Smoking Behavior Among Immigrants from the Former Soviet Union
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Description of cigarette smoking behavior and beliefs in high risk ethnic groups is a critical step to bringing cultural considerations into tobacco cessation interventions. This study focused on variables related to smoking behavior among immigrants from former Soviet Union (FSU) countries, with high smoking prevalence (53-63% men), now living in Ohio. A qualitative perspective was gained from interviews in addition to a larger study of quantitative data, employing a descriptive correlational design with 80 participants, including men and women, smokers and non-smokers.
Variable selection was guided by The Biobehavioral Model of Tobacco Use, which depicts biological and behavioral factors both influencing and being influenced by tobacco use. Study variables included depressive symptoms, stressful life antecedents, acculturation, acculturative stress, level of tobacco use, salivary cotinine (the major nicotine metabolite), nicotine dependence, and the cultural context of smoking (decisional balance and reasons for smoking). Cross-sectional data was collected in community settings among those immigrating within the last 20 years.
Qualitative interviews in a subset of the sample of smokers and former smokers (n=14) helped to illuminate attitudes toward smoking and cessation. Data emphasized the importance of social factors and stress management for smoking behaviors in this culture. Personal will-power was the most helpful cessation strategy identified, with a firm lack of openness to pharmacologic approaches expressed. The importance of social connectedness was a strong theme.
Quantitative results with 80 participants found high identification with both dominant and ethnic cultures, though ethnic identification was significantly higher. The average acculturative stress score reflected moderate levels, despite an average of 12 years since emigration. Acculturative stress was significantly higher in those under 60 years old. Neither acculturation nor acculturative stress were significantly correlated with numbers of years since immigration. Fifty-two percent scored above the depressive instrument cut-off score for further evaluation. Depression was negatively correlated with dominant society immersion and positively correlated with ethnic society immersion. Depression score was positively correlated with acculturative stress score.
In the current smokers (n=26), depression was negatively correlated with number of cigarettes smoked per day (CPD). The smokers had a positive correlation between depression score and ethnic identification. A regression model including the Craving and Habit subscales from the Reasons for Smoking scale and depression score best predicted CPD, explaining 68% of the variance. Those who reported higher levels of Craving and Habit and less depressive symptoms reported a higher CPD. Cotinine level was predicted by an indicator of nicotine dependence, time to first cigarette of the day.
Smoking cessation interventions should address acculturative stress within a cultural context that identifies strongly with both ethnic and American culture. In this culture where smoking may be an important part of stress management and social connectedness, smoking may provide protective effects against depressive symptoms, for which FSU immigrants appear to be at risk. Smoking cessation interventions must include replacing the social and coping functions of smoking with healthier alternatives. Research explicating mechanisms by which potentially health damaging social influences can be ameliorated without damaging beneficial effects of social support is needed.
Document number: osu1218638322
Permalink: http://rave.ohiolink.edu/etdc/view?acc_num=osu1218638322
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