title: Acculturation and misclassification of tobacco use status among Hispanic men and women in the United States.
abstract: BACKGROUND
  This study sought to determine the relationship between acculturation and misclassification of tobacco use among Hispanic Americans.
  
  
  METHODS
  The dataset was limited to respondents from the 1999-2002 National Health and Nutrition Examination Surveys who self-reported as "Mexican American" or "other Hispanic" and were at least 20 years old. Acculturation was measured with a short language scale, and self-reported tobacco use was verified with serum cotinine. Misclassified tobacco users were individuals who self-reported as never or former users but had a cotinine concentration of 15 ng/ml or higher.
  
  
  RESULTS
  A gender-specific association between misclassification and acculturation was found. Among males (n = 1,175), the prevalence estimates of misclassification were 4.8%, 1.8%, and 2.2% for low, medium, and highly acculturated males, respectively (p < .02). Among females (n = 1,345), the prevalence estimates of misclassification were 0.8%, 2.0%, and 4.9% for low, medium, and highly acculturated females, respectively (p < .03).
  
  
  CONCLUSIONS
  The findings of this study support the notion that the association between tobacco use and acculturation among Hispanics is gender specific. Several possible barriers to accurate self-report of tobacco use among Hispanics may include (a) the misconception among Hispanic men that infrequent tobacco use does not qualify one as a current user, (b) increasing desire among acculturated Hispanic women to conform to the tobacco use behaviors of non-Hispanic White women, and (c) the perceived acceptability of tobacco among Hispanic women in the United States. Finally, these trends support the use of early tobacco prevention efforts among Hispanic women and especially among those with low levels of acculturation.
authors.affiliation: The Ohio State University College of Medicine, Columbus, OH 43210, USA.
authors.forename: Joshua
authors.initials: J
authors.lastname: Everhart
authors.forename: Amy K
authors.initials: AK
authors.lastname: Ferketich
authors.forename: Kristine
authors.initials: K
authors.lastname: Browning
authors.forename: Mary E
authors.initials: ME
authors.lastname: Wewers
mesh_terms: D000069:Acculturation; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D009749:Nutrition Surveys; D015995:Prevalence; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology / Q000208:ethnology*; D014481:United States / Q000453:epidemiology