Hazards of smoking initiation among Asian American and non-Asian adolescents in California: a survival model analysis.
BACKGROUND
Information about the risk of smoking initiation among whites, African Americans, and Latino Americans has provided an important information base for smoking prevention programs among adolescents from these ethnic backgrounds. Unfortunately, there is a lack of such information for Asian Americans, a fast-growing ethnic minority group with much internal diversity.


METHODS
This study used cross-sectional data from 20,482 subjects 12-17 years of age, randomly sampled in California, to describe and compare the risk of smoking initiation for adolescents by age among Asian American and other non-Asian ethnic groups, using survival analysis. Computer-aided telephone interview techniques were used in data collection.


RESULTS
The risk of early smoking initiation among Asian American adolescents is about a third of that of Caucasians. However, the risk among Asian Americans continues to increase throughout adolescence, while the same risk among Caucasians and African Americans plateaus around 14-15 years of age. Significant differences in the levels and patterns of smoking initiation among Asian American subgroups were observed, with Chinese Americans showing the lowest risk of smoking initiation and Filipino Americans the highest, Japanese and Korean Americans being in-between.


CONCLUSIONS
Asian American adolescents may be especially at risk of smoking initiation later in adolescence, even though they are at lower risk early in adolescence. Smoking prevention programs for Asian Americans should continue throughout adolescence and early adulthood.
Institute for Health Promotion and Disease Prevention Research, University of Southern California School of Medicine, Los Angeles 90033, USA. xinguang@hsc.usc.edu
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D000293:Adolescent; D017668:Age of Onset; D001208:Asia / Q000208:ethnology; D001213:Asian / Q000706:statistics & numerical data*; D002140:California / Q000453:epidemiology; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D015995:Prevalence; D012306:Risk; D012907:Smoking / Q000208:ethnology*; D016019:Survival Analysis