Social Capital and Smoking Among Asian American Men: An Exploratory Study

摘要

Objectives. We examined how different dimensions of social capital (i.e., family and friend connections, neighborhood and family cohesion, family conflict) were associated with smoking behavior among a nationally representative sample of Asian American men and whether the associations varied by ethnic group. Methods. The sample consisted of 998 adult Asian American men who participated in the National Latino and Asian American Survey from 2002 to 2003. We conducted weighted multivariate logistic regressions on data for the sample and for each of 4 ethnic subgroups (Chinese, Vietnamese, Filipino, and Other). Results. Vietnamese American men had the highest prevalence of current smoking; Chinese American men, the lowest. After controlling for sociodemographics, socioeconomic status, acculturation, and perceived discrimination, neighborhood cohesion was inversely associated with smoking among Asian American men, and family and friend connections and family cohesion were not. An exception was family cohesion, which was associated with increased odds of smoking among Filipino American men. Conclusions. The relationship between social capital and smoking among Asian American men varied according to specific dimensions of social capital and was ethnicity specific. These findings highlight the need for smoking prevention and cessation interventions to take into consideration the heterogeneity that exists among Asian Americans. Cigarette smoking and exposure to environmental tobacco smoke are the leading preventable causes of illness and death in the United States, accounting for 443?000 premature deaths and $96.8 billion loss in productivity annually during 2000 through 2004. 1 Men are among those most affected, accounting for 61% of smoking-related deaths and 66.3% of economic loss. 1 The gender differences in smoking behavior and consequences are even larger among Asian American populations (i.e., people who have Chinese, Filipino, Vietnamese, and other Asian backgrounds), in which smoking among men is common and exchange of cigarettes is an accepted social practice, a cultural norm, and a reflection of a person's affection or respect for others. 2 Although existing studies have shown that smoking prevalence among Asian Americans as a whole is low, 3,4 smoking rates among Asian American men have been persistently higher than those among men in the general population. For example, during the past decade several studies, using non-nationally representative samples, have shown that current smoking prevalence ranges from 24.1% to 33.6% for Chinese Americans, 2,5,6 26.8% to 35.9% for Korean Americans, 2,3 31.6% to 40.3% for Vietnamese Americans, 2,3,7 and 24.4% to 34.6% for Filipino Americans. 3,8 Although Asian American men face a higher risk of tobacco-related morbidity and mortality, a dearth of information is available on smoking in this community. 2,4,9 According to Maxwell et al., 9 research on Asian American smoking is limited by the lack of quality data. On the one hand, studies using culturally and linguistically appropriate survey methodology have often recruited Asian American participants from geographic locations in which they are highly concentrated, raising the question of generalizability. On the other hand, studies that have drawn data from national probability samples have represented only English-speaking Asian Americans, which have may led to underestimates of smoking prevalence because many Asian Americans are immigrants with limited English ability and are thus excluded from national surveys. In addition, national surveys have usually aggregated Asian American subgroups into the broad category of Asian Americans because specific subgroups have insufficient sample sizes, thus precluding precise analyses. Another common shortcoming of existing studies on Asian American smoking is the focus on individual characteristics such as sociodemographics (i.e., gender, marital status), socioeconomic status (i.e., education and income), and acculturation (i.e., English language ability, food preference). Although these individual characteristics can help explain smoking behaviors, they are insufficient in themselves given that the underlying causal determinants of smoking are also influenced by social factors. 10 In this article, we have provided 2 important contributions to the literature on cigarette smoking behavior among Asian American men. First, we remedied the data limitation found in previous studies by using a nationally representative sample who were surveyed in a culturally and linguistically appropriate way. In particular, we investigated smoking prevalence among Asian American men and the magnitude of differences by ethnic subgroup. Second, we tested a general model of smoking behavior among Asian American men that uses social capital as its theoretical framework. Our introduction of the concept of social capital—which has increasingly been used in examinations of health behaviors among the Euro