Is smoking an epidemic for Asians?

By Sarah Yee
Northwest Asian Weekly

Tong K. began to smoke when he secretly took a smoking pipe from his parents in China at the age of eight.

“If it did not kill my parents, why quit?” said Tong, who declined to give his full last name. He has used tobacco for more than 45 years.

It is the time of the year to make New Year’s resolutions. Many people are determined to live a healthier lifestyle. Although health-related issues are among people’s goals, to quit smoking may not be a priority for many Asian American smokers.

“My grandma smoked, my dad smokes, and people around me smoke,” said Tong. “Especially back in the days [when] there was no TV, no entertainment. People smoke everywhere [in China].”

According to the World Health Organization (WHO), smoking rates are as high as 67 percent of the male population in China and Korea. In Japan, there are more than 570,000 cigarette vending machines across the nation, making it easy for youth to have access to tobacco. The populations in Asia are exposed to billions of dollars of advertisements from multinational tobacco companies. They are not necessarily exposed to education about the harmful effects of cigarettes.

There are more than 4,000 toxic and cancer-causing chemicals in tobacco smoke. According to the WHO, a survey found that 96 percent of the Chinese population are unaware that smoking can cause heart disease.

This habit, mindset, and lack of knowledge have not changed much even after they immigrate to the United States. From 1997 to 2009, the United States has seen a gradual decline in smoking among adults, from 24.7 percent to 20.6 percent. Laws have been applied to restrict tobacco advertisements.

More education has been implemented to explain the harms of cigarettes.

However, these statistics may not reach some Asian/Pacific Islander groups due to language barrier.

“In [the] 2002 needs assessment, [Asian American] community members said that [anti-tobacco use] messages weren’t reaching them,” said Elaine Ishihara, director of the Asian Pacific Islander Coalition Against Tobacco (APICAT). “We need resources that are [in their] language and culturally appropriate. If it’s not in [their] languages, people are not going to notice it.”

APICAT announced that it prepared a gift that may help some Asian American smokers’ New Year’s resolutions come true.

“Through a 15-year data collection, Dr. Shu Hong Zhu concluded that if you offer a service in [different] languages, people will access it,” said Ishihara.

APICAT has partnered with California Smokers’ Helpline and Zhu, an internationally recognized leader in smoking quitline research, to launch a new service in January. Quitline, a telephone counseling service to smokers who are interested in quitting, will be made available in Chinese (Cantonese/Mandarin), Korean, and Vietnamese.

“There is a helpline for the Korean-speaking, [Chinese-speaking, and Vietnamese-speaking people]. Somebody will answer the phone in your language,” said Ishihara.

Smokers trying to quit may also receive the aid of Nicotine Replacement Therapy (NRT) patches, although the Department of Health will only provide these patches for free until July of this year due to budget cuts.

Whether it’s in Asia or in the United States, studies show that smoking prevalence rates vary among API subgroups, genders, and age groups.

In 2008, the American Lung Association claimed that 9.9 percent of Asian Americans smoked, compared to 22.0 percent of non-Hispanic whites and 21.3 percent of non-Hispanic Blacks. However, these studies may not be accurate.

“In specific Asian American communities, it’s way over that rate. Many studies use phone surveys as a measuring tool, and they are only done in English and Spanish. They don’t desegregate that data — not [showing a different rate for] youths, not reflective of different communities. It’s very misleading,” said Ishihara.

For example, Ishihara explained that the smoking rate among Asian Americans is much higher in the International District than in Mercer Island or Bellevue, because tobacco companies target specific communities for advertisements.

“Tobacco companies went to the convenience stores in our community [to place advertisements]. But FDA passed some laws, so a lot of places in the ID have reduced their advertising,” explained Ishihara.

Even though the younger generation can understand anti-smoking educational messages that are produced in English, fighting tobacco use may not be easy.  To attract teenagers, tobacco companies employ the strategies of highly-lit displays and bright colors in their advertisements.

A few years ago, a company launched the “Find Your Boy” campaign, in order to draw women into the smoking crowd.

“I started smoking at tenth grade as a social thing,” said Peter C., who has now used tobacco for more than 10 years. “Everyone would cut class and would be smoking and I would, too.”

For smokers who have more exposure to anti-tobacco messages, such as the younger generation born in the United States, this habit often started as a result of trying to fit into a crowd.

“I quit twice. First time was after high school and I quit for six months. Second time was when I was 23, and it was for three years. I started smoking again due to stress and social [purposes],” said Peter C.

However, Peter C. recently got married, causing him to think twice about his addiction. “I plan on stopping [smoking] again soon for my children in the future. I know the risk with smoking,. I want to be there for my wife and children and am slowly weening off the addiction.”

APICAT supports leadership development, funds community-based organizations, and organizes community forums that educate people about tobacco use issues. The key is making the content culturally relevant and accommodating diverse communities.

In 2008, APICAT sponsored the Photo Voice Project. The youth of diverse backgrounds — Blacks, APIs, and the lesbian/gay community — went around King County communities to trace tobacco industry’s targets. Recently, the youth reconvened to compare their findings two years later. APICAT invests a great deal in educating the youth about the reality.

“After all, cigarettes are expensive. Aren’t they like $10 a pack?” said Ishihara. ♦

For more information, visit Asian Language Quitline’s hours of operations are Monday–Friday from 9 a.m.–9 p.m., with a 24-hour voicemail service. Direct numbers are: Chinese (Cantonese/Mandarin) 1-800-838-8917, Korean 1-800-556-5564, Vietnamese 1-800-778-8440.

Sarah Yee can be reached at

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