Smoking Among Asian American Men: A Social Capital Perspective

Purpose: Men were among the most impacted by tobacco smoking, accounting for 61% of the 443,000 premature deaths and 66.3% of the $96.8 billion in economic loss (Adhikari et al, 2008). Smoking is particularly problematic for Asian men, who are more than three times likely than female to smoke cigarettes (Tang, 2005). Unfortunately, there is a dearth of nationally representative data for analyzing smoking patterns and correlates among Asian American men. The purpose of this study is twofold. First, it tends to increase our understanding of cigarette smoking behaviors among Asian American men using national representative samples. Second, it contributes to the scholarly literature by utilizing the concept of social capital as the underlying organizing framework.

Methods: The sample consisted of the 987 Chinese, Vietnamese, Filipinos and other Asian American men from the National Latinos and Asian Americans Study (NLAAS). Current smoking status was determined if respondents identified themselves as current smokers at the time of interview, a valid indicator of smoking status in large population studies (Rebagliato, 2002). Social capital was conceptualized as a multidimensional construct, which included respondents' social connections and resources at individual, family and neighborhood levels. Specifically, a factor analysis of related items resulted in five composite variables of social capital - Friends support, Relatives support, Neighborhood cohesion, Family cohesion, and Family conflict. Following the estimation of current smoking prevalence for the entire sample and by Asian ethnic group, multivariate logistic regression analyses were conducted for Asian men in aggregate and then stratified by ethnic groups. Survey design effects were taken into account in the estimation of standard errors in the presence of stratification and clustering (Kish, 1965).

Results: Vietnamese men had the highest prevalence of current smoking (29.4%) and Chinese men the lowest (17.1%). Regression analysis revealed that neighborhood cohesion was inversely associated with smoking among men in aggregate, but in subsequent analysis, it was only significant among Vietnamese. Family cohesion was not significantly associated with smoking among entire sample of Asian American men, but the stratified analysis showed it was positively associated with smoking among Filipinos (OR = 2.72). Aside from social capital, the analysis revealed discrepancies of associations between other socio-demographic variables and smoking. Everyday discrimination was positively associated with smoking for the entire sample but only among Filipinos in subgroup analysis. Individuals who were better acculturated (measured by English ability) were less likely to be current smokers, but the relationship was reversed for Filipinos (OR=3.85).

Implications: Findings of this study point to an important conclusion, that is, social capital, as several other socioeconomic factors, is neither uniformly beneficial nor harmful for Asian American men with regard to smoking. Instead, it depends on the context. This finding is particular helpful for health professionals including social work practitioners to tailor their tobacco prevention and cessation interventions to be culturally appropriate.