摘要：Objectives. This study sought to compare smoking behavior among Latino men and women from different countries of origin. Methods. A telephone-administered survey was conducted in 8 cities with Latino men and women of different national origin living in census tracts with at least 70% Latino individuals. Results. A total of 8882 participants completed the survey; 53% were women. The average age of respondents was 44 years; 63% were foreign-born, and 59% preferred Spanish for the interview. Current smoking was more prevalent among men (25.0%, 95% confidence interval [CI] = 23.7, 26.3) than among women (12.1%, 95% CI = 11.1, 13.0). Smoking rates were not significantly different by national origin among men, but Puerto Rican women had higher rates of smoking than other women. Central American men and women had the lowest smoking rates. Foreign-born respondents were less likely to be smokers (odds ratio [OR] = 0.77, 95% CI = 0.66, 0.90) than US-born respondents, and respondents with 12 years or less of education had an increased odds of smoking (OR = 1.17, 95% CI = 1.01, 1.35). High acculturation was associated with more smoking in women (OR = 1.12, 95% CI = 1.00–1.25) and less smoking in men (OR = 0.86, 95% CI = 0.78–0.95). Puerto Rican and Cuban respondents were more likely to be current smokers and to smoke more than 20 cigarettes per day. Conclusions. Older, US-born, and more-educated respondents were less likely to be current smokers. Respondents of Puerto Rican and Cuban origin were more likely to smoke. Acculturation has divergent effects on smoking behavior by sex. Cigarette smoking is the leading cause of preventable morbidity and mortality in the United States. 1 National and regional surveys have found that, on average, Latinos smoke at lower rates compared with Whites and that among current smokers, Latinos average fewer cigarettes per day. 2 – 4 Data from the 1997 National Health Interview Survey (NHIS) show that the overall prevalence of cigarette smoking was lower for Latinos (20.4%, SD = 1.4) than for Whites (25.3%, SD = 0.7) and African Americans (26.7%, SD = 1.4) and not significantly different from that for Asian/Pacific Islanders (16.9%, SD = 2.7). 5 The proportion of current smokers among Latino men (26.2%, SD = 2.1) was not significantly different from that among White men (27.4%, SD = 1.0) or Asian/Pacific Islander men (21.6%, SD = 4.4) and was lower than that among African American men (32.1%, SD = 2.4). The proportion of current smokers among Latino women (14.3%, SD = 2.1) was substantially lower than that among White women (23.3%, SD = 0.8) and African American women (22.4%, SD = 1.7) and was similar to that among Asian/Pacific Islander women (12.4%, SD = 3.5). 5 Although the NHIS includes Latino respondents, analyses of rates by national origin are limited by the small sample size of groups other than Mexican Americans. The only national survey of Latinos that addressed smoking behavior and compared groups of different national background was the Hispanic Health and Nutrition Examination Survey (HHANES), completed in 1982–1984. 2 The Third National Health and Nutrition and Examination Survey (NHANES III), conducted in 1988–1994, oversampled Mexican Americans but did not include Latinos from other backgrounds. 6 The level of acculturation, as measured by short language-based scales, is an important predictor of smoking behavior among US Latinos of Mexican and Central American origin. 7 , 8 These data suggest that smoking behavior among Latinos becomes increasingly similar to that among Whites with increasing levels of acculturation; as a consequence, smoking may become a more serious problem for Latinos as their acculturation increases. Given current smoking trends among Latino youths and the observed effects of acculturation on smoking, there is appropriate concern that tobacco-related disease morbidity among Latinos may increase. 9 , 10 Latino smokers report that they smoke an average of 8 cigarettes per day (women) and 12 cigarettes per day (men). These figures compare with an average of 19.1 and 23.4 cigarettes per day reported by White women and men, respectively. 1 Although a smaller proportion of highly acculturated Latino men smoke, they report smoking a larger number of cigarettes per day than less-acculturated Latino men. 7 , 11 Among Latino women, an increased level of acculturation is associated with a higher rate of smoking and, among smokers, with a larger number of cigarettes smoked per day. Latino smokers may underreport their daily consumption of cigarettes to some extent, but biochemical studies support the self-report data that Latinos smoke fewer cigarettes per day than Whites. 12 – 14 These observations have important implications for cessation strategies, because light smokers are more likely to quit smoking successfully with appropriate motivational messages and self-help methods. 15 As part of the National Hispanic Leadership Initiative on Cancer: En Acción program, we conducted a survey of Latino adults to examine cigarette smoking behavior. 16 Our objective was to evaluate smoking rates, smoking behavior, and the proportion of former smokers by national origin group and demographic predictors. This is the first study to compare smoking rates in a large sample of Latinos from 6 major national origin groups.
