The present study examined prospective predictors of smoking initiation during the college years in a sample of Chinese and Korean-American students. Both global and ethnic specific factors were examined as predictors of initial smoking experimentation. Twenty five percent of baseline never-smokers tried their first cigarette during the course of the study. Overall, men were about twice as likely to smoke their first cigarette than were women. Of the global factors, most variables found to predict initial smoking were associated with problem behavior theory. Ethnic specific variables did not add significantly to the prediction of experimentation after accounting for the effects of gender and global variables. Of those who tried their first cigarette during college, about one-third (37%) progressed to established smoking. Men were almost seven times as likely to progress to established smoking as were women. Of the global and ethnic specific variables examined, only ethnicity was a significant predictor of established smoking, indicating that Koreans were six times more likely to progress than were Chinese.
Findings from the present investigation are consistent with studies suggesting recent increases in rates of initial smoking during college (Costa et al., 2007
; Tercyak et al., 2007
). Twenty five percent of those who had not smoked before the initial interview reported trying their first cigarette while in college. Most experimentation was initiated between the baseline and second year assessments (between first half of freshmen year to second half of sophomore year). Of those who progressed to established smoking, the majority (67%) did so within 15 months of smoking their first cigarette, a more rapid rate than reported for adolescents (Choi et al., 2001
). To our knowledge this is the first study to demonstrate a high rate of initiation to smoking in an ethnic minority sample of college students. These data underscore the need for efforts to prevent smoking uptake among Asian-American students.
As anticipated from prior reports of gender differences in smoking rates for Asian-American youth (Chen, Unger, Boley Cruz et al., 1999
), men were at elevated risk of initial smoking during college, especially progression to established smoking. In contrast, prospective studies of college smoking experimentation with predominantly white samples have found no effect of gender on experimentation rates (Costa et al., 2007
; Tercyak et al., 2007
; Wetter et al., 2004
). Further, the temporal pattern of initial smoking experimentation varied by gender in the present sample. While most men had their first cigarette during freshman and sophomore years, over three quarters of women who started smoking in college did so during their junior and senior years. It may be that the delayed onset of experimentation and lower rates of progression observed for women reflect cultural factors unique to Asian Americans. For example, previous research has suggested that Asian female youth perceive more negative consequences from smoking (Mermelstein, 1999
), which might serve to delay or reduce experimentation. Additionally, a recent study from Taiwan found a later age of smoking onset for women, and indicated that compared with men, the smoking behavior of women was less sensitive to social influences (Tsai, Tsai, Yang, & Kuo, 2008
). Since college smoking frequently occurs in social settings, this difference may also have contributed to the observed gender differences.
The present findings suggest that among Chinese and Korean-American students, males may be especially important targets for smoking prevention, particularly during their first two years in college. Identifying factors that influence the observed gender differences in onset of experimentation will be important for informing primary prevention programs.
A number of variables suggested by problem behavior theory were found to predict smoking experimentation but not progression to established smoking. Consistent with previous studies, recent alcohol and other drug use at baseline were both strongly associated with initial smoking. Evidence for the strong proximal association of cigarette and alcohol use in college students (Weitzman & Chen, 2005
) suggests that alcohol use may provide a context in which students are exposed to cigarette use and may provide social impetus for experimentation. Although occurring at much lower rates, illicit drug use may similarly provide exposure to smoking in a social context. Behavioral undercontrol, a temperamental trait reflecting impulsivity, sensation seeking, and disinhibition, is frequently associated with problem behaviors and has been identified as an etiological factor underlying tobacco, alcohol and other substance use. Given that individuals highest on this trait would have been expected to begin smoking prior to college, it is noteworthy that behavioral undercontrol significantly predicts experimentation in the current sample. In addition, the effect of behavioral undercontrol remained significant when entered in a model including alcohol and illicit drug use, behaviors with which this trait is highly associated. These findings thus suggest that behavioral undercontrol has a unique influence on smoking experimentation above any shared influence with alcohol and other drug use. Overall, variables suggested by problem behavior theory found to predict smoking experimentation onset in white youth were also the primary predictors of smoking experimentation among Asian-American college students. This finding suggests that those most likely to try smoking may also be at risk for elevated involvement with alcohol and other drug use. That these variables did not predict progression may reflect that problem behaviors play a greater role in the transition to experimentation than to established smoking. Alternately, the failure to discriminate those most at risk for established smoking may reflect a restricted range of global risk variables among those who started smoking in college or the small sample size. It may also be that indicators of heavier alcohol and other drug use would better predict progression.
Social influence variables showed limited effect on smoking experimentation in the present sample. Parental smoking was a significant predictor of experimentation before accounting for the effects of ethnic specific variables. The lack of significance in the full model (which included ethnic origin) may reflect the different rates of parental smoking between Chinese and Korean participants. That parental but not peer smoking was significantly associated with initial smoking may reflect cultural differences, as suggested by evidence that parental smoking has a greater effect on smoking uptake for Asian than white youth (Choi et al., 2001
). Similarly, studies find that peer smoking explained less variance in smoking behavior of Asian-American than for white youth (Landrine, Richardson, Klonoff, & Flay, 1994
; Siddiqui, Mott, Anderson, & Flay, 1999
That peer influences did not predict experimentation in the present sample may also reflect that assessment typically occurred in the first term of college, and as such friendships may not have been established and/or participants may have responded with respect to their high school friends. Further, peer smoking was assessed broadly and did not consider the closeness of friendships. In addition, all on-campus residences were non-smoking, which may have attenuated the influence of roommates who smoked. Previous prospective studies on college smoking uptake did not consistently find an effect for peer influences (Costa et al., 2007
; Tercyak et al., 2007
; Wetter et al., 2004
). Despite limited support for the social influence model, it seems likely that social factors play an important role in college smoking uptake. As noted above, the influence of alcohol and other drug use may operate through exposure to smoking in social settings. One study of smoking context reported that a significant proportion of college cigarette use occurs exclusively in the presence of others (Moran, Wechsler, & Rigotti, 2004
). For example, the influence of peer smoking may be mediated through substance use. As such, further study of the social context and proximal influences is warranted to more clearly understand the role of social influences on college smoking experimentation among Asian-American students.
Our examination of ethnic specific factors yielded few significant predictors. Only nationality predicted initiation in the present sample. Specifically, Korean nationality predicted progression to established smoking, but not initial experimentation. The lack of prediction for experimentation may reflect that Koreans were significantly more likely to have smoked prior to college than were Chinese students (37% versus 24%, respectively). When viewed in context with the finding that Koreans were more likely to progress to established smoking, these findings are consistent with California population-level estimates showing higher rates of smoking in college educated Koreans than Chinese (Carr et al., 2005a
That acculturation was not associated with experimentation in the present study may be due to a number of factors. For example, studies with high school samples may have been more broadly representative of the populations examined, since many high school students do not go on to college (Green & Forster, 2003
) and smoking is much more common for non-college attending youth (Green et al., 2007
; Johnston et al., 2006
). Further, the present participants were drawn from a single university, and may not represent all Chinese and Korean-American college students. Additionally, previous research has found that the relationship between acculturation and smoking was mediated by risk factors such as smoking related attitudes and peer smoking (Unger et al., 2000
). This type of relationship with global predictors of experimentation, which was not considered in the present analysis, may have obscured the effect of acculturation. Another consideration is that the present study focused only on acculturation at initial assessment. Because the acculturative process likely continues during the college years, it may be that changes in acculturation bear a stronger relationship to smoking acquisition than baseline levels. Finally, methodological differences from prior studies, such as utilizing a broad based assessment of acculturation rather than proxy measures, considering Chinese and Korean ethnicities separately rather than classified together as “Asian Americans”, and examination of longitudinal rather than cross-sectional data, may account for the discrepant findings.
Nonetheless, clear ethnic effects are apparent in the present findings. Consistent with population estimates, Koreans were at substantially greater risk for progression to established smoking than were Chinese students. In addition, the observed gender differences are consistent with differences in smoking rates observed between whites and several ethnic minority populations. These findings indicate the need for smoking prevention programs aimed at Asian-American students to target males in general and Koreans in particular.
It is of interest to note that global risk factors, but not nationality, predicted initial smoking experimentation, while the opposite pattern was observed for smoking progression. Although baseline risk and protective factors differed by nationality, the cumulative risk for initiation may have been similar. For example, while Chinese students were more likely to drink alcohol they also reported less exposure to smoking from peers and parents. Conversely, Korean students reported more exposure to peer and parental smoking. The greater smoking progression observed among Koreans may reflect an erosion of protective factors after beginning smoking (e.g., increased alcohol consumption). Future studies examining changes in global risk factors over time in relation to ethnicity, and whether these reflect additive or moderating mechanisms of influence, are needed to better understand the observed patterns of smoking.
The present findings must be considered within the limitations of this study. First, the variables examined represent only a subset of potential influences on initiation to smoking. The role of other influences clearly bears examination. In particular, the focus in this study was on baseline predictors in order to identify risk factors among incoming college freshmen. However, temporal changes in certain variables (e.g., smoking related attitudes, exposure to smoking, alcohol and other drug use) may also influence the initiation process. In addition, the relatively small number of experimenters and moderate overall sample size may have limited statistical power to detect smaller effects. In particular, a larger sample size may have yielded significant effects for ethnic specific variables and permitted more detailed examination of gender differences. Also, the inclusion of only Chinese and Korean students does not permit direct comparison with predictors of experimentation for students of other ethnic groups, precluding inferences regarding similarities or differences across groups. It is important to note that participants in the present study were self-selected and as such may not be representative of the larger population of Chinese and Korean-American college students. In addition, some participants could have been international students, a group that may be an important target for smoking prevention since studies indicate that over 40% of Chinese and over half of Korean male college students are smokers (Jeong, Lee, Kim, Park, & Sung, 1999
; Zhu, Feng, Wong, Choi, & Zhu, 2004
). These limitations highlight the importance of replicating the current findings with independent samples of Chinese and Korean American college students.
Results of the present study serve to show that initiation to smoking during college is a growing concern. These findings indicate the potential value of targeted interventions for at-risk subgroups such as Asian Americans. Furthermore, the current findings serve to reinforce the powerful association between smoking and alcohol use on college campuses. While shown here for the first time among Chinese and Korean Americans, this association has been previously demonstrated in prospective and cross-sectional reports of college smoking uptake (e.g., Costa et al., 2007
; Reed et al., 2007
; Tercyak et al., 2007
). The observed associations of cigarette and alcohol use indicate the potential value of addressing Asian-American cigarette smoking in the context of college campus-based alcohol use prevention programs. These results also serve to highlight more generally the importance of investigations into contextual factors to enhance our understanding of the relationship between alcohol use and the smoking initiation process during the college years.