Differences in patterns of tobacco use in Vietnamese, African-American, Hispanic, and Caucasian adolescents in Worcester, Massachusetts

Reduction of cigarette smoking among Southeast Asian men is a national health promotion objective for the year 2000. Early onset of cigarette smoking is known to be a risk factor for later nicotine addiction, yet little is known about tobacco patterns among Southeast Asian youths. Using questionnaire items from the Youth Risk Behavior Survey (YRBS) translated into Vietnamese and Spanish, this article reports such data on a school-based sample of Vietnamese adolescents in Worcester, Massachusetts, and compares smoking and other tobacco use among Caucasian, African-American, and Hispanic adolescents. A sample of 2,816 adolescents was surveyed in two public middle and two public high schools. Prevalence of cigarette smoking among Vietnamese boys (27.9%) was similar to that for Caucasian boys (28.3%) and was higher than that for Hispanic boys (19.7%) or African-American boys (18.9%). Vietnamese girls smoked rarely (3.7%). Vietnamese boys were less likely to smoke in middle school than were other students, and more likely to report smoking in high school than were non-Vietnamese. They were also significantly less likely than others to have smoked their first cigarette at age 12 years or younger (odds ratio (OR) = 0.2, 95 percent confidence interval (CI) = 0.1, 0.4). In multivariate analyses, older age, male gender, smoking by friends, and carrying of a weapon were independent risk factors for current cigarette smoking. Vietnamese subjects differed from others with respect to factors associated with smoking, perceived susceptibility to cancer, and belief in the importance of not smoking for preventing cancer. Among Vietnamese adolescents over age 16, increasing length of time in the United States was associated with decreasing smoking prevalence. The prevalence of smokeless tobacco use among Vietnamese boys (12.0%) was similar to that among other minority boys but was rare among Vietnamese girls. This study is the first to document the rates of tobacco use among Vietnamese adolescents, and the findings suggest that Vietnamese boys should be targeted in efforts to achieve the goal of reducing smoking among Southeast Asian men. Medical Subject Headings (MeSH): adolescent behavior, health surveys, smoking, health promotion, tobacco, smokeless, Asians, Asian Americans, Vietnam.