Objective-To determine the extent to which Chinese American and white minor
s differ in age of smoking initiation, and to determine the effect of accul
turation on smoking initiation.
Design-Cross-sectional telephone surveys.
Setting-Stratified random samples of the state of California, United States
Subjects-347 Chinese American and 10 129 white adolescents aged 12 through
17 years, from the California Tobacco Survey (1990-93) and the California Y
outh Tobacco Survey (1994-96).
Outcome measures-Hazards (risk) of smoking initiation by age, smoking initi
ation rate, cumulative smoking rate, mean age of smoking initiation, and ac
Statistical methods-Life table methods, proportional hazards models, and ch
Results-The risk of smoking initiation by age among Chinese American miners
was about a third of that among white miners. The risk for Chinese America
ns continued to rise even in later adolescence, in contrast to that for whi
tes, which slowed after 15 years of age. Acculturation was associated signi
ficantly with smoking onset among Chinese Americans. Acculturation, smoking
among social network members, attitudes toward smoking, and perceived bene
fits of smoking were associated with the difference in hazards of smoking o
nset between Chinese American miners and their white counterparts.
Conclusions-Chinese American adolescents had a lower level and a different
pattern of smoking onset than white adolescents. Levels of acculturation an
d other known risk factors were associated with the hazards of smoking init
iation among Chinese American miners and with the difference in smoking ini
tiation between the Chinese and white adolescents. Tobacco prevention polic
ies, strategies, and programmes for ethnically diverse populations should t
ake acculturation factors into account.