A Multilevel Approach on Determinants of Smoking Behavior for Individual, School and Neighborhood Effects among Asian American Adolescents

The purpose of this study is to identify determinants of smoking behavior among Asian American adolescents. The sample includes 1584 Asian American adolescents in grades 7 to 12 that participated in Wave I of the National Longitudinal Study of Adolescent Health as a nationally representative data. Hierachical Linear Model and SAS 9.1 are employed to define determinants of adolescent smoking behavior.

In the lifetime smoking experience, peer (OR=2.31) and parental smoking (OR=2.06) are positively associated with adolescent smoking behavior. The most acculturated group is more likely to smoke cigarettes than the least acculturated group (OR= 2.37). Within school level, adolescents are less likely to smoke cigarettes when school or school districts include rules or policies against student tobacco use. In neighborhood level, if state that does not have restrictions for vending machine of tobacco is strongly and positively associated with adolescent smoking than state does have restrictions. However, the requirement of school offer for tobacco use prevention, median household income and crime rates are not associated with smoking behavior.

Within current smokers, the strongest factor is acculturation. The most acculturated group tends to smoke more cigarettes than their counterpart (OR=4.27). Adolescents with friends who smoked cigarettes are more likely to smoke cigarettes (OR=4.25). Parental smoking influenced adolescent smoking behavior (OR=2.82). School and neighborhood level factors do not associated with current smoking cigarettes.

Acculturation toward adolescent cigarette smoking must be considered for implementing interventions and education. School policies and State vending machine restrictions should be emphasized to reduce adolescent smoking behavior.