Choi Sarah, Rankin Sally, Stewart Anita, Oka Roberta
Department of Family Health Care Nursing, School of Nursing, University of California, San Francisco, CA, USA.
J Cardiovasc Nurs. 2008 Jan-Feb;23(1):67-73. doi: 10.1097/01.JCN.0000305057.96247.f2.
Cigarette smoking is the most preventable risk factor for many negative health consequences, such as cancer, heart disease, and lung disease. In the United States, the prevalence rate in Asian immigrants is high (26%-70%), with Southeast Asian men having the highest rate. Acculturation has been associated with smoking behavior in this ethnic group.
The purposes of this meta-analysis are to describe the extent to which acculturation affects smoking behavior in Asian immigrants and to compare the direction and magnitude of the effect between subgroups by gender and age.
Databases within PubMed, CINAHL, The Cochrane Library, and PsycINFO were searched. Twenty-one studies published in English or Korean from 1994 through 2005 met criteria, and 9 of these studies contained sufficient data. Among the 9 studies, 3 presented gender-specific data; thus, these studies were entered separately for men and women, making a total of 12 entries for final analysis. The odds ratio was used as an effect size statistic. The values of odds ratios were calculated from the data in the studies.
The average effect size for men was 0.53 (95% confidence interval, 0.28-0.99), indicating that acculturated men are 53% less likely to smoke than nonacculturated or "traditional" men. The average effect size for women was 5.26 (2.75-10.05), suggesting that acculturated women are 5 times more likely to smoke than traditional women. In adolescents, the average effect size was 1.92 (1.22-3.01), indicating that acculturated adolescents are almost 2 times more likely to smoke than traditional adolescents.
Acculturation may have a protective effect on smoking behavior in Asian men and a harmful effect in Asian women and adolescents. The magnitude of effect is larger in women and adolescents than in men. Smoking cessation programs should target acculturated women, adolescents, and traditional men.
吸烟是导致许多负面健康后果的最可预防的风险因素，如癌症、心脏病和肺病。在美国，亚洲移民中的吸烟流行率很高（26%-70%），其中东南亚男性的吸烟率最高。文化适应与该族群的吸烟行为有关。
本荟萃分析的目的是描述文化适应对亚洲移民吸烟行为的影响程度，并比较按性别和年龄划分的亚组之间影响的方向和程度。
检索了PubMed、CINAHL、Cochrane图书馆和PsycINFO数据库。1994年至2005年发表的21项英文或韩文研究符合标准，其中9项研究包含足够的数据。在这9项研究中，3项提供了按性别分类的数据；因此，这些研究按男性和女性分别录入，最终分析共有12项录入。比值比用作效应量统计量。比值比的值根据研究中的数据计算得出。
男性的平均效应量为0.53（95%置信区间，0.28-0.99），表明文化适应的男性吸烟的可能性比未适应文化或“传统”男性低53%。女性的平均效应量为5.26（2.75-10.05），表明文化适应的女性吸烟的可能性是传统女性的5倍。在青少年中，平均效应量为1.92（1.22-3.01），表明文化适应的青少年吸烟的可能性几乎是传统青少年的2倍。
文化适应可能对亚洲男性的吸烟行为有保护作用，而对亚洲女性和青少年有有害作用。女性和青少年的影响程度大于男性。戒烟项目应针对文化适应的女性、青少年和传统男性。
