Tobacco use in the Asian American community

Asian Americans are people with origins from the far east or Southeast Asia, or the Indian subcontinent. The largest subgroups originate from China, the Philippines, India, Korea, Vietnam and Japan. Additionally, Pacific Islanders and Native Hawaiians are often grouped with Asian Americans in surveys.

Asian Americans have the lowest cigarette smoking prevalence compared with other racial and ethnic groups. However, tobacco use prevalence varies within Asian American subgroups. Distinct differences in smoking prevalence between subgroups might be attributable to variations in socioeconomic status, exposure to targeted advertising and attitudes toward tobacco use.

PATTERNS OF USE IN THE U.S.

YOUTH AND YOUNG ADULTS

• In 2019, 2.5% of Asian American high schoolers and 0.4% of Asian American middle schoolers were current smokers, compared with 5.8% of high schoolers and 2.3% of middle schoolers overall.
• In 2018, 10.1% of Asian Americans aged 18-25 were current cigarette smokers, compared with 19.1% of young adults overall.
• In 2019, 3.9% of Asian American middle schoolers and 13.7% of Asian American high schoolers were current users of e-cigarettes, compared with 27.5% of high schoolers and 10.5% of middle schoolers overall.
• Among Asian American young adults aged 18- 24, 2.1% were current users of e-cigarettes in 2017, compared with 5.2% of young adults overall.

ADULTS

• In 2018, 7.1% of Asian American adults smoked. In comparison, 15% of non- Hispanic white, 14.6% of non-Hispanic black and 9.8% of Hispanic adults smoked in 2018.
• In 2016, 14% of Asian American men and 4.6% of Asian American women were current cigarette smokers. Among the general American population, 17.5% of men and 13.5% of women were current smokers in the same year.
• From 2010-2013, Korean American (20%) and Vietnamese (16.3%) adults had the highest smoking prevalence among Asian American subgroups, while Chinese (7.6%) and Asian Indian (7.6%) adults had the lowest smoking prevalence among Asian American subgroups.
• In 2017, 0.9% of Asian American adults were current users of e-cigarettes compared to 2.8% of all adults.
• In 2014, the most recent year data are available, 27% of Native Hawaiian adults were current cigarette smokers. Although they are a distinct ethnic group, Native Hawaiians are often grouped with Asian Americans in surveys.

HEALTH EFFECTS

Despite lower smoking prevalence, tobacco-related diseases still have a substantial impact on Asian American and Pacific Islander populations.

• Cancer, heart disease and stroke, the three leading causes of death among Asian Americans and Pacific Islanders, can all be caused by cigarette smoking.
• The leading cause of cancer death among Asian Americans and Pacific Islanders is lung and bronchus cancer.

MARKETING IN THE U.S.

Tobacco companies found promise in marketing to Asian Americans because of high population growth, high smoking prevalence in their countries of origin, increasing consumer power, and a high brand loyalty to American products.

• Tobacco companies sponsored east Asian, Asian American and Pacific Islander community festivals, and advertised in magazines in east Asian languages.
• Billboards and stores in predominantly urban Asian American communities have been found to have more tobacco advertising compared with other urban neighborhoods, and to be less likely to have health warnings compared with predominantly white neighborhoods.
• Although smoking prevalence among Asian Americans are higher in countries of origin, it is much lower in the U.S. Research has shown this may be due to higher excise tax on cigarettes in the U.S. compared with the prices in their countries of origin.