Smoking cessation messages miss Asian Americans

Cigarettes are a particular problem among Asian-American immigrants, where smoking has been estimated to be more than 10 percent above the national average.

Yet for many Korean-American immigrants, the social benefits of cigarettes may trump any health concerns, according to a new baseline study of Korean smokers from the Center for Asian Health at Temple University, conducted by Grace Ma, PhD, professor of public health and director of the Center.

The study involved one hundred Korean smokers who were beginning a smoking cessation treatment program at the Center. The majority were first-generation immigrants, 61 percent of whom were heavy smokers. Results showed that younger immigrants with more education exhibited more initiative and interest in quitting. As a group, however, about 69 percent had made no attempts to quit in the past three months, while 59 percent had not tried to stop smoking in the past twelve months.

Despite the importance given to quitting smoking in the U.S., Ma says few cigarette cessation programs have targeted Asian immigrants. Along with ingrained social and cultural habits which may encourage cigarette smoking - the study notes that Korean-American men often initiate a conversation with the offer of a cigarette - Ma points out that many in the Asian immigrant community lack a corresponding understanding of the health risks associated with tobacco use, which may not have been stressed in their home countries.

"Smoking cessation programs must be culturally tailored to Asian populations," says Ma, "Not only in language but also intent." Along with social and cultural considerations, the insular nature of the Asian American communities can also prove problematic for the success of cessation programs. Ma points to New York's Chinatown, where many long-time residents may never voyage outside the self-sufficient community, making it tough for immigrants to absorb messages - such as anti-smoking campaigns - of the culture at large.

"Many mainstream smoking cessation programs are not culturally appropriate to the daily life of Asian immigrants," says Ma.

While older Asian-American men of lower socioeconomic status are more likely to have difficulty in quitting smoking or even in developing the intention to quit, Ma has ferreted out other smoking problems in the immigrant community, including issues of second hand smoke, and among women, who often - ironically - take up cigarettes as they grow more attuned to American culture. Another cultural issue involves younger immigrants who adopt the behaviors of their elders, including the smoking habit.

The Korean-American study is part of a larger examination by the Center of smoking programs in various Asian immigrant populations across Delaware, New Jersey, Pennsylvania and New York. Results will help fine tune ongoing smoking cessation treatment programs at the Center, which are currently provided to Vietnamese, Chinese, Cambodian, Korean and other Asian immigrants to see if an individualized, culturally appropriate approach to anti-smoking using a combination of behavior modification, cessation activities, pharmaceuticals and educational information can help recent immigrants end their dependence on tobacco.