting this group.

Hughes SC; Corcos IA; Hofstetter CR; Hovell MF; Irvin VL. Longitudinal study of household smoking ban adoption among Korean Americans. American Journal of Preventive Medicine 37(5): 437-440, 2009. (23 refs.)

Background: Few longitudinal studies have examined the adoption of bans on smoking in private homes. Purpose: This longitudinal Study examined: (1) the prevalence of home smoking bans at baseline, (2) the incidence and predictors of new ban implementation by follow-up, and (3) the reasons for banning smoking and the difficulties with enforcement. Methods: The sample consisted of 1360 adults of Korean descent residing in California who were interviewed by telephone (in English/Korean) at baseline during 2001-2002 and re-interviewed in 2006-2007. Data analyses were conducted in 2007-2008. Results: The proportion of respondents with a complete household smoking ban grew from 59% at baseline to 91% by the follow-up interview. Among the 552 respondents who did not have a ban at baseline, 84% had adopted a ban by follow-up. Three baseline factors independently predicted ban adoption during the follow-up period: the presence of a nonsmoking respondent or spouse, the presence of nonsmoking family members, and respondent's belief that secondhand smoke caused lung cancer. The most highly rated reasons for banning smoking were as follows: because smoke annoys others, to protect family members, to avoid the odor, to discourage youth from smoking, and to encourage smokers to quit. Finally, respondents indicated that they would find it most difficult to ask their parent-in-law not to smoke. Conclusions: The proportion of households with smoking bans increased substantially, but households with smokers or family members who smoke remained less likely to implement bans. The importance of culturally sensitive programs to promote household bans cannot be overstated.

Iwamoto DK; Corbin W; Fromme K. Trajectory classes of heavy episodic drinking among Asian American college students. Addiction 105(11): 1912-1920, 2010. (57 refs.)

Aims: Heavy episodic drinking (HED) among Asian Americans is a growing concern. However, little is known about the etiology and developmental patterns of HED among Asian Americans, even though this group is one of the fastest-growing populations in the United States. Design Three year longitudinal design. Participants: Sample included 404 Asian American college students transitioning from high school, through the college years. Measurement Measures included heavy episodic drinking, parental and peer relationships, alcohol expectancies, drinking values, and alcohol-related problems. Findings: Results from growth-mixture models (GMM) identified two discrete latent classes of HED comprising 59% of our sample: these trajectory classes (high increasers and low increasers) corresponded to expected changes and stability in well-established correlates of drinking behaviour, including alcohol-related problems, personal drinking values and alcohol expectancies. Parental awareness and caring and quality of peer relationships during senior year of high school were associated directly and indirectly with HED class membership. Conclusion: These findings advance the literature by providing information about the developmental course of HED among Asian American young adults. The significant within-group variability in problematic drinking in this sample highlights the fact that subgroups of high-risk drinkers can be identified even in relatively low-risk groups such as Asian Americans.

Kandula NR; Wen M; Jacobs EA; Lauderdale DS. Association between neighborhood context and smoking prevalence among Asian Americans. American Journal of Public Health 99(5): 885-892, 2009. (62 refs.)

Objectives. To study neighborhood-level determinants of smoking among Asian Americans, we examined 3 neighborhood factors (ethnic enclave, socioeconomics, and perceived social cohesion) and smoking prevalence in a population-based sample. Methods. We linked data from the 2003 California Health Interview Survey to tract-level data from the 2000 Census. We used multivariate logistic regression models to estimate the associations between smoking and neighborhood-level factors, independent of individual factors. Results. Twenty-two percent of 1693 Asian men and 6% of 2174 Asian women reported current smoking. Women living in an Asian enclave were less likely to smoke (adjusted odds ratio [AOR]=0.27; 95% confidence interval [CI]=0.08, 0.88). Among men, higher levels of perceived neighborhood social cohesion were associated with lower odds of smoking (AOR=0.74; 95% CI=0.61, 0.91). Conclusions. The association between contextual factors and smoking differed for men and women. For women, living in an Asian enclave may represent cultural behavioral norms. For men, neighborhood trust and cohesiveness may buffer stress. Smoking prevention and cessation interventions among Asian Americans may be more effective if they address contextual factors.

Kim W; Kim I; Nochajski TH. Risk and protective factors of alcohol use disorders among Filipino Americans: Location of residence matters. American Journal of Drug and Alcohol Abuse 36(4): 214-219, 2010. (33 refs.)

Background: Despite the growing number of Asian Americans (AA) in the United States, research on alcohol abuse in this population is sparse. Although AA have few alcohol use disorders (AUD) as an aggregate group, within-group variations in AUD need to be explored among specific ethnic groups in this population. Objectives: This study compared correlates of 12-month prevalence of AUD between Filipino Americans who currently drink alcohol and live in San Francisco (SF) or Honolulu. Methods: Data from the 1998-1999 Filipino American Community Epidemiological Survey (N = 537) were used to test two hypotheses: 1) current drinkers in SF and Honolulu will differ in the characteristics and prevalence of AUD and 2) current drinkers in SF and Honolulu do not share the same protective and risk factors of AUD. Results: Current drinkers from the two regions substantially differed in age, years of education, age at first drink, religiosity, ethnic identity, psychological distress, the nativity status, as well as the prevalence of AUD. Logistic regression models revealed that AUD risk factors were different for SF current drinkers (higher psychological distress, U. S.-born, and lower religiosity) compared to Honolulu drinkers (more years of education and lower emotional support). Conclusion: Filipino American drinkers living in SF and Honolulu have different risk and protective factors for AUD. Health professionals need to be aware of this difference when screening for factors associated with AUD among Filipino Americans. Scientific Significance: The current study revealed the importance of socioenvironmental context (location of residence) in predicting AUD among an Asian ethnic group.

Lee JP; Battle RS; Lipton R; Soller B. 'Smoking': Use of cigarettes, cigars and blunts among Southeast Asian American youth and young adults. Health Education Research 25(1): 83-96, 2010. (61 refs.)

Increased use of cigars has been noted among youth, as well as use of blunts (hollowed-out cigars filled with marijuana). Three types of relationships have been previously hypothesized between use of tobacco and marijuana in substance use progression. We aimed to assess these relationships for Southeast Asian American youth and adults in an urban population. We conducted in-person interviews with 164 Southeast Asians, smokers and non-smokers, in two low-income urban communities in Northern California, collecting both quantitative and qualitative data. Analysis of the quantitative data indicated distinct use patterns for blunts, cigars and other forms of marijuana in terms of associations with generation in the United States. The use of these items was also found to be related: ever having smoked cigarettes or blunts increased the risk of ever having smoked the other three items. Qualitative data found indications of all three hypothesized relationships between tobacco and marijuana for youths but not for older adults. For youths in the study, 'smoking' was found to constitute a social construct within which use of cigarettes, cigars and blunts were somewhat interchangeable. Youths in similar settings may initiate into and progress through smoking as an activity domain rather than any one of these items.

Liao YL; Tsoh JY; Chen R; Foo MA; Garvin CC; Grigg-Saito D et al. Decreases in smoking prevalence in Asian communities served by the Racial and Ethnic Approaches to Community Health (REACH) Project. American Journal of Public Health 100(5): 853-860, 2010. (26 refs.)

Objectives. We examined trends in smoking prevalence from 2002 through 2006 in 4 Asian communities served by the Racial and Ethnic Approaches to Community Health (REACH) intervention. Methods. Annual survey data from 2002 through 2006 were gathered in 4 REACH Asian communities. Trends in the age-standardized prevalence of current smoking for men in 2 Vietnamese communities, 1 Cambodian community, and 1 Asian American/Pacific Islander (API) community were examined and compared with nationwide US and state-specific data from the Behavioral Risk Factor Surveillance System. Results. Prevalence of current smoking decreased dramatically among men in REACH communities. The reduction rate was significantly greater than that observed in the general US or API male population, and it was greater than reduction rates observed in the states in which REACH communities were located. There was little change in the quit ratio of men at the state and national levels, but there was a significant increase in quit ratios in the REACH communities, indicating increases in the proportions of smokers who had quit smoking. Conclusions. Smoking prevalence decreased in Asian communities served by the REACH project, and these decreases were larger than nationwide decreases in smoking prevalence observed for the same period. However, disparities in smoking prevalence remain a concern among Cambodian men and non English-speaking Vietnamese men; these subgroups continue to smoke at a higher rate than do men nationwide.

Luczak SE; Pandika D; Shea SH; Eng MY; Liang TB; Wall TL. ALDH2 and ADH1B interactions in retrospective reports of low-dose reactions and initial sensitivity to alcohol in Asian American college students. Alcoholism: Clinical and Experimental Research 35(7): 1238-1245, 2011. (52 refs.)

Background: A mechanistic model has been proposed for how alcohol-metabolizing gene variants protect individuals from the development of alcohol use disorders, with heightened sensitivity to alcohol being an early step (endophenotype) in this model. This study was designed to determine whether possession of 2 alcohol-metabolizing genes variations, the aldehyde dehydrogenase ALDH2*2 allele and the alcohol dehydrogenase ADH1B*2 allele, was associated with self-reported sensitivity to alcohol at low doses and at initial use. Methods: Asian-American college students (N = 784) of Chinese and Korean descent were genotyped at the ALDH2 and ADH1B loci and assessed for lifetime alcohol symptoms following 1 or 2 drinks and level of response to alcohol during the first 5 lifetime drinking episodes. Results: Participants who had an ALDH2*2 allele were more likely to report experiencing all 6 low-dose symptoms and having heightened initial response to alcohol. An interaction was found between ALDH2*2 and ADH1B*2, with ADH1B*2 being associated with heightened self-reported sensitivity to alcohol only in individuals who also possessed 1 ALDH2*2 allele. Conclusions: These findings suggest the effects of ADH1B*2 may be felt more strongly in Asians who already have some heightened sensitivity to alcohol from possessing 1 ALDH2*2 allele, but who are not too sensitized to alcohol from possessing 2 ALDH2*2 alleles. These results offer additional insight into the discrepant findings that have been reported in the literature for the role of ADH1B*2 in response to alcohol and the development of alcohol-related problems.

Luk JW; Tsoh JY. Moderation of gender on smoking and depression in Chinese Americans. Addictive Behaviors 35(11): 1040-1043, 2010. (24 refs.)

This study examined the moderating role of gender in the association between smoking status and depression in a nationwide convenience sample of Chinese American current, former, and never smokers (N = 1393). Participants were recruited in smoker-supporter dyads. Multilevel modeling was used to take into account the dyadic nature of the data. Depressive symptoms were measured by a 10-item CES-D (Center of Epidemiologic Studies-Depression Scale). Results showed significant effects of smoking status by gender interaction and smoking status on depression after adjusting for acculturation and social support. Among Chinese females, current smokers reported elevated depression level than both former and never smokers. Among Chinese males, current smokers reported more depressive symptoms when compared to former smokers only. Chinese females reported higher depression level than males among current smokers: no gender difference in depression was observed among former or never smokers. The association between smoking and depression is moderated by gender among Chinese Americans where substantial gender difference in smoking prevalence exists. Findings highlight the importance of addressing depression in treating tobacco use among Chinese American smokers, especially among females.

Lum C; Corliss HL; Mays VM; Cochran SD; Lui CK. Differences in the drinking behaviors of Chinese, Filipino, Korean, and Vietnamese college students. Journal of Studies on Alcohol and Drugs 70(4): 568-574, 2009. (41 refs.)

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.

Marshall GN; Elliott MN; Schell TL. Prevalence and correlates of lifetime disordered gambling in Cambodian refugees residing in Long Beach, CA. Journal of Immigrant and Minority Health 11(1): 35-40, 2009. (19 refs.)

Background Research has suggested that disordered gambling is endemic to Cambodian refugees. Whereas earlier study of the prevalence and correlates of disordered gambling has relied on convenience sampling, this investigation used a subset of a sample representative of the largest Cambodian refugee community in the US. Methods Face-to-face interviews assessing gambling disorder were conducted with a subsample of persons (N = 127) participating in a broader study of the mental health of this community. Results 13.9% of participants met screening criteria for lifetime disordered gambling, in contrast to previous research suggesting that prevalence rates may exceed 70%. After adjusting for a range of covariates, breadth of trauma exposure and marital status emerged as significant predictors of disordered gambling. Discussion Given the myriad mental health challenges facing the Cambodian refugee community, these data indicate that scarce prevention and treatment resources may be more productively channeled toward addressing other mental health and social service needs.

Myers MG; Doran NM; Trinidad DR; Klonoff EA; Wall TL. A prospective study of cigarette smoking initiation during college: Chinese and Korean American students. Health Psychology 28(4): 448-456, 2009. (59 refs.)

Objective: The present study was a prospective investigation of baseline influences on initial smoking and transition to established smoking among college students who had not smoked prior to college. Design: Included were 267 participants in a longitudinal study of tobacco use. Students of Chinese (52%) or Korean (48%) descent were enrolled during their freshman year in college. Data for the present study were collected during four annual in-person interviews. Main outcome measures: (1) Initial use of a cigarette reflected having first smoked a cigarette (more than a puff) during college. (2) Established smoking was defined as having smoked at least 100 cigarettes. Results: Over the course of the study, 25% of baseline never-smokers tried their first cigarette, and 9% became established smokers. Overall, men were significantly more likely to experiment and progress to established smoking. Baseline alcohol and drug use, behavioral undercontrol, and parental smoking predicted smoking experimentation but not established smoking. Students of Korean ethnicity were more likely to become established smokers. However, acculturation was not a significant predictor of experimentation or established smoking after accounting for the effects of other predictors. Conclusion: These findings suggest a need for efforts to prevent smoking uptake among Asian American college students.

Myung SK; McDonnell DD; Kazinets G; Seo HG; Moskowitz JM. Relationships between household smoking restrictions and intention to quit smoking among Korean American male smokers in California. Journal of Korean Medical Science 25(2): 245-250, 2010. (26 refs.)

This cross-sectional study examined the relationships between household smoking restrictions and intentions to quit smoking among Korean American male smokers in California. We used data from the California Korean American Tobacco Use Survey (CKATUS), which was conducted in 2004 using computer-assisted telephone interviewing. Among the 2,545 respondents who participated in the CKATUS, the 387 male smokers who answered a question assessing their intention to quit smoking were included in the final analyses. In univariable analyses, smokers who reported having household smoking restrictions were more likely to intend to quit smoking as compared with those who did not (P<0.01). Other independent correlates of having an intention to quit smoking were being less than 50 yr of age, having spent more than 50% of one's life in the US, being assimilated, and having other smokers in the household. In a multiple logistic regression analysis, the significant correlates of having an intention to quit smoking were household smoking restrictions (complete or partial restriction vs. no restriction on smoking; odds ratio, 2.54; 95% confidence interval, 1.22-5.28) and absence of other smokers in the household. In conclusion, smoking restrictions in the household are associated with an intention to quit smoking among Korean American male smokers in California.

Nguyen HV; Kaysen D; Dillworth TM; Brajcich M; Larimer ME. Incapacitated rape and alcohol use in White and Asian American college women. Violence Against Women 16(8): 919-933, 2010. (69 refs.)

This study examined the role of Asian ethnicity as a moderator of drinking outcomes associated with alcohol-related sexual assault (incapacitated rape). Participants were 5,467 Asian American and White college women. Results found the overall MANOVA for ethnicity and incapacitated rape (IR) interactions to be significant. Asian American participants with no history of IR had fewer drinking problems than White American participants with no history of IR. Asian American participants with IR histories had more drinking problems than White Americans with IR histories. Findings indicate Asian Americans who experience IR may be at increased risk for negative alcohol outcomes.

Page RM; Huong NT; Chi HK; Tien TQ. Smoking media literacy in Vietnamese adolescents. Journal of School Health 81(1): 34-41, 2011. (26 refs.)

METHODS: A cross-sectional survey of 2000 high school students completed the SML scale, which is based on an integrated theoretical framework of media literacy, and items assessing cigarette use. Ordinal logistic regression was used to determine the association of SML with smoking and susceptibility to future smoking. Ordinal logistic regression was also to determine whether smoking in the past 30 days was associated with the 8 domains/core concepts of media literacy which comprise the SML. RESULTS: Smoking media literacy was lower among the Vietnamese adolescents than what has been previously reported in American adolescents. Ordinal logistic regression analysis results showed that in the total sample SML was associated with reduced smoking, but there was no association with susceptibility to future smoking. Further analysis showed that results differed according to school and grade level. There did not appear to be association of smoking with the specific domains/concepts that comprise the SML. CONCLUSIONS: The association of SML with reduced smoking suggests the need for further research involving SML, including the testing of media literacy training interventions, in Vietnamese adolescents and also other populations of adolescents.

Rosario-Sim MG; O'Connell KA. Depression and language acculturation correlate with smoking among older Asian American adolescents in New York City. Public Health Nursing 26(6): 532-542, 2009. (45 refs.)

Objective: To explore the correlates of smoking status among a sample of Asian American adolescents in New York City (NYC). Design and Sample: This descriptive, correlational study compared current smokers and current nonsmokers in terms of age, gender, ethnicity, academic performance, acculturation, depressive symptoms, smoking history, and parental, sibling, and peer smoking. The convenience sample included 328 Asian American adolescents, ages 16-19, who lived in NYC, and were recruited from members, friends, and affiliates of 6 organizational sources. Measures: The study used demographic, depression (Center for Epidemiological Studies Depression scale), English language acculturation, and smoking opportunity survey questionnaires. Results: Statistical analyses revealed that being older, being more English-language acculturated, having poor academic performance, increased depressive symptoms, and having siblings and peers who smoked were significantly associated with current smoking. Conclusions: Asian American adolescents initiate smoking later than other groups. Depressive symptoms were at high levels in the sample and were correlated with smoking. Thus, for Asian American adolescents, smoking prevention programs should be extended to later grades, with particular attention to low-performing students and those who are more acculturated. Likewise, programs that identify and assist adolescents with depressive symptoms may be useful in smoking prevention.

Shelley D; Nguyen N; Peng CH; Chin M; Chang MD; Fahs M. Increasing access to evidence-based smoking cessation treatment: Effectiveness of a free nicotine patch program among Chinese immigrants26. Journal of Immigrant and Minority Health 12(2): 198-205, 2010. (26 refs.)

Pharmacotherapy substantially increases smoking cessation rates. However, programs to reduce barriers to this evidence-based treatment may not improve access among high risk immigrant non English speaking populations. This study estimates the effectiveness of a tailored free nicotine patch (NRT) program among Chinese American smokers living in New York City (NYC). Between July 2004 and May 2005 NRT was distributed to 375 smokers through two community-based organizations that serve the Asian American population in NYC. Participants completed an in person baseline survey and a 4-month follow-up telephone survey. Using an intention to treat analysis the abstinence rate at 4 months was 26.7% (100/375). Predictors of cessation included higher levels of self efficacy at baseline, not smoking while using the patch and concern about personal health risks. Distribution through easy to access, culturally competent local community organizations increased the reach of a free nicotine patch program and assisted smokers in quitting.

Shetgiri R; Kataoka S; Ponce N; Flores G; Chung PJ. Adolescent fighting: Racial/ethnic disparities and the importance of families and schools. Academic Pediatrics 10(5): 323-329, 2010. (35 refs.)

OBJECTIVE: To identify factors associated with fighting among African American, Asian/Pacific Islander, Latino, and white youth, with a focus on family and school connectedness. METHODS: Subjects were 4010 adolescents (12-17 years old) from the 2003 California Health Interview Survey. Stratified logistic regression examined whether fighting in the past year was associated with various risk and protective factors among African American, Asian/Pacific Islander, Latino, and white youth subsamples. RESULTS: Fighting was reported by 27% of African American, 24% of Latino, 16% of white, and 6% of Asian/Pacific Islander youth. Male gender, alcohol use, and smoking were associated with higher odds of fighting among whites and Latinos. Poverty was associated with higher odds of fighting among whites and African Americans, as was depression among Latinos. Higher family support was associated with decreased odds of fighting for white youth. Higher school support was associated with decreased odds of fighting for Latino youth. CONCLUSIONS: A higher proportion of African American and Latino youth report fighting than do whites and Asians/Pacific Islanders. There is, however, important variation in racial/ethnic disparities in risk and protective factors associated with fighting. Family and school factors may be protective against fighting. Prevention and intervention efforts to decrease youth violence might benefit from tailoring to communities' racial/ethnic composition and paying greater attention to family and community influences on adolescent fighting.

Shih RA; Miles JNV; Tucker JS; Zhou AJ; D'Amico EJ. Racial/ethnic differences in adolescent substance use: Mediation by individual, family, and school factors. Journal of Studies on Alcohol and Drugs 71(5): 640-651, 2010. (117 refs.)

Objective: This study examined racial/ethnic differences in alcohol, cigarette, and marijuana use among a diverse sample of approximately 5,500 seventh and eighth graders. We also evaluated the extent to which individual, family, and school factors mediated racial/ethnic disparities in use. Method: Students (49% male) from 16 participating middle schools in southern California reported on lifetime and past-month substance use, individual factors (expectancies and resistance self-efficacy), family factors (familism, parental respect, and adult and older sibling use), and school factors (school-grade use and perceived peer use). We used generalized estimating equations to examine the odds of consumption for each racial/ethnic group adjusting for sex, grade, and family structure. Path analysis models tested mediation of racial/ethnic differences through individual, family, and school factors. Results: After adjusting for sex, grade, and family structure, Hispanics reported higher and Asians reported lower lifetime and past-month substance use, compared with non-Hispanic Caucasians. Rates of substance use did not differ between non-Hispanic African Americans and Caucasians. Several individual factors mediated the relationship between Hispanic ethnicity and substance use, including negative expectancies and resistance self-efficacy. Higher use among Hispanics was generally not explained by family or school factors. By contrast, several factors mediated the relationship between Asian race and lower alcohol use, including individual, family (parental respect, adult and older sibling use), and school (perceived peer use, school-grade use) factors. Conclusions: Results highlight the importance of targeting specific individual, family, and school factors in tailored intervention efforts to reduce substance use among young minority adolescents.

Smith SM; Dawson DA; Goldstein RB; Grant BE. Examining perceived alcoholism stigma effect on racial-ethnic disparities in treatment and quality of life among alcoholics. Journal of Studies on Alcohol and Drugs 71(2): 231-236, 2010. (43 refs.)

Objective: The aim of this study was to examine racial-ethnic differences in perceived stigmatization of former alcoholics and their effect on associations of race-ethnicity with treatment history and psychological function among lifetime alcoholics. Method: Logistic regression analyses were conducted using data from Waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a nationally representative sample of U.S. adults 18 years or older. Results: Stigma scores were lowest for Whites and Native Americans, higher for Blacks, and highest for Asians and Hispanics, both in the total population and among lifetime alcoholics. Neither race-ethnicity nor stigma was associated with treatment utilization. Psychological function was negatively associated with stigma, but the impact of stigma on racial-ethnic differences in psychological function fell short of statistical significance. Conclusions: Stigma may reduce quality of life among those with alcohol dependence, but there is no clear evidence that it affects racial-ethnic differences in quality of life.

Soller B; Lee JP. Drug-intake methods and social identity: The use of marijuana in blunts among southeast asian adolescents and emerging adults. Journal of Adolescent Research 25(6): 783-806, 2010. (61 refs.)

This article examines why Southeast Asian American adolescents and emerging adults in two urban settings prefer to use "blunts," or hollowed-out cigars filled with marijuana, over other methods of drug intake. Rationales for preferring blunts were both instrumental and social. Blunts allowed users to more easily share marijuana, the preferred drug among their peers, and protected against potential adverse effects associated with the "high." Blunts also allowed users to identify with the dominant style of drug use and differentiate themselves from users of stigmatized drugs such as crack cocaine and methamphetamine. This article highlights the importance of drug-intake methods in the formation and performance of drug-using behaviors among adolescents, emerging adults, and members of ethnic minority subgroups.

Stoddard P; Adler NE. Education associations with smoking and leisure-time physical inactivity among Hispanic and Asian young adults. American Journal of Public Health 101(3): 504-511, 2011. (38 refs.)

Objectives. We assessed whether associations between education and 2 health behaviors-smoking and leisure-time physical inactivity (LTPI)-depended on nativity and age at immigration among Hispanic and Asian young adults. Methods. Data came from the 2000-2008 National Health Interview Survey. The sample included 13345 Hispanics and 2528 Asians aged 18 to 30 years. Variables for smoking and LTPI were based on self-reported data. We used logistic regression to examine education differentials in these behaviors by nativity and age at immigration. Results. The association of education with both smoking and LTPI was weaker for foreign-born Hispanics than for US-born Hispanics but did not vary by nativity for Asians. Education associations for smoking and LTPI among foreign-born Hispanics who had immigrated at an early age more closely resembled those of US-born Hispanics than did education associations among foreign-born Hispanics who had immigrated at an older age. A similar pattern for smoking was evident among Asians. Conclusions. Health-promotion efforts aimed at reducing disparities in key health behaviors among Hispanic and Asian young adults should take into account country of residence in childhood and adolescence as well as nativity.

Stommel M; Schoenborn CA. Variations in BMI and prevalence of health risks in diverse racial and ethnic populations. Obesity 18(9): 1821-1826, 2010. (48 refs.)

When examining health risks associated with the BMI, investigators often rely on the customary BMI thresholds of the 1995 World Health Organization report. However, within-interval variations in morbidity and mortality can be substantial, and the thresholds do not necessarily correspond to identifiable risk increases. Comparing the prevalence of hypertension, diabetes, coronary heart disease (CHD), asthma, and arthritis among non-Hispanic whites, blacks, East Asians and Hispanics, we examine differences in the BMI-health-risk relationships for small BMI increments. The analysis is based on 11 years of data of the National Health Interview Survey (NHIS), with a sample size of 337,375 for the combined 1997-2007 Sample Adult. The analysis uses multivariate logistic regression models, employing a nonparametric approach to modeling the BMI-health-risk relationship, while relying on narrowly defined BMI categories. Rising BMI levels are associated with higher levels of chronic disease burdens in four major racial and ethnic groups, even after adjusting for many socio-demographic characteristics and three important health-related behaviors (smoking, physical activity, alcohol consumption). For all population groups, except East Asians, a modestly higher disease risk was noted for persons with a BMI <20 compared with persons with BMI in the range of 20-21. Using five chronic conditions as risk criteria, a categorization of the BMI into normal weight, overweight, or obesity appears arbitrary. Although the prevalence of disease risks differs among racial and ethnic groups regardless of BMI levels, the evidence presented here does not support the notion that the BMI-health-risk profile of East Asians and others warrants race-specific BMI cutoff points.

Tong EK; Gildengorin G; Nguyen T; Tsoh J; Modayil M; Wong C et al. Smoking prevalence and factors associated with smoking status among Vietnamese in California. Nicotine & Tobacco Research 12(6): 613-621, 2010. (39 refs.)

Vietnamese American men have smoking prevalence rates higher than the general population. We analyzed Vietnamese American smoking behavior by demographic and health-related factors, including some specific to Vietnamese, in the largest tobacco-specific survey yet targeting the Vietnamese population. Using a statewide surname probability sample and computer-assisted telephone interviewing, we surveyed 1,101 Vietnamese men and 1,078 Vietnamese women in California (63.5% participation among successfully contacted eligible individuals) in 2007-2008. We conducted multivariate regression models to analyze the association between Vietnamese male smoking status and demographic and health-related factors. Among women, < 1% were current smokers and < 2% were former smokers. Among men, 25% were current and 24% were former smokers. Regression models for Vietnamese men delineated factors associated with both current and former smoking (vs. never smoking): being married, being employed, having lower educational attainment, and consuming alcohol. Other factors associated with current smoking (vs. never smoking) were having no health insurance, having seen a Vietnamese doctor or no doctor visit in the past year, having Vietnamese military or Vietnamese reeducation camp experience, having less knowledge about the harms of smoking, and reporting higher depression symptoms. Increasing age and not being Buddhist were associated with former (vs. never) smoking. Smoking patterns of Vietnamese women and Vietnamese men are significantly different from the general California population. Tobacco control efforts targeting Vietnamese men should include community outreach since current smokers have low health care access, utilization, and knowledge.

Tong EK; Nguyen T; Vittinghoff E; Perez-Stable EJ. Light and intermittent smoking among California's Asian Americans. Nicotine & Tobacco Research 11(2): 197-202, 2009. (16 refs.)

Asian Americans, along with other ethnic minorities, have been described to be more likely than Whites to be light and intermittent smokers. Characterizing Asian American smoking behavior accurately on a population level requires oversampling groups of different national origin and including non-English-speaking participants. We analyzed the California Health Interview Survey to compare moderate/heavy (>= 10 cigarettes/day), light (0-9 cigarettes/day), and intermittent (not daily) smoking patterns in Asian Americans with those of Whites. We also examined whether social and demographic factors that had been associated with Asian American smoking prevalence also were associated with light and intermittent smoking patterns in each of the national origin groups. Most Asian American smokers were more likely to be light and intermittent smokers (range = 36.6%-61.5% for men and 29.9%-81.5% for women) compared with Whites, with lower mean cigarette consumption. Asian American light and intermittent smokers were more likely than moderate/heavy smokers to be women (odds ratio [OR] = 2.12, 95% CI = 1.14-3.94), highly educated (OR = 3.16, 95% CI = 1.21-8.28), not Korean (compared with Chinese; OR = 0.32, 95% CI = 0.13-0.79), and bilingual speakers with high English language proficiency compared with English-only speakers (OR = 2.83, 95% CI = 1.21-6.84). Asian American intermittent smokers were more likely than daily smokers to be women (OR = 2.25, 95% CI = 1.08-4.72) and to have lower household income. The predominance of Asian American light and intermittent smoking patterns has important implications for developing effective tobacco control outreach. Further studies are needed to elaborate the relationship between biological, psychosocial, and cultural factors influencing Asian American smoking intensity.

Tong EK; Tang H; Chen MS; McPhee SJ. Provider smoking cessation advice among California Asian-American smokers. American Journal of Health Promotion 25(5, Supplement S): S70-S74, 2011. (9 refs.)

Purpose. To determine proportions of provider advice to quit smoking for Asian-American smokers and to describe factors that may affect the provision of such advice. Design. Secondary data analysis of population-based survey. Setting. California. Subjects. Current smokers from the California Tobacco Use Surveys for Chinese-Americans (n = 2117, participation rate = 52%), Korean-Americans (n = 2545, participation rate = 48%), and Vietnamese-Americans (n = 2179, participation rate = 63.5%). Measures. Sociodemographics including insurance status, smoking frequency, provider visit in past year, and provider advice to quit. Analysis. Multivariate logistic regression models examined dependent outcomes of (1) provider visit in past year and (2) provider advice to quit. Results. Less than a third (30.5%) of smokers in our study reported both seeing a provider (50.8%) and then receiving advice to quit (60.1%). Factors associated with provider visits included being female, being 45 years or older, having health insurance, and being Vietnamese. Among smokers who saw a provider, factors associated with provider advice to quit included having health insurance and being a daily smoker. Conclusions. Asian-American smokers reported low proportions of provider advice to quit in the past year, largely because only half of smokers saw a provider. Providers who see such smokers may need greater awareness that several effective cessation treatments do not require health insurance, and that intermittent smokers need advice to quit.

Tong EK; Tang H; Tsoh J; Wong C; Chen MS. Smoke-free policies among Asian-American women: Comparisons by education status. American Journal of Preventive Medicine 37(2, Supplement S): s144-s150, 2009. (23 refs.)

Background: California has significantly decreased racial/ethnic and educational disparities in smoke-free home and indoor work policies. California's ethnic-specific surveys present an opportunity to disaggregate data and examine the impact of California's smoke-free social norm campaign for Asian-American women. Methods: The California Tobacco Use Surveys for Chinese Americans and Korean Americans were conducted in 2003 and analyzed in 2008 to compare women with lower (<= high school graduate) or higher education status for smoke-free policy adoption and enforcement. Results: Lower-educated and high er-educated women had similar proportions of smoke-free policies at home (58%) or indoor work (90%). However, lower-educated women were more likely than higher-educated women to report anyone ever smoking at home (OR=1.62, 95% CI=1.06, 2.48, p=0.03) and exposure during the past 2 weeks at an indoor workplace (OR=2.43, 95% CI=1.30, 4.55, p=0.005), even after controlling for ethnicity, smoke-free policy, knowledge about the health consequences of secondhand smoke exposure, and acculturation. There was no interaction between education and knowledge about secondhand smoke health harms. Conclusions: The intended consequences of California's tobacco-control efforts have resulted in similar rates of smoke-free policies at home and in indoor work environments among Asian-American women across educational levels. However, an unintended consequence of this success is a disparity in enforcement by educational status, with lower-educated Asian-American women reporting greater smoke exposure despite similar rates of knowledge about the health consequences of secondhand smoke exposure. Besides establishing policies, lower-educated Asian-American women may need to be empowered to assert and enforce their right to smoke-free environments.

Tsoh JY; Tong EK; Gildengorin G; Tung TN; Modayil MV; Wong C et al. Individual and family factors associated with intention to quit among male Vietnamese American smokers: Implications for intervention development. Addictive Behaviors 36(4): 294-301, 2011. (67 refs.)

Smoking prevalence among Vietnamese American males remains higher than the U.S. general population. This study examined the associations of individual and family factors with quit intention among Vietnamese male smokers in California to guide intervention development to reduce their smoking prevalence. Data for Vietnamese male current smokers (n = 234) in the 2008 California Vietnamese Adult Tobacco Use Survey (N = 1101 males) were analyzed to describe quit intention and previous quit attempts. One-third of Vietnamese male smokers (33%) had no intention to quit at any time, 36% intended to quit soon (in the next 30 days), and 31% intended to quit later (beyond the next 30 days). Half (51.7%) of the sample was in "precontemplation," indicating no intention to quit within 6 months. Many (71%) had made a serious quit attempt in the past year, but 68% of those who tried to quit used no cessation assistance. Multivariate logistic regression adjusting for age, depression, smoking intensity, nicotine dependence, health knowledge, children in the household and home smoking ban revealed that having smoking-related family conflicts and a quit attempt in the past year with or without assistance were independently associated with an intention to quit either in the next 30 days or later. Higher education was associated with no intention to quit. Findings underscore the importance of designing strategic interventions that meet the needs of smokers at both individual and family levels to promote quit intention and to facilitate successful quitting in this population.

Wallace JM; Vaughn MG; Bachman JG; O'Malley PM; Johnston LD; Schulenberg JE. Race/ethnicity, socioeconomic factors, and smoking among early adolescent girls in the United States. Drug and Alcohol Dependence 104(Supplement 1): S42-S49, 2009. (32 refs.)

Background: This study uses large nationally representative samples of White, Black, Mexican American, Puerto Rican, Other Latina, Asian American, and American Indian 8th-grade girls to examine racial/ethnic differences and similarities in patterns, trends, and socioeconomic correlates of cigarette use. Methods: The data are drawn from the University of Michigan's Monitoring the Future study. Prevalence and trend data (from 1991 to 2007) in girls' cigarette use were examined by racial/ethnic subgroup. Logistic regression analyses were conducted to determine the extent to which socioeconomic factors predict girls' cigarette use, and whether the relationships between socioeconomic status (SES) and smoking differed across racial/ethnic Subgroup. Results: Cigarette use was highest among American Indian girls; at an intermediate level among Mexican American, Puerto Rican, Other Latinas, and White girls; and lowest among Black and Asian American girls, Trend data show that cigarette use has declined for all racial/ethnic subgroups, and that small but consistent racial/ethnic differences in girls' cigarette use have persisted. Generally, girls who did not live in two-parent households, whose parents had lower levels of educational attainment, who attended lower SES schools, and who had more disposable income were more likely than their peers to smoke. That said, however, the relationships between smoking and parental education and school SES were, on average, stronger for White girls than for Black or Hispanic (Mexican American, Other Latina, Puerto Rican) girls. Conclusions: Future research should seek to understand the mechanisms by which low SES impacts smoking.

Wong W; Barnett PG. Characteristics of Asian and Pacific Islanders admitted to US drug treatment programs in 2005. Public Health Reports 125(2): 250-257, 2010. (36 refs.)

Objective. We determined how Asian and Pacific Islanders (APIs) differ from clients from other ethnic groups in regard to drug use and admissions to drug treatment programs. Methods. We used national survey and treatment admissions data to characterize drug problems and first-time adult admissions to publicly funded drug treatment programs in the U.S. in 2005. Results. APIs accounted for 1.9% of illicit drug use in U.S. adults and for 1.3% of adult clients entering drug treatment for the first time. Compared with other ethnic groups, APIs were significantly more likely to be entering treatment for the first time. Stimulants were the primary drug problem for 57.3% of API first-time treatment clients, a significantly greater proportion than other ethnic groups. This figure had increased from 45.3% in 2001, significantly greater than the increase among Caucasian or African American clients. API first-time admissions had used drugs less frequently (13.6 days in the prior 30 days), began drug use at a slightly older age (mean = 20.7 years), and had a shorter period between start of use and first admission (mean = 9.4 years) than other racial/ethnic groups. Conclusion. Stimulant use was the predominant problem of API clients entering treatment for the first time. APIs were underrepresented in the treatment system relative to their share of the population with drug problems. Diverse groups were aggregated to form the API category. Information on APIs needs to be disaggregated to develop more culturally appropriate and effective treatment.

Xu J; Kochanek KD; Murphy SL; Tejada-Vera B. QuickStats: Rates of Drug-Induced Deaths, by Race/Ethnicity --- United States, 1999--2007. MMWR. Morbidity and Mortality Weekly Review 59(42): 1376, 2010. (1 refs.)

Drug-induced deaths include deaths from poisoning, drug dependence, and conditions resulting from acute or chronic exposure to drugs. Drug-induced deaths exclude deaths from adverse events caused by drugs in therapeutic use (ICD-10 codes Y40--59), deaths indirectly related to drug use (e.g., motor vehicle crashes), and newborn deaths associated with the mother's drug use. During 1999--2007, age-adjusted rates for drug-induced deaths generally increased for each race group. The rate increased by 80.0% for the total population, 97.1% for the white population, 15.8% for the black population, 65.8% for American Indians/Alaska Natives, and 42.9% for Asians/Pacific Islanders. However, for the Hispanic population the rate was more stable, with a decline of 5.8%. During this period, Asians/Pacific Islanders had substantially lower rates than all other groups.

Public Domain

Yu M; Hahm HC; Vaughn MG. Intrapersonal and interpersonal determinants of smoking status among Asian American adolescents: Findings from a national sample. Nicotine & Tobacco Research 12(8): 801-809, 2010. (36 refs.)

Asian American youth are one of the fastest growing populations in the United States. This present study examined intrapersonal and interpersonal determinants of smoking status among Asian American adolescents. Using data from the 2006 National Youth Tobacco Survey, 1,368 Asian American adolescents in Grades 6 through 12 were selected. Findings revealed that one eighth (12%) experimented with cigarettes, 3% smoked occasionally, and 2% smoked regularly. High school students reported higher rates for experimental, occasional, and regular smoking than middle school students. More male than female youth reported the three types of smoking status. Multivariate analyses showed that, compared with nonsmoking, age, weekly income, family members' smoking, refusal of cigarettes from best friends predicted experimental smoking; and positive images of smoking, perception of safety of smoking for only 1 year, awareness of the harmful effects of secondhand smoking, refusal to smoke, and absence from school predicted occasional smoking. Age interacted with refusal to smoke in predicting occasional smoking. Male gender, awareness of the harmful effects of secondhand smoking, refusal to smoke, absence from school, and receptivity to tobacco marketing were determinants of regular smoking. This study uniquely examined how the impacts of multiple intrapersonal and interpersonal predictors differed by various stages of smoking in a nationally representative sample of Asian American adolescents. Our findings underscore that smoking treatment and prevention programs should consider predictors of risk for different stages of adolescent smoking.