Institute of Behavioral Science, University of Colorado Boulder, Boulder, CO.
Institut National d'Etudes Démographiques, Paris, France.
Nicotine Tob Res. 2020 Apr 17;22(4):532-538. doi: 10.1093/ntr/ntz022.
Immigrants in the United States are less likely to smoke than those born in the United States, but studies have not fully described the diversity of their smoking patterns. We investigate smoking by world region of birth and duration of residence in the United States, with a comprehensive approach covering current prevalence levels, education gradients, and male-to-female ratios.
The data originate from the National Health Interview Surveys, 2000-2015, and the sample of 365 404 includes both US-born and foreign-born respondents aged 25-70 years. World region of birth and duration of residence in the United States measure immigrant characteristics. Current cigarette smoking was analyzed using logistic regression.
Immigrant groups were protected from smoking and had weaker education gradients in smoking and larger male-to-female smoking ratios than the US-born population. However, large differences emerged among the immigrant groups for region of birth but less so for duration of residence in the United States. For example, immigrants from sub-Saharan Africa and the Indian subcontinent have low prevalence, weak education gradients, and high male-to-female ratios. Immigrants from Europe have the opposite pattern, and immigrants from Latin America fall between those two extremes.
The stage of the cigarette epidemic in the region of birth helps explain the diverse group profiles. Duration of residence in the United States does less to account for the differences in smoking than region of birth. The findings illustrate the heterogeneity of immigrant populations originating from diverse regions across the world and limited convergence with the host population after immigration.
The study identifies immigrant groups that, because of high smoking prevalence related to levels in the host country, should be targeted for cessation efforts. It also identifies immigrant groups with low prevalence for which anti-smoking programs should encourage maintenance of healthy habits. Many immigrant groups show strong education disparities in smoking, further suggesting that smokers with lower levels of education be targeted by public health programs.
与土生土长的美国人相比，美国移民吸烟的可能性较低，但研究尚未充分描述他们吸烟模式的多样性。我们通过出生地的世界区域和在美国的居住时间来研究吸烟情况，采用全面的方法涵盖当前流行水平、教育程度梯度和男女比例。
数据来源于 2000-2015 年的全国健康访谈调查，样本包括 365404 名年龄在 25-70 岁之间的美国出生和外国出生的受访者。出生地的世界区域和在美国的居住时间衡量移民特征。使用逻辑回归分析当前吸烟情况。
移民群体受到吸烟的保护，其吸烟的教育程度梯度较弱，男女吸烟比例较大，与美国出生的人群相比。然而，在出生地区的移民群体之间存在很大差异，但在美国居住时间的移民群体之间则差异较小。例如，来自撒哈拉以南非洲和印度次大陆的移民吸烟率较低，教育程度梯度较弱，男女吸烟比例较高。来自欧洲的移民则相反，来自拉丁美洲的移民则介于两者之间。
吸烟地区的流行阶段有助于解释不同的群体特征。在美国的居住时间比出生地对吸烟差异的解释作用较小。研究结果表明，来自世界各地不同地区的移民群体存在异质性，并且在移民后与宿主人口的融合程度有限。
该研究确定了一些移民群体，由于与宿主国水平相关的高吸烟率，应成为戒烟努力的目标。它还确定了一些吸烟率低的移民群体，应为其提供反吸烟计划，以鼓励保持健康习惯。许多移民群体的吸烟存在强烈的教育差异，这进一步表明，教育程度较低的吸烟者应成为公共卫生计划的目标。
