How does acculturation influence smoking beha vior among latinos? The role of education and national background

Abstract

Introduction: As Latinos acculturate, they are assumed to smoke at higher rates. This study investigated the relationship between acculturation level, educational attainment, and cigarette smoking by gender and national background among Latinos. Methods: Data from the 2009-2012 National Health Interview Survey were analyzed and participants included 1,111 Cubans, 813 Dominicans, 13,281 Mexicans, and 2,197 Puerto Ricans. Multivariable logistic regression was used to model acculturation and educational predictors of current smoking, stratified by gender and national background. Acculturation level was categorized into less acculturated, bicultural, and more acculturated by combining birthplace and language preference. Current cigarette smoking was defined by self-reported use every day or some days among those who ever smoked at least 100 cigarettes. Results: Most respondents were interviewed in English (62%) and had a high school education or less (60%), but only 39% were US-born. Overall, 17.8% of men and 9.6% of women reported current smoking. By national background, smoking prevalence was highest among Puerto Ricans (16% of women and 23% of men) and lowest among Dominicans (6% of women and 10% of men). More acculturated Mexican women and men had significantly higher odds of current smoking (OR=2.94; 95% CI=2.01, 4.31 and OR=1.88; 95% CI=1.39, 2.55; respectively). Mexican men who were more acculturated and had greater levels of educational attainment had lower odds of smoking (OR=.84; 95% CI=.74,.96). Conclusions: The relationship between acculturation and health behaviors among Latinos is influenced by education and should be considered by public health and clinician stakeholders when developing or adapting tobacco control strategies.