Psychological and Environmental Determinants of Smoking Initiation and Persistence among Asian American adolescents: Findings from a National Sample

Background and Purpose: Although it is well documented that adolescent smoking is a public health concern, few studies have examined multiple determinants of different stages of cigarette smoking, particularly, among Asian American adolescents. Given this population is one of the fastest-growing minority groups in the U.S., it is important to provide evidence-based findings to inform smoking cessation and prevention programs for these youth with smoking problems. Therefore, the present study examines the prevalence and psychological, familial and social environmental predictors of experimental and regular smoking among Asian American adolescents in a national representative sample.

Methods: Using data from the 2004 National Youth Tobacco Survey, 1,290 Asian American adolescents in grades 6 through 12 were selected (female, 47.5%; male, 52.2%). The nationally representative self-administered mailing survey data are well-suited for this study in that they include multiple factors associated with smoking-related behaviors such as smoking intention, having good friends that smoke, using various tobacco products, having family discussions about smoking, and exposure to advertising. We employed multivariate logistic regression analysis in order to predict specific forms of these smoking-related behaviors.

Results: Findings revealed nearly one-fifth (17.2%) of study sample youth experimented with cigarettes (less than 100 lifetime use occasions and not smoked in the past 30 days); and 1.4% were regular smokers (greater than 100 lifetime use occasions and smoked in the past 30 days). Significantly more male than female youths reported both forms smoking behavior (experimental smokers, 20.3% vs. 14.0%; regular smokers, 2.3% vs. 0.4%). Multivariate logistic analyses showed that, compared with non-smokers, experimental smokers were significantly more likely to report intentional smoking (OR=1.70, 95%CI: 1.24, 2.34), have best friends who were regularly smoking (OR=1.51, 95%CI: 1.24, 1.83), miss school classes (OR=1.45, 95%CI: 1.15, 1.84), and use various tobacco company products (OR=1.46, 95%CI: 1.09, 1.95). Regular smokers were significantly more likely to report having family discussions regarding the dangers of smoking (OR=2.11, 95%CI: 1.10, 4.04) as well as smoking intention (OR=8.33, 95%CI: 3.32, 20.86). However, regular smokers were also less likely to report having an in-house smoking ban (OR=0.14, 95%CI: 0.03, 0.56) and experience exposure to tobacco advertising (OR=0.77, 95%CI: 0.60, 1.00) than non-smokers.

Conclusions and Implications: Study findings underscore the need to establish smoking treatment and prevention programs that take into account the patterns of smoking-related behaviors among Asian-Americans. In particular, peer effects, family rules and expectations regarding the initiation and continuation of smoking, and using various forms of tobacco appear to alterable pathways that could reduce the deleterious consequences of smoking among this population.