1. Smoking Cessation in Asian and Pacific Islander Youth Amy Tun Albert Einstein College of Medicine National Education Officer 2004-05

2. Facts About Tobacco Use Tobacco use is a major cause of preventable death in the United States Smoking-related diseases claim an estimated 430,700 lives per year Smoking is directly responsible for 90% of lung cancer deaths About 80% of tobacco users started before the age of 18 In 2003, 22% of high school students were using tobacco Adolescents who smoke are less physically fit and have more respiratory illnesses than their nonsmoking peers

3. Asian Americans and Tobacco Use Most Asian Americans initiated smoking when they were young adults with a mean initiation age of 18 Asian American men are more likely to smoke than women In 2000, almost 21% of Asian American high school students reported using cigarettes In 2000, Asian American adolescents had the sharpest rate of increase in smoking activity during high school among all racial groups

4. Factors Associated with Smoking Among Asian Americans Recently moving to the United States Living in poverty Having limited English proficiency Having little knowledge about the health effects of tobacco use Acculturation and assimilation to the dominant culture (American culture)

5. Acculturation vs Assimilation Acculturation = adaptation to a new or different culture Assimilation = absorption into a new or different culture

6. Acculturation More acculturated adolescents have higher smoking rates than less acculturated adolescents Prevalence of tobacco use among Asian Americans is because of social norms and targeted marketing by the tobacco industry

7. Key Findings from University of Maryland 42.7% of Asian American adolescents reported “ever” cigarette use 16.2% of Asian American adolescents initiated smoking during ages 13-16 No systematic pattern of cigarette use on the basis of grade level. Indicated a profile of Asian American adolescents at higher risk for cigarette use

8. Behavioral Risk Factors for Tobacco Use Among Asian American Adolescents Alcohol and other drug use (marijuana) Those who drink alcohol at least 1 or more days during a period of 30 days are more than 15 times as likely to use cigarettes as those who do not drink. Those who smoke marijuana at least 1 or more times during a period of 30 days are more than 16.48 times as likely to use cigarettes as those who do not smoke marijuana. Promiscuous Behavior Those with multiple sex partners use cigarettes six times more than those without multiple partners.

9. Non-Behavioral Risk Factors for Tobacco Use Among Asian American Adolescent Low academic grades Asian American adolescents with grades of C or lower are 5.23 times more likely to use cigarettes than those with higher grades.

10. Main Point of Study Asian American adolescents who drink alcohol, use marijuana, engage in risky sexual behavior, and have academic grades of C or lower have higher usage of cigarettes. This risk factor profile can be used by parents, teachers, and counselors to identify youth at-risk for tobacco use.

11. The Problem Little data exists on Asian American adolescents and the risk factors associated with this group Data that does exist on Asian Americans is not broken down into the different ethnic subgroups Without reliable data, it is difficult to develop culturally and linguistically appropriate tobacco prevention and control programs for Asian Americans

12. What Needs to be Done More studies must be conducted to understand cigarette use among Asian American adolescents To be reliable, these studies must include large sample sizes and analyze different ethnic subgroups Future studies should examine parental involvement and cultural influences More research should be done on the effects of acculturation, family, and social networks as risk or protective factors toward Asian American adolescent tobacco use

13. How to Help Reduce Tobacco Use Among Young People Tobacco-free policies involving the school’s faculty, staff, and students play an important role in reducing tobacco use among adolescents. Schools should also strictly enforce these policies. Implementing effective educational programs for preventing tobacco use during the critical years for smoking initiation (age 11-15) are more likely to be effective

14. How to Help Reduce Tobacco Use Among Young People These educational programs must become more consistent and effective by continuing efforts to include strong, multiyear prevention units into school health education curricula The involvement of mass media, parents, and other community resources make school-based programs more effective.

15. Effective Programs for Youth The following programs have proven effective in reducing tobacco use in young people: Life Skills Training Program http://www.lifeskillstraining.com/ A school based program that teaches kids drug resistance skills, personal self-management skills, and general social skills. The three year curriculum is taught by trained teachers. Project Toward No Tobacco http://www.modelprograms.samhsa.gov/template_cf.cfm?page=model& pkProgramID=12 http://www.modelprograms.samhsa.gov/template_cf.cfm?page=model& pkProgramID=12 http://www.childtrends.org/lifecourse/programs/ProjectTowardNoTobac coUse.htm http://www.childtrends.org/lifecourse/programs/ProjectTowardNoTobac coUse.htm A school based program that teaches kids the physical dangers of smoking, how to deal with peer pressure, build better self-esteem, and how advertisements are deceiving. Taught by trained teachers.

16. For more information on the health effects of smoking or how to help someone you love quit smoking please go to: Asian and Pacific Islander Tobacco Education Network http://www.apiahf.org/programs/apiten/ Asian Pacific Partners for Empowerment and Leadership http://www.appealforcommunities.org/index2.php American Lung Association http://www.lungusa.org Centers for Disease Control http://www.cdc.gov/

17. References Kwon, H.T., Wang, M.Q., Valmidiano, L.L. (2005). Risk behaviors associated with cigarette use among Asian American adolescents. The International Electronic Journal of Health Education, 8: 11-17. Perry-Casler, S.M., Shah, A., Pitt, S., Westhoff, E.R., McDermott, R.J. (2004). Minority youth: “Big tobacco’s” 21 st century marketing targets. Florida Public Health Review, 1: 42-47. http://www.lungusa.org http://www.cdc.gov/