title: Effects of acculturation on smoking behavior in Asian Americans: a meta-analysis.
abstract: BACKGROUND
  Cigarette smoking is the most preventable risk factor for many negative health consequences, such as cancer, heart disease, and lung disease. In the United States, the prevalence rate in Asian immigrants is high (26%-70%), with Southeast Asian men having the highest rate. Acculturation has been associated with smoking behavior in this ethnic group.
  
  
  OBJECTIVE
  The purposes of this meta-analysis are to describe the extent to which acculturation affects smoking behavior in Asian immigrants and to compare the direction and magnitude of the effect between subgroups by gender and age.
  
  
  METHODS
  Databases within PubMed, CINAHL, The Cochrane Library, and PsycINFO were searched. Twenty-one studies published in English or Korean from 1994 through 2005 met criteria, and 9 of these studies contained sufficient data. Among the 9 studies, 3 presented gender-specific data; thus, these studies were entered separately for men and women, making a total of 12 entries for final analysis. The odds ratio was used as an effect size statistic. The values of odds ratios were calculated from the data in the studies.
  
  
  RESULTS
  The average effect size for men was 0.53 (95% confidence interval, 0.28-0.99), indicating that acculturated men are 53% less likely to smoke than nonacculturated or "traditional" men. The average effect size for women was 5.26 (2.75-10.05), suggesting that acculturated women are 5 times more likely to smoke than traditional women. In adolescents, the average effect size was 1.92 (1.22-3.01), indicating that acculturated adolescents are almost 2 times more likely to smoke than traditional adolescents.
  
  
  CONCLUSIONS
  Acculturation may have a protective effect on smoking behavior in Asian men and a harmful effect in Asian women and adolescents. The magnitude of effect is larger in women and adolescents than in men. Smoking cessation programs should target acculturated women, adolescents, and traditional men.
authors.affiliation: Department of Family Health Care Nursing, School of Nursing, University of California, San Francisco, CA, USA. Sarah.Choi@ucsf.edu
authors.forename: Sarah
authors.initials: S
authors.lastname: Choi
authors.forename: Sally
authors.initials: S
authors.lastname: Rankin
authors.forename: Anita
authors.initials: A
authors.lastname: Stewart
authors.forename: Roberta
authors.initials: R
authors.lastname: Oka
mesh_terms: D000069:Acculturation; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D001213:Asian / Q000706:statistics & numerical data*; D015984:Causality; D005260:Female; D015438:Health Behavior / Q000208:ethnology; D006801:Humans; D008297:Male; D016017:Odds Ratio; D012307:Risk Factors; D017678:Sex Distribution; D012907:Smoking / Q000208:ethnology*; D014481:United States / Q000453:epidemiology