Asian American/Native Hawaiian/ Pacific Islander

Why it Matters

  • People who are Asian American, Native Hawaiian, or Pacific Islander are often combined as one group in survey data due to smaller numbers of the individual groups surveyed. However, with respect to tobacco use patterns, they are actually three distinct groups. Cigarette smoking among adults who are Asian American/Pacific Islanders is lower
    than other racial ethnic groups. However, prevalence among sub-groups of people who are Asian varies and can be higher than that of the general population. By sub-groups, prevalence of cigarette smoking among people who are Asian Americans varies considerably:
    • Chinese = 7.6%
    • Asian Indian = 7.6%
    • Japanese = 10.2%
    • Filipino 12.6%
    • Vietnamese = 16.3%
    • Korean = 20.0%1
  • According to the Hawaii State Department of Health in 2010, among individuals 18 years and older in Hawaii, 24.3% of people who are Native Hawaiian report being current smokers, compared with 16.4% of people who are Filipino, 13.6% of people who are Japanese, and 15.4% of people who are Caucasian.2
  • There is a very large difference in smoking prevalence by sex across all racial/ethnic groups, with women having a much lower prevalence than men.3
  • In general, people who are Asian American or Pacific Islander tend to be light, non-daily smokers. One study among
    college students in California who are Asian American or Pacific Islander showed that:
    • 48% of current smokers smoke cigarettes on fewer than 2 days per month
    • 46% of current smokers smoke less than 2 cigarettes per day.4
  •  Cigarette smoking during pregnancy is less common among women who are Asian American/Pacific Islander compared to women of other racial/ethnic groups.5
  •  Among people who are Asian American aged 18 years and older and are current daily cigarette smokers:
    •  69.6% report that they want to quit, compared to 72.8% of people who are African American, 67.5% of people
      who are white, 67.4% of people who are Hispanic, and 55.6% of people who are American Indian/Alaska Native.
    • 69.4% report attempting to quit during the past year compared to 56.2% of people who are Hispanic, 63.4% of
      people who are African American, and 53.3% of people who are white.6
  • Current tobacco use (of any kind) was highest among middle and high school students who are (23.4%) and
    American Indians/Alaska Natives (20.6%) during 2014-2017. Current use for people who are Asian was 5.0%. For male
    students who are Native Hawaiian/Pacific Islander it was 29.6% versus 16.8% for females. The most common form of
    tobacco use for this entire ethnic/racial group was e-cigarettes.7
  • Researchers estimate that nearly one third of people who are South Asian Americans use smokeless tobacco, such
    as betel nut combined with tobacco leaves and other flavorings and spices, known as paan or gutka.8

What We Know About What Works

  • In 2012, the Centers for Disease Control and Prevention (CDC) funded the national Asian Smokers’ Quitline (ASQ) in all states. ASQ had the greatest success reaching middle-aged older men. Almost all eligible callers received nicotine replacement therapy. Cigarette smokers enrolled in counseling at a high rate, and those who participated
    in counseling completed an average of four sessions. ASQ strives to provide services in a culturally appropriate manner; for example, because Asian-language speakers tend to respect authority figures, ASQ coaches assume an authoritative tone when counseling callers. Asian language speakers who smoke are willing to use services from a
    culturally tailored in-language quitline and actively engage in the counseling program once enrolled.9

What’s Relevant in Pennsylvania

  • 9.5% of adults (18+) who are Asian/Pacific Islander in Pennsylvania smoke cigarettes (2018)10
  •  The Asian Smokers’ Quitline is available in Pennsylvania. Free telephone counseling, self-help materials, nicotine
    patches, and online help is available Monday through Friday, 10 a.m. to 12 a.m., Eastern Standard Time or via 24/7
    online sign up. Web referrals are also available.
  • UPMC Pinnacle, formerly Pinnacle Health System (PHS) had a project to expand existing tobacco cessation outreach efforts and resources to Nepali speaking and Vietnamese speaking communities and to promote the use of the PA Free Quitline (which can offer translated cessation service in these languages) in Dauphin, Cumberland, Perry and Lebanon Counties. The translated tobacco cessation materials were made available for the PA State Refugees Resettlement Conference/Consultation and internal and external partners.11

What Other States Are Doing

References and Resources

  • Asian Pacific Partners for Empowerment, Advocacy and Leadership (APPEAL) is a national health justice organization working to achieve health equity for people who are Asian American, Native Hawaiian, Pacific Islander or other underserved communities. Their tobacco control resources include fact sheets, and an infographic.
  • CDC’s TIPS campaign includes stories of people who are Asian Americans living with smoking-related diseases and disabilities.
  •  Cancer Survivorship: Improving Health Equity with Culturally Relevant Tobacco Cessation for Asian Populations Presentation Slides
  1. “Asian Americans, Native Hawaiians, Pacific Islanders and Tobacco Use,”  Centers for Disease Control and Prevention, August 28, 2018. https://www.cdc.gov/tobacco/disparities/asianamericans/index.htm.
  2. Thaddeus A Herzog et al., “Ethnic Differences in Smoking Rate, Nicotine Dependence, and Cessation-Related Variables Among Adult Smokers in Hawaii,” Journal of Community Health. 2012. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3425666/#R12.
  3. Nancy Gordon et al., “Aggregation of Asian-American Subgroups Masks Meaningful Differences in Health and Health Risks Among Asian Ethnicities: and Electronic Health Record Based Cohort Study,” BMC Public Health. 2019. https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-019-7683-3.
  4. Ibid.
  5. Ibid.
  6. Ibid
  7. Satomi Odani et al., “Racial/Ethnic Disparities in Tobacco Product Use Among Middle and High School Students – United States,” 2018. https://www.cdc.gov/mmwr/volumes/67/wr/mm6734a3.htm
  8. “Tobacco Use in Asian American Communities,” Asian Pacific Partners for Empowerment, Advocacy & Leadership. https://appealforhealth.org/wpcontent/uploads/2014/06/6135_APPEAL_AsianAmerican_factsheet_FINAL.pdf.
  9. Nicole Kuiper, “A National Asian-Language Smokers’ Quitline — United States, 2012–2014,” Preventing Chronic Disease. 2015.
    https://doi.org/10.5888/pcd12.140584.
  10. “State Highlights Pennsylvania,” Centers for Disease Control STATE System.
    https://nccd.cdc.gov/STATESystem/rdPage.aspx?rdReport=OSH_STATE.Highlights&rdRequestForwarding=Form
  11. “Tobacco Cessation Resource Project.” Live Healthy PA. 2019. https://www.livehealthypa.com/data-resources/resources/healthy-living-practices/healthy-living-practices-listing/health-living-practicesdetails/tobaccocessation-resource-project-2.

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