Disaggregating Asian American Cigarette and Alternative Tobacco Product Use: Results from the National Health Interview Survey (NHIS) 2006-2018

Manaeha Rao; Lilly Bar; Yunnan Yu; Malathi Srinivasan; Arnab Mukherjea; Jiang Li; Sukyung Chung; Siddharth Venkatraman; Shozen Dan; Latha Palaniappan

doi:10.1007/s40615-021-01024-5

Disaggregating Asian American Cigarette and Alternative Tobacco Product Use: Results from the National Health Interview Survey (NHIS) 2006-2018

J Racial Ethn Health Disparities. 2022 Jun;9(3):856-864. doi: 10.1007/s40615-021-01024-5. Epub 2021 Apr 28.

Authors

Manaeha Rao^{1

2}, Lilly Bar^{3

4}, Yunnan Yu^{1

5}, Malathi Srinivasan^{1

6}, Arnab Mukherjea⁷, Jiang Li⁸, Sukyung Chung^{1

9}, Siddharth Venkatraman^{1

10}, Shozen Dan^{1

11}, Latha Palaniappan^{1

6}

Affiliations

¹ Stanford Center for Asian Health Research and Education, Stanford University School of Medicine, Stanford, CA, USA.
² Department of Neuroscience, University of Chicago, Hyde Park, IL, USA.
³ Stanford Center for Asian Health Research and Education, Stanford University School of Medicine, Stanford, CA, USA. lbar@stanford.edu.
⁴ Departments of Biology and Chemistry, Pomona College, Claremont, CA, USA. lbar@stanford.edu.
⁵ School of Computing and Information, University of Pittsburgh, Pittsburgh, PA, USA.
⁶ Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, CA, USA.
⁷ Department of Health Sciences, California State University, East Bay, Hayward, CA, USA.
⁸ Center for Health Systems Research, Palo Alto Medical Foundation Research Institute, Sutter Health, Palo Alto, CA, USA.
⁹ Quantitative Sciences Unit, Primary Care and Population Health, Stanford University School of Medicine, Stanford, CA, USA.
¹⁰ Johns Hopkins School of Medicine, Baltimore, MD, USA.
¹¹ Department of Environmental and Information Science, Keio University, Tokyo, Japan.

Abstract

Introduction: Asian Americans suffer high rates of smoking and tobacco-related deaths, varying by ethnic group. Trends of cigarette and alternative tobacco product use among Asian Americans, specifically considering ethnic group, sex, and nativity, are infrequently reported.

Methods: Using National Health Interview Survey (NHIS) data from 2006-2018 and the 2016-2018 alternative tobacco supplement (e-cigarettes, cigars, smokeless tobacco, pipes), we explored cigarette and alternative tobacco product use by Asian ethnic group (Asian Indian (n = 4373), Chinese (n = 4736), Filipino (n = 4912)) in comparison to non-Hispanic Whites (NHWs (n = 275,025)), adjusting for socioeconomic and demographic factors.

Results: Among 289,046 adults, 12% of Filipinos were current smokers, twice the prevalence in Asian Indians and Chinese (p < 0.001). The male-female gender difference was fivefold for Chinese (10.3% vs. 2.2%; p < 0.001), eightfold for Asian Indians (8.7% vs. 1.1%; p < 0.001), and twofold for Filipinos (16.8% vs. 9.0%). Moreover, 16.3% of US-born and 10.3% of foreign-born Filipinos were current smokers. Odds of ever using e-cigarettes, cigars, smokeless tobacco, and pipes in comparison to NHWs were lowest for Chinese (ORs 0.6, 0.5, 0.2, and 0.5).

Discussion: Filipinos had the highest current smoking rates of Asian ethnic groups. Though more Asian men were current smokers, the high rate of current smoking among Filipinas is concerning. More US-born Filipinos were current smokers than foreign-born, despite rates typically decreasing for US-born Asians. Investigating cultural factors contributing to less frequent use of tobacco products, such as alternative tobacco products among Chinese, may aid campaigns in curbing tobacco usage.

Keywords: Asian American; E-cigarettes; National Health Interview Survey; Smoking; Tobacco.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Asian
Electronic Nicotine Delivery Systems*
Female
Humans
Male
Smoking / epidemiology
Tobacco Products*
Tobacco Use
United States / epidemiology

Abstract

Publication types

MeSH terms

Grants and funding