Is acculturation a risk factor for early smoking initiation among Chinese American miners? A comparative perspective

Objective-To determine the extent to which Chinese American and white minor s differ in age of smoking initiation, and to determine the effect of accul turation on smoking initiation. Design-Cross-sectional telephone surveys. Setting-Stratified random samples of the state of California, United States . Subjects-347 Chinese American and 10 129 white adolescents aged 12 through 17 years, from the California Tobacco Survey (1990-93) and the California Y outh Tobacco Survey (1994-96). Outcome measures-Hazards (risk) of smoking initiation by age, smoking initi ation rate, cumulative smoking rate, mean age of smoking initiation, and ac culturation status. Statistical methods-Life table methods, proportional hazards models, and ch i(2) tests Results-The risk of smoking initiation by age among Chinese American miners was about a third of that among white miners. The risk for Chinese America ns continued to rise even in later adolescence, in contrast to that for whi tes, which slowed after 15 years of age. Acculturation was associated signi ficantly with smoking onset among Chinese Americans. Acculturation, smoking among social network members, attitudes toward smoking, and perceived bene fits of smoking were associated with the difference in hazards of smoking o nset between Chinese American miners and their white counterparts. Conclusions-Chinese American adolescents had a lower level and a different pattern of smoking onset than white adolescents. Levels of acculturation an d other known risk factors were associated with the hazards of smoking init iation among Chinese American miners and with the difference in smoking ini tiation between the Chinese and white adolescents. Tobacco prevention polic ies, strategies, and programmes for ethnically diverse populations should t ake acculturation factors into account.