Immigration and smoking initiation in the Mexican-origin population in the United States

One in five deaths in the U.S. is believed to be smoking related, with minority groups bearing the greatest health burden. Of particular concern has been the finding that smoking risk rises among Mexican Americans between the first and later generations. The primary explanation for this pattern has been acculturation. This study investigates an alternative explanation – that economic pressures associated with immigration, due to factors such as limited labor market access, result in declines in smoking risk among Mexican immigrants, relative to risk in Mexico. As these pressures ease in the second and later generations, smoking risk would be expected to increase relative to Mexican immigrants. Data come from the 2005 National Health Interview Survey, a cross-sectional, nationally representative survey of the U.S. population. The analysis sample included 932 Mexican immigrants and 1,406 U.S.-born Mexican Americans. Discrete-time hazard models were used to estimate risk of initiation of regular smoking from ages 10 to 30, using immigration status (resident in the U.S. or Mexico) as a time-varying covariate. Findings suggest Mexican immigrants are less likely to initiate smoking after immigration than while in Mexico (males, OR=0.54; 95% CI 0.34, 0.88; females, OR=0.25; 95% CI 0.14, 0.46). Risk of initiation of regular smoking increases among U.S.-born Mexican Americans relative to Mexican immigrants (males, OR=1.41; 95% CI=1.09, 1.82; females, OR=2.49; 95% CI 1.60, 3.86). These findings suggest that patterns of smoking initiation in the Mexican-origin population in the U.S. may be related to pressures associated with immigration, rather than exclusively due to acculturation.