Acculturation and smoking in North Americans of Chinese ancestry: A systematic review

Abstract

were extracted from Canadian and American studies for population characteristics, study design, measures of smoking and acculturation, and findings regarding smoking rates and associations between smoking and acculturation. SYNTHESIS:The literature search identified 147 articles, and 14 met inclusion criteria. Three studies were based on Canadian samples and the remaining 11 were from the United States. Of the 14 papers, 3 reported findings for youth and 11 for adults. Among adults, daily smoking rates were consistently much higher in men than women; for men, rates varied from 9% to 30%. Language use and time in North America were the most common indicators of acculturation. Almost all studies found a relationship between acculturation and smoking, such that more acculturated men smoke less and more acculturated women smoke more. CONCLUSION:The findings suggest that the association between acculturation and smoking is gender-specific. This correlation is found in youth and adults and in both Canada and the US. Increased acculturation has a protective effect on smoking for Chinese North American men, but a harmful effect for women. Tobacco control interventions need to develop targeted strategies appropriate to these different populations. Smoking rates vary markedly internationally. For women, rates range from 1% (in Saudi Arabia) to 50% (in Nauru), and for men, rates go from a low of 8% (in Ethiopia) to 71% (in Kiribati). Rates in North America are intermediate, with 17% and 25% of women and 24% and 33% of men smoking in Canada and the United States respectively. 4 Individuals who emigrate from other parts of the world to North America often face many challenges in adjusting to their new homes, including differences in modal behaviours such as the prevalence of smoking. Immigrants from China comprise an interesting subgroup, since they are the largest group of immigrants to Canada (making up almost 13% of new Canadians) 5 and one of the largest groups in the US, accounting for 4.2% of new immigrants (after individuals from Mexico, India and the Philippines). 6 Smoking rates in China are 2% for women and 51% for men, both greatly different from North American rates. 4This paper reviews published literature on smoking rates in North Americans of Chinese origin, with an emphasis on understanding one of the most important factors affecting smoking in these individuals. Specifically, we focus on acculturation, which has been defined as "a complex, multidimensional process by which foreign born individuals adopt the values, customs, norms, attitudes, and behaviors of the mainstream culture".7 Acculturation plays a crucial role in many health behaviours, including smoking, diet and exercise.

Egocentric social networks, lifestyle behaviors, and body size in the Asian Community Health Initiative (CHI) cohort

“…Associations in this study were consistent with social influences associated with Western norms on behaviors including alcohol intake, smoking, and diet and thus showed parallels to the literature on acculturation and smoking [39][40][41], diet [41][42][43], and physical activity [42,44]. Women who have been in the US longer often have a higher Western diet intake, particularly higher intakes of meat, sweets, and sweetened beverages, a greater likelihood of smoking, and higher levels of physical activity [45][46][47]. In prior work, social network composition has differed by nativity with immigrant (vs. US-born) women having larger proportions of family in their networks [48,49].…”

Immigration factors and potentially avoidable hospitalizations in Canada

“…With time spent in the host country, immigrants’ health deteriorates to become similar to that of the local population (Gushulak et al, 2011). Researchers have hypothesized that the deterioration reflects an acculturation process whereby immigrants take cultural characteristics and behavioral habits of the non-immigrant host population (Gotay, Reid, Dawson, & Wang, 2015). The relationship between the acculturation and health is not clear either.…”

“…The relationship between the acculturation and health is not clear either. The lifestyle changes within the acculturation process can differ between men and women (Gotay et al, 2015). Immigrants may take lifestyle habits that either hinder their health, such as being more sedentary, or eating more processed food, or lifestyle habits that benefit their health, such as reducing their tobacco consumption (Gotay et al, 2015).…”

The Influence of Smoking Status on the Health Profiles of Older Chinese American Men

“…Prior research has identified several risk factors associated with elevated smoking rates among Chinese American men, including level of acculturation, symptoms of anxiety and depression, low perceived risk associated with smoking, and social environmental influences, such as peer smoking and smoking norms . Although the negative consequences of smoking on health outcomes have been well documented among smokers in the general populations, there is a paucity of information on a comprehensive examination of the relationship between cigarette smoking and health conditions among older Chinese Americans.…”