Study Lifts Haze Over Tobacco Use

By Hector Becerra

Sept. 7, 2005 12 AM PT

Times Staff Writer

The state’s first detailed look at tobacco use by specific populations, released Tuesday, found that Marines, Korean men, gays and transsexuals were more likely to smoke than other people.

The data, compiled by the state Department of Health Services working with other researchers, offered a striking counterpoint to an overall decrease in smoking throughout California.

More than one in four Korean men smoked, the study found, a rate 46% higher than for California men overall. Only half of California’s Korean households were smoke-free, compared with about 77% for other California households.

Korean and Chinese women smoked at higher rates the longer they had lived in the United States -- and their chances of smoking also rose as their command of English improved. The opposite was true for Korean and Chinese men.

“For men, English fluency or acculturation can be a factor that can lead to resistance to smoking,” said Dr. Moon Chen, a health expert for the UC Davis Cancer Center. “But for women, English fluency or acculturation can be a risk factor for starting smoking.”

It’s against the social norm in Asia for women to smoke, Chen said, so coming to this country or growing up here encourages them, in some cases, to use tobacco more freely.

In general, the more education or the higher the military rank, the less likely a person was to light up, according to the study. Approximately 30% of the active duty military’s junior enlisted men smoked, compared with 2% of senior officers.

Smoking among the military as a whole was higher than average, and Marines had by far the highest tobacco use rate: nearly 27%.

The gay, lesbian, bisexual and transgender community reported smoking rates of 30.4%, nearly twice the 15.4% rate for the general population. Gay men smoked at twice the rate of other men among the California general population.

“The data for lesbian and bisexual women is even worse,” said Larry Bye, vice president of the Field Research Corp., which assisted in the studies, overseen by the Department of Health Services. “Lesbian and bisexual women are smoking at almost three times the rate of women in general.”

The findings come two years after a UCLA study also found that gays and lesbians were more likely to smoke than the general population, prompting a push in some gay communities across the country for new anti-smoking campaigns.

The state’s study did not offer an explanation for those figures. But some activists have speculated that some gays turn to cigarettes as teenagers to deal with the stress of “coming out” and potential discrimination.

Ed Mullen, 53, a lawyer, said he has wondered why he and other gay friends seem to smoke so much even though they are aware of the health risks.

“I had a cookout the other night and there were 10 people there, and only one person did not smoke -- and that was my mother,” Mullen said.

Mullen said it may be a reflection of a life in which many gays and lesbians have been rejected by family. But he shrugged at a definitive answer.

“You think the gay community is smart, and you would think they understand the health risks,” Mullen said.

By contrast, Asian Indians had a considerably lower smoking rate -- 5.5% -- than the general population, explainable in large part because the average member of this community had a postgraduate degree, said Dr. William J. McCarthy, adjunct associate professor of public health at UCLA.

“They’re way below everybody else,” McCarthy said.

However, second-generation Asian Indians -- particularly women -- appear to be smoking more than their parents, McCarthy said. Chinese Americans also reported a low tobacco use rate: about 7.7%.

The study was commissioned by the state in 2003 to understand the smoking habits of certain groups -- notably Asians, gays and active-duty military -- that had received little attention.

Researchers from UCLA, UC Davis and other institutions gathered the data in a variety of ways. Phone interviews were conducted for the Asian Indian, Chinese, Korean and gay, lesbian, bisexual and transgender studies.

For the military study, active-duty personnel received surveys through the mail and online. More than 2,800 returned them.

Lighting up outside a Koreatown office building, Beak Sung said he began smoking as a 20-year-old soldier in the Korean army and never gave it up.

“Life in the army was very tough,” the 47-year-old insurance agent said.

He said a constant threat of war with North Korea and working under spartan conditions was stressful. Soldiers routinely smoked during their breaks to relax. Military duty is obligatory among South Korean men.

Sung said being a businessman in South Korea was stressful too -- another factor that drove him for a while to a pack-a-day habit.

“The previous working condition in Korea was very, very hard,” Sung said. “I worked very late in the night. My main office was my home. Home was just my sleeping place.”

For those in America’s military, smoking may seem like a relaxing balm in times of war and stress, said Air Force Lt. Col. Sherry Sasser.

But she said that even on the battlefield there can be consequences of smoking.

Sasser said smoking’s effects on military readiness include reduced night vision and immunity, and increased respiratory problems.

She said being addicted to anything, including nicotine, can lead to distracted service members.

Military smoking rates were 20.2% in the Navy, 17.8% in the Army and 17.5% in the Air Force, according to the study.

According to researchers, activity duty personnel reported using tobacco products other than cigarettes -- such as pipes, cigars, snuff or chewing tobacco -- at 17.4%, far higher than the 5.9% rate in the general population.

Service members cited stress and “social situations” half of the time as reasons they started to smoke.

However, deployment away from home was not cited as a significant factor in promoting smoking.

Sasser said there were probably several reasons Marines were the heaviest smokers.

“There’s the social environment. It’s probably more acceptable because it’s more male-dominant, and hence the macho image of smoking is more acceptable,” she said.

“But partly it might be due to the fact that their weight requirements are so stringent,” Sasser added. “They probably use it a lot to control their weight sometimes, because they know they have got to keep that down. They’re very adamant about weight control.”

Although younger military members, ages 18 to 24, were far more likely to smoke, “those who do smoke at an older age smoke more cigarettes,” Sasser said.

Bye, of the Field Research Corp., said it was still unclear why gay, lesbian, bisexual and transgender people reported higher rates of tobacco use. These groups did not report feeling as if there were overt attempts by the tobacco industry to target them through advertisements, Bye said.

“We’re not finished with that part of the analysis,” he said.

Dr. Howard Backer, interim state public health officer for the Department of Health Services, said the studies--which will be discussed today at a summit in Sacramento -- will help address ways to improve anti-smoking efforts.

“It validates our need to continue our anti-tobacco programs,” Backer said, “and our commitment to California’s smoke-free future.”

(BEGIN TEXT OF INFOBOX)

Smokers

A study reveals large variations in tobacco use among different groups in California.

Percent who smoke cigarettes:*

California adults

All: 15.4%

Men: 19.1%

Women: 11.9%

Lesbian, gay, bisexual and transgender Californians

All: 30.4%

Men: 27.4%