Asian American Smoking Rates Jump After Elementary School

The number of Asian American youths who smoke increases dramatically between middle school and high school--from 3.8% in sixth grade to 33.1% by 12th grade--a rate much steeper than in any other ethnic group, according to a report released Thursday.

The survey of 35,000 young people is the first to look at youth smoking rates among Asian Americans, according to researchers. It was conducted by the American Legacy Foundation, the anti-smoking organization formed by the 1998 settlement agreement between the states and the tobacco industry.

In middle school, the survey found, overall smoking rates among students of Asian decent are the lowest of all ethnic groups--about 5.5%, compared with 10.7% of whites, 11.3% of African Americans and 11.2% of Latinos.

However, by high school graduation, the situation has reversed dramatically--with a third of Asian Americans smoking in the 12th grade, second only to whites.

The report stressed what researchers have long believed: that middle school, “when barriers to smoking begin to drop dramatically,” is when smoking rates begin to increase among students of all ethnic backgrounds.

The report “confirms that the middle school years are the real breeding ground for . . . smoking,” said Alan Leshner, director of the National Institute on Drug Abuse, part of the National Institutes of Health.

The foundation, which is also developing counter-marketing campaigns aimed at specific ethnic groups, has asked researchers to examine the reasons for the trends in each group, with the idea of ultimately designing new approaches to keep kids from starting to smoke.

Thus far, foundation experts believe, the reason smoking explodes so rapidly among Asian American youth after middle school and upon entering high school may be related to parenting styles that differ from other ethnic groups.

“The theory--and it is only a theory--is that [Asian American youths] have more parental supervision at a younger age” than other groups, said Cheryl Healton, president of the foundation. “They think that [cigarette] use burgeons as they spend more time away from the home environment.”

The foundation has already begun an anti-tobacco comic book campaign geared to Asian American kids, known as “Manga,” the Japanese term for the comic or cartoon style of drawing popular in Asia.

The books were designed by the Asian advertising agency Imada Wong Communications Group in Los Angeles, part of an alliance of advertising firms led by Arnold Worldwide in Boston.

The first issue made its debut in June, and more than 700,000 copies have been distributed since then at 5,900 retail locations in 26 key Asian markets. The second issue was released in December and is in communities now.

Healton blamed economic reasons for the lack of previous data on smoking among Asian American youth, saying that such a survey needed a large enough sample to be statistically valid.

“It required over-sampling,” she said. “We had the money to do it right, and we did it right.”

The survey was conducted by the foundation in collaboration with the federal Centers for Disease Control and Prevention in the fall of 1999 and spring of 2000, talking with a large national sample of about 35,000 students.

Interviewing students twice--in the fall and in the spring--enabled researchers to compare data during the course of a single school year, the foundation said.

They found that smoking increases over the course of each grade, Healton said.

In the fall, for example, 12.8% of middle school students reported using tobacco products, including cigarettes, cigars and pipes. By the spring of the same school year, just six months later, the number had risen to 15.2%, the study said.

After peaking in the early 1990s, smoking among youth overall declined slightly in the last few years as cigarette prices increased. But the survey findings show underlying increases from grade to grade and among specific ethnic groups, the study said.

“Despite the fact that we have some good news,” Healton said, referring to the overall modest decline, “the underlying reality is still fairly horrendous.”

The report is “a grim portrait of the epidemic of smoking by America’s children and teenagers,” said Joseph A. Califano Jr., president of the National Center on Addiction and Substance Abuse at Columbia University, who served as President Carter’s secretary of health, education and welfare.

The report said that 2.7 million, or 9%, of youths ages 11 to 19 were “established” smokers in 1999. Established smokers are defined as people who have smoked on at least 20 of the previous 30 days and who have smoked more than 100 cigarettes in their lifetime. Experts believe that established smoking is a key indicator of current or future addiction to nicotine.

“Nicotine is as addictable as any other substance,” Leshner said, stressing that most youths cannot stop once they have started. “Nobody wants to become addicted. You don’t begin with the quiet hope that you will become a nicotine addict.”