Smoke-Free Policies Among Asian-American Women

Abstract

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 higher-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.

Smoking prevalence and factors associated with smoking status among Vietnamese in California

“…Although declining response rates have already been observed in statewide tobacco surveys for the general population in California and Massachusetts, there is no evidence that this has resulted in different representation of population subgroups and any less accurate or biased estimates of smoking behavior (Biener, Garrett, Gilpin, Roman, & Currivan, 2004). In comparison with the California tobacco surveys for other Asian American subgroups that used similar methodology, our study achieved a higher participation rate of eligible contacted participants (63.5%) than the surveys for Chinese Americans (52%) or Korean Americans (48%; Tong, Tang, et al, 2009). …”

“…We modified the age variable into a continuous variable with 10-year increments and the education variable into lower (less than or equal to high school) versus higher (more than or equal to some college) educational levels in order to facilitate our interaction analysis. The education variable was dichotomized since the lower education levels were behaving in a similar manner as were the higher education levels, and this categorization has been used in other Asian American surveys (Tong, Tang, Tsoh, Wong, & Chen, 2009). We calculated adjusted odds ratio with 95% CIs, with a significance level of p < .05 for all statistical tests.…”

Women and tobacco: a call for including gender in tobacco control research, policy and practice

“…In California, a US state which has comprehensive smoke-free legislation, low SES women reported higher workplace exposure to SHS, more exposure to SHS in the home and less control over home smoking policies than high SES women 87. Comprehensive smoke-free public places legislation can also encourage home smoking restrictions and reductions in children's exposure to SHS.…”

Effect of Media Campaigns and Smoke-Free Ordinance on Public Awareness and Secondhand Smoke Exposure in Taiwan

“…Those who had low income and people who live in Central and Southern Taiwan were more likely to report household SHS exposure. A study found disadvantaged women were more likely exposed to SHS at home because of their lack of power and ability to negotiate smoke-free home policies (Tong, Tang, Tsoh, Wong, & Chen, 2009). Media campaigns, community education programs about the harm of SHS, smoking cessation services, smoke-free home policies, and other tobacco control measures should continue to be promoted to maximize their effect on reducing smoking prevalence and household SHS exposure.…”