Epidemiology of Tobacco Use Among Native Hawaiian or Other Pacific Islander Adolescents: Results From a National Sample

Background and Purpose: There is a paucity of information concerning tobacco use among Native Hawaiian or Other Pacific Islander(NH/OPI hereafter) adolescents. Limited information on adolescent tobacco use in this population hinders development of effective and efficacious smoking cessation and prevention strategies. Using a nationally representative sample, this study examines prevalence rates and predictors of different types of adolescent tobacco use (i.e., cigarettes, menthol cigarettes, smokeless tobacco, cigars, pipes, and polytobacco use). Methods: Using data from the 2006 National Youth Tobacco Survey, 292 NH/OPI adolescents in grades 6 through 12 were selected (male, 58% and mean age=14.7 [SD=1.9]). The nationally representative self-administered mailing survey data are well-suited for this study in that they include information about key study variables such as different types of tobacco, family member's smoking, refuse tobacco from best friends, # of days absent from school, and receptivity to tobacco marketing. Weighted percentages were calculated for prevalence rates of the different types of tobacco use; and multiple logistic regression analyses with a weighted variable were performed to identify determinants of each type of tobacco use. Results: Findings revealed that nearly half of the youths(48%) used any tobacco product in life. Specifically, the majority(45%) used cigarettes; one in six(15%) used menthol cigarettes; one in nine(12%) used smokeless tobacco; one in four(23%) used cigars; one in eight(13%) used pipes; one in six(13%) used two tobacco products; and one in six (16%) used three or more tobacco products. Bivariate analyses showed that high school students had significantly higher rates of cigarettes, smokeless tobacco, cigars, and any two tobacco products than middle school students; and male youths had significantly higher rates of smokeless tobacco and cigars than female youths. Multivariate analyses showed that, age(OR=1.3,95%CI:1.0,1.6), male(OR=2.1,95%CI:1.1,4.2), weekly income(OR=1.1,95%CI:1.0,1.3), family members' smoking(OR=2.5,95%CI:1.3,4.8), and refuse tobacco from best friends(OR=0.2, 95%CI:0.1,0.4) predicted any tobacco users (vs. nonusers). Of these predictors, refuse tobacco from best friends predicted both cigarette-only smoking(OR=0.4, 95%CI:0.2,0.9) and polytobacco users: any two products(OR=0.1,95%CI:0.0,0.4) and any three or more products(OR=0.02,95%CI:0.0,0.1); and family members' smoking predicted polytobacco users: any two products(OR=4.6,95%CI:1.5,14.6) and any three or more products(OR=11.0,95%CI:1.1,11.7). Receptivity to tobacco marketing uniquely predicted any three or more products(OR=6.8,95%CI:1.9,23.9). No significant models for predicting the other types of tobacco use were found. Conclusions and Implications: This study found that NH/OPI youth have higher rates of tobacco use than general population of the same age (48% vs. 41%). Previous research indicates that peer smoking is strongly related to adolescent smoking. The study suggests that encouraging youths to refuse tobacco from best friends may be an important component of smoking cessation and prevention programs. In addition, programs should focus on educating adolescents about how to handle family members' smoking. It may be important to provide information to youths who are using multiple tobacco products on how the tobacco industry has manipulated the public regarding positive characteristics with smoking through media.