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Acculturation and smoking in North Americans of Chinese ancestry: A systematic review

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Abstract

Objectives

Many North American immigrants come from China. Given the critical impact of tobacco use on health, it is important to understand rates and correlates of smoking in this population. This systematic review addressed the question: based on current research, what is the association between acculturation and smoking behaviours in Chinese immigrants to North America?

Methods

The search was conducted in PubMed, Medline, Web of Science, and Academic Search Complete for papers published from 2005 to 2014. Data were extracted from Canadian and American studies for population characteristics, study design, measures of smoking and acculturation, and findings regarding smoking rates and associations between smoking and acculturation.

Synthesis

The literature search identified 147 articles, and 14 met inclusion criteria. Three studies were based on Canadian samples and the remaining 11 were from the United States. Of the 14 papers, 3 reported findings for youth and 11 for adults. Among adults, daily smoking rates were consistently much higher in men than women; for men, rates varied from 9% to 30%. Language use and time in North America were the most common indicators of acculturation. Almost all studies found a relationship between acculturation and smoking, such that more acculturated men smoke less and more acculturated women smoke more.

Conclusion

The findings suggest that the association between acculturation and smoking is gender-specific. This correlation is found in youth and adults and in both Canada and the US. Increased acculturation has a protective effect on smoking for Chinese North American men, but a harmful effect for women. Tobacco control interventions need to develop targeted strategies appropriate to these different populations.

Résumé

Objectifs

De nombreux immigrants nord-américains viennent de la Chine. Vu l’impact crucial du tabagisme sur la santé, il est important de connaître les taux de tabagisme et leurs corrélats dans cette population. Notre revue systématique tente de répondre à la question suivante: D’après les études actuelles, quelle est l’association entre l’acculturation et l’usage du tabac chez les immigrants chinois en Amérique du Nord?

Méthode

Nous avons interrogé les articles publiés entre 2005 et 2014 dans PubMed, Medline, Web of Science et Academic Search Complete. Nous en avons extrait les données d’études canadiennes et américaines sur les caractéristiques de la population, les protocoles d’étude, les indicateurs du tabagisme et de l’acculturation, et les constatations portant sur les taux de tabagisme et les associations entre le tabagisme et l’acculturation.

Synthèse

La recherche bibliographique a identifié 147 articles, dont 14 répondaient à nos critères d’inclusion. Trois études se fondaient sur des échantillons canadiens, et les 11 études restantes provenaient des États-Unis. Sur ces 14 articles, 3 présentaient des constatations axées sur les jeunes et 11, des constatations axées sur les adultes. Chez les adultes, les taux de tabagisme quotidiens étaient systématiquement plus élevés chez les hommes que chez les femmes; chez les hommes, les taux variaient entre 9 % et 30 %. La langue utilisée et le temps passé en Amérique du Nord étaient les indicateurs les plus courants de l’acculturation. Presque toutes les études ont observé une relation entre l’acculturation et le tabagisme: les hommes plus acculturés fument moins, et les femmes plus acculturées fument davantage.

Conclusion

L’association entre l’acculturation et le tabagisme est sexospécifique. Cette corrélation est observée chez les jeunes et les adultes, tant au Canada qu’aux États-Unis. L’acculturation accrue a un effet protecteur sur le tabagisme chez les hommes nord-américains d’origine chinoise, mais elle a un effet nocif chez les femmes. Les mesures de lutte antitabac doivent élaborer des stratégies ciblées en fonction de ces différentes populations.

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Author information

Authors and Affiliations

  1. Centre of Excellence in Cancer Prevention, School of Population and Public Health, University of British Columbia, Vancouver, BC, V6T 1Z3, Canada

    Carolyn C. Gotay PhD, Michelle S. Reid MPH & Marliese Y. Dawson BA

  2. Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China

    Shouzheng Wang MD

Authors
  1. Carolyn C. Gotay PhD
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  2. Michelle S. Reid MPH
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  3. Marliese Y. Dawson BA
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  4. Shouzheng Wang MD
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Corresponding author

Correspondence to Carolyn C. Gotay PhD.

Additional information

Acknowledgements: Support for Dr. Wang’s studentship was provided by the Mitacs Globalink program. Support for the work of the Centre of Excellence in Cancer Prevention is provided by the Canadian Cancer Society BC Yukon Division.

Conflict of Interest: None to declare.

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Gotay, C.C., Reid, M.S., Dawson, M.Y. et al. Acculturation and smoking in North Americans of Chinese ancestry: A systematic review. Can J Public Health 106, e333–e340 (2015). https://doi.org/10.17269/cjph.106.4762

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  • DOI: https://doi.org/10.17269/cjph.106.4762

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