The rates of smoking in the U.S. as a whole have been declining. The average for U.S. adults is 30%. The rate of smoking in Chinese-American males is estimated at 28%. In some states, the rate of smoking among Chinese-American males is greater than in whites. Chinese-American women currently have low rates of smoking, but are being targeted by tobacco advertising.

Effect of Acculturation

Fu et al (2003) studied the relationship between linguistic aspects of acculturation and cigarette smoking among Chinese Americans. They conducted a survey of 541 Chinese American adults attending four pediatric, medical, or dental practices located in Philadelphia’s Chinatown from November 2000 to February 2001. English and Chinese language proficiency subscales were utilized to analyze the association between language proficiency and current smoking.

Men Compared to Women

Whereas 25% of Chinese American men reported current smoking, only 3% of Chinese American women reported current smoking. Chinese American men with lower English proficiency reported higher rates of current smoking compared with Chinese American men with higher English proficiency (33% vs. 18%, p<.01).

Less English-proficient Chinese American male smokers were less likely to have received advice from a physician to quit smoking (50% vs. 85%, p=.01). In multivariate analysis, increased English proficiency was associated with decreased odds of current smoking (OR=0.38, 95% CI=0.16-0.89) among Chinese American men after controlling for confounding variables. Thus, Chinese American men with limited English proficiency should especially be targeted for tobacco control interventions.

Lam et al (2007) conducted a study of Chinese elderly in Hong Kong to examine the relationship of smoking with all-cause and major cause-specific mortality in elderly Chinese men and women aged > or = 65 years. They found that even in old age, smoking continued to be a major cause of death, and quitting was beneficial.