Elsevier

Social Science & Medicine

Volume 61, Issue 6, September 2005, Pages 1223-1242
Social Science & Medicine

The effect of immigrant generation on smoking

https://doi.org/10.1016/j.socscimed.2005.01.027Get rights and content

Abstract

Immigrants to the US are not only an increasingly significant demographic group but overall they also have lower socioeconomic status (SES) than the native-born. It is known that tobacco use is a major health risk for groups that have low SES. However, there is some evidence that tobacco use among certain immigrant groups is lower than among the respective native-born ethnic group, and that immigrant assimilation is positively related to tobacco use. We investigated the relationship between immigrant generation and daily smoking, using the Tobacco Use Supplement of the Current Population Survey (TUS-CPS), 1995–96, a national data set representative of the US general and immigrant populations.

Our multivariate logistic regression analysis of the relationship between immigrant generation and daily smoker status (n=221,798) showed that after controlling for age, gender, race/ethnicity, SES variables (i.e. equivalized household income, education, occupation), and central-city residence, the odds of being a daily smoker were highest among US-born individuals of US-born parents (reference group) and lowest among foreign-born individuals (95% CI: 0.54–0.62). Being a second-generation immigrant (i.e. US born) with two immigrant parents also conferred a protective effective from smoking (95% CI: 0.64–0.77). However, having only one foreign-born parent was not protective against smoking. Testing for interaction effects, we also found that being foreign born and being second generation with two immigrant parents were especially protective against smoking among females (vis-à-vis males); racial/ethnic minorities (vis-à-vis whites); and low-income individuals (vis-à-vis high-income individuals).

We discuss possible mechanisms that may explain the protective effect against smoking of being foreign born and being second generation with two immigrant parents, including differences in the stage of the tobacco epidemic between immigrants’ countries of origin and the US, the “healthy immigrant effect”, and anti-smoking socialization in immigrant families.

Introduction

In 2002, 32.5 million foreign-born individuals (i.e. first-generation immigrants) represented 11.5% of the total US population (Schmidley & US Census Bureau, 2003)—the largest absolute number of immigrants ever and the highest proportion foreign born since the 1930s. US-born individuals of foreign-born parents (i.e. second-generation immigrants) represented about 10% of the US population (Foner, Rumbaut, & Gold, 2000). Cigarette smoking, the single most preventable cause of premature death in the US (Centers for Disease Control and Prevention, 2002), is a major health risk for groups of low socioeconomic status (SES) (Centers for Disease Control and Prevention, 2000; Pamuk, Makuc, Heck, Reuben, & Lochner, 1998). Although among immigrants some national-origin groups have considerably higher poverty rates and lower educational status than the US born (Schmidley & US Census Bureau, 2003; US Census Bureau, 2000a), seemingly contradictory, there is some evidence that within certain groups, tobacco use is lower among the foreign born than among the US born, and that tobacco use is positively correlated with measures of immigrant assimilation (Acevedo, 2000; Amaro, Whitaker, Coffman, & Heeren, 1990; Baluja, Park, & Myers, 2003; Chen, Unger, Cruz, & Johnson, 1999a; Chen, Unger, & Johnson, 1999b; Cobas, Balcazar, Benin, Keith, & Chong, 1996; Coonrod, Balcazar, Brady, Garcia, & Van Tine, 1999; Gfroerer & Tan, 2003; Harris, 1999; Perez-Stable et al., 2001). However, since US national health surveys frequently do not include information about immigrant status and/or are not representative of the immigrant population, much of the empirical evidence on tobacco use among immigrants has been fragmentary, i.e. studies have focused on a single state/community, a single national origin/ethnic group, and/or convenience samples.

The Current Population Survey (CPS), a labor-force survey of the civilian non-institutionalized population conducted monthly by the US Census Bureau, is the only nationally representative survey that permits the study of both first-generation and second-generation immigrants (Hirschman, 1996; Schmidley & Robinson, 1998). Additionally, since 1992, in selected months, the CPS has included a 46-item Tobacco Use Supplement (TUS) developed by the National Cancer Institute (US Census Bureau, 2000b). The unique combination of information on immigrant status and tobacco use makes the Tobacco Use Supplement of the Current Population Survey (TUS-CPS) a highly valuable resource for studying tobacco outcomes among the US immigrant population (Baluja et al., 2003)

In this paper, we report the results of new multivariate analyses of the CPS to examine the role of immigrant generation in tobacco use (i.e. daily smoking).

Section snippets

The second generation

In addition to distinguishing the foreign-born population, we examine daily smoking status among five groups according to their generation in the US: US-born individuals of US-born parents (i.e. the third (and higher) generation); US-born individuals with a foreign-born mother (and a US-born father), US-born individuals with a foreign-born father (and a US-born mother), and US-born individuals with two foreign-born parents (i.e. the second generation); and foreign-born individuals (i.e. the

Data

The CPS is a national, monthly labor-force survey. The universe consists of all civilian, non-institutionalized persons living in households. The probability sample selected to represent the universe consists of about 57,000 occupied households throughout the US (US Census Bureau, 2000b). The Population Division of the US Census Bureau has determined that the CPS provides reliable data about the foreign-born population at the national level and state level (90% level of confidence) (Schmidley &

Results

Table 1 presents the age, racial/ethnic, and SES distribution of our sample by gender and generation. Nearly 80% of the sample was US born of US-born parents, while 11.4% was foreign born. The second generation included those with a foreign-born mother (2.0%), those with a foreign-born father (2.6%), and those with two foreign-born parents (4.3%). There are some important differences in the sample composition, which are indicative of differences in the US population. First, the second

Discussion

Our results suggest that the protective effect of immigrant status against smoking is only partially mediated by demographic and socioeconomic factors. After controlling for age, gender, race/ethnicity, SES variables, and central-city residence, we found that the odds of being a daily smoker are highest among US-born individuals of US-born parents and lowest among foreign-born individuals. Being second generation with two immigrant parents also confers a protective effective from smoking.

Acknowledgements

This work was supported by the National Cancer Institute (NCI) through a grant (1 R03 CA093198-01) to the author. The authors would like to thank Lisa Bates, participants at the 2002 NCI Annual Small Grants Meeting, and two anonymous reviewers for helpful comments.

References (81)

  • D. Acevedo-Garcia

    Acculturation

  • D. Acevedo-Garcia et al.

    Undoing an epidemiologic paradox: The tobacco industry's targeting of US immigrants

    American Journal of Public Health

    (2004)
  • R. Alba et al.

    Remaking the American mainstream: Assimilation and contemporary immigration

    (2003)
  • M. Alegria et al.

    Considering context, place and culture: the National Latino and Asian American Study

    International Journal of Methods in Psychiatric Research

    (2004)
  • H. Amaro et al.

    Acculturation and marijuana and cocaine use: Findings from HHANES 1982–84

    American Journal of Public Health

    (1990)
  • C. Anderson et al.

    Patterns of adolescent smoking initiation rates by ethnicity and sex

    Tobacco Control

    (2000)
  • E. Arillo-Santillán et al.

    Prevalencia de tabaquismo y bajo desempeno escolar, en estudiantes de 11 a 24 anos de edad del estado de Morelos, Mexico

    Salud Publica de Mexico

    (2002)
  • K.F. Baluja et al.

    Inclusion of immigrant status in smoking prevalence statistics

    American Journal of Public Health

    (2003)
  • C.E. Bartecchi et al.

    The global tobacco epidemic

    Scientific American

    (1995)
  • G.J. Botvin et al.

    Predictors of cigarette smoking among inner-city minority youth

    Journal of Developmental & Behavioral Pediatrics

    (1994)
  • Cigarette smoking among adults—United States, 1998

    MMWR—Morbidity & Mortality Weekly Report

    (2000)
  • Annual smoking-attributable mortality, years of potential life lost, and economic costs—United States, 1995–1999

    MMWR—Morbidity & Mortality Weekly Report

    (2002)
  • X. Chen et al.

    Is acculturation a risk factor for early smoking initiation among Chinese American minors? A comparative perspective

    Tobacco Control

    (1999)
  • J.A. Cobas et al.

    Acculturation and low-birthweight infants among Latino women: A reanalysis of HHANES data with structural equation models

    American Journal of Public Health

    (1996)
  • D.V. Coonrod et al.

    Smoking, acculturation and family cohesion in Mexican–American women

    Ethnicity & Disease

    (1999)
  • I. Cuellar

    Mexican-origin migration in the US and mental health consequences (JSRI Occasional Paper 40)

    (2002)
  • M.P. Fernandez Kelly et al.

    Divided fates: Immigrant children and the new assimilation

  • N. Foner et al.

    Immigration and immigration research in the United States

  • L. Franzini et al.

    Understanding the Hispanic paradox

    Ethnicity & Disease

    (2001)
  • A.T. Geronimus et al.

    Age patterns of smoking in US black and white women of childbearing age

    American Journal of Public Health

    (1993)
  • J.C. Gfroerer et al.

    Substance use among foreign-born youths in the United States: Does the length of residence matter?

    American Journal of Public Health

    (2003)
  • Giovino, G. A., Pederson, L. L., & Trosclai, R. A. (2000). The prevalence of selected cigarette smoking behaviors by...
  • M. Gordon

    Assimilation in American life: The role of race, religion, and national origins

    (1964)
  • K.M. Harris

    The health status and risk behaviors of adolescents in immigrant families

  • K.M. Hassmiller et al.

    Nondaily smokers: Who are they?

    American Journal of Public Health

    (2003)
  • C. Hirschman

    Studying immigrant adaptation from the 1990 census: From generational comparisons to the process of becoming American

  • L.M. Hunt

    The concept of acculturation in health research: Assumptions about rationality and progress (JSRI Occasional Paper 69)

    (1999)
  • What in the world works? (Final conference report)

    (1999)
  • C. Jackson et al.

    The early use of alcohol and tobacco: Its relation to children's competence and parents’ behavior

    American Journal of Public Health

    (1997)
  • G. Jasso et al.

    The new immigrant survey pilot (NIS-P): Overview and new findings about US legal immigrants at admission

    Demography

    (2000)
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