The effect of immigrant generation on smoking
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.
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