In this cross-sectional survey of KA adult male smokers in California, we found that household smoking restrictions were associated with having an intention to quit smoking. This finding is similar to those of previous studies (7
). A prospective study reported that a complete ban at baseline, compared with no ban or a partial ban, was significantly associated with an increase in subsequent quit attempts (OR, 2.0) (7
). The International Tobacco Control (ITC) Four Country Survey-a cohort study conducted in 2002 with an average of seven months follow-up-reported that intentions to quit at baseline were associated with implementing bans between baseline and follow-up (8
). Bans at baseline were also associated with more quit attempts and success at follow-up (8
). Another longitudinal study showed that smokers in the preparation stage (i.e., planning to quit seriously within the next 30 days and having made at least one-day quit attempt in the past year) were more likely to adopt a full ban than those either in precontemplation (having no intention to quit within the next 6 month) or contemplation (considering quitting seriously within the next 6 months) stages (12
We also found that those who lived with 2 or more other smokers were less likely to intend to quit smoking, and those who were more educated were more likely to intend to quit smoking. Other significant factors associated with an intention to quit from univariable analyses included age and proportion of life spent in the US. Also, higher education and younger age had marginally significant associations with intentions to quit smoking. Several previous studies have reported that the intention to quit smoking was more prevalent among those who were younger, had higher income, and smoked fewer cigarettes per day (13
). Our findings were consistent with earlier studies except for daily cigarette consumption, which may be due to missing data on this variable in the CKATUS.
Smokers who were linguistically assimilated and spent more than half of their life in the US were more likely to have an intention to quit smoking. These findings may be due to different social norms about smoking in the US and their country of origin (in this case, Korea). According to the Organisation for Economic Cooperation and Development (OECD) 2001 Health Data, current smoking prevalence of adult men in Korea (52.9%) was much higher than in the US (20.3%) (16
). The low smoking prevalence in the US may, therefore, facilitate intentions to quit smoking, especially among more assimilated men.
Also, we performed univariable analyses and a multiple logistic regression analysis based on a different operationalization for the outcome variable (i.e., intention to quit in the next 6 months-stages of contemplation and preparation vs. no intention to quit in the next 6 months-stage of precontemplation). However, there was no significant association between household smoking restrictions and having an intention to quit smoking (P=0.40). Therefore, in the current study, we could conclude that those who had household smoking restrictions were significantly more likely to have an intention to quit smoking (vs. never expect to quit smoking), even though they were not likely to contemplate quitting in the near future (i.e., in the next 6 months).
Our study had several limitations. First, due to the cross-sectional nature of the survey, we are unable to assess whether the smoking restrictions in the household led to having an intention to quit smoking or vice versa. We were neither able to evaluate the causal direction between household smoking restrictions and intention to quit smoking, nor test the relationship between household smoking restrictions and successful smoking cessation. Although two longitudinal studies (13
) mentioned above indicated that stages of change at baseline predicted the adoption of smoking restrictions in the household, the direction in our study is unclear. Further large cohort studies are needed to confirm the directional relationship between these factors. Second, we were unable to evaluate these relationships in women because of the small number of women smokers in the CKATUS data. Larger studies are needed that focus on recruiting Korean American women who smoke. Last, the overall response rate for the survey was only 48%. The response rate varied by region, with the lowest response rate being 43% and the highest, 55%. Although interviewers attempted to complete an interview by calling at least ten times at different times of day and on different days of the week, the response rate was low, possibly leading to selection bias. However, we believe that we compensated for this by using a weighting technique.
In conclusion, we found that household smoking restrictions are associated with an intention to quit smoking among KA adult male smokers in California. The results suggest that the adoption of smoking bans in the household could encourage smokers to quit.