title: Prevalence and predictors of smoking behavior among Samoans in three geographical regions.
abstract: OBJECTIVE
  Provide comprehensive data on smoking behavior among Samoans.
  
  
  METHODS
  Cross-sectional, using systematic random sampling procedures, and in-person interviews.
  
  
  METHODS
  US Territory of American Samoa, Hawaii, and Los Angeles, California.
  
  
  METHODS
  1834 adult, non-institutionalized Samoans.
  
  
  METHODS
  None.
  
  
  METHODS
  Prevalence and independent predictors of smoking.
  
  
  RESULTS
  Approximately one fourth (26.6%) of Samoans were current smokers, with 31.4% of men and 22.5% of women currently smoking. More current smokers were found in American Samoa (28.9%), followed by Hawaii (26.9%) and Los Angeles (24.1%, P<.001). At each site, Samoan men compared with the women were significantly more likely to smoke (P<.001), initiate smoking earlier (P<.05), and smoke more cigarettes (P<.05). Cessation rates for the sample were very low. Predictors of smoking included being younger, male, married, less educated, with lower income, and more acculturated.
  
  
  CONCLUSIONS
  The high smoking and low cessation rates indicate that smoking-related diseases will be significant causes of morbidity and mortality for Samoans for many years. The findings further underscore the importance of documenting smoking patterns and their determinants for subgroups rather than aggregates such as Asian American and Pacific Islanders. If Samoans are to meet the Healthy People 2010 tobacco goals, there is a need to: 1) develop tailored tobacco awareness and cessation programs based on the recommendations made by the Taskforce on Community Preventive Services; 2) understand the complex interactions between social, cultural, and psychological determinants of smoking and cessation behaviors; and 3) develop policies to limit availability of tobacco, environmental exposure from tobacco, and increase cessation efforts.
authors.affiliation: Department of Epidemiology and Preventive Medicine and the Office of Policy and Planning, University of Maryland at Baltimore School of Medicine, Baltimore, Maryland 21201, USA. smishra@som.umaryland.edu
authors.forename: Shiraz I
authors.initials: SI
authors.lastname: Mishra
authors.forename: Kathryn
authors.initials: K
authors.lastname: Osann
authors.forename: Pat H
authors.initials: PH
authors.lastname: Luce
mesh_terms: D000293:Adolescent; D000328:Adult; D018948:American Samoa / Q000453:epidemiology / Q000208:ethnology; D001294:Attitude to Health / Q000208:ethnology*; D005260:Female; D005843:Geography; D006254:Hawaii / Q000453:epidemiology; D015438:Health Behavior / Q000208:ethnology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D044468:Native Hawaiian or Pacific Islander / Q000523:psychology* / Q000706:statistics & numerical data; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution; D012907:Smoking / Q000208:ethnology* / Q000523:psychology; D016540:Smoking Cessation / Q000208:ethnology / Q000523:psychology