Ethnic enclaves, acculturation, mental health, and tobacco use among California Asian Indian immigrants

Background: Little is known about the impact of ethnic enclaves, acculturation, and mental health on tobacco use among Asian subgroups. Among women in India, conventional uses (e.g., cigarettes) are lower and traditional uses (e.g., chewing tobacco) are higher than in the U.S.

Methods: Study aims include understanding how ethnic enclaves, acculturation, and mental health status impact conventional and traditional use on an immigrant subsample of California Asian Indians (N=2209) based on a representative telephone statewide survey. Regression models stratified by gender were conducted on: ever use of traditional tobacco use (TTU), and ever use of conventional tobacco (CTU).

Results: Zip codes were geocoded and grouped to identify ethnic enclaves. Fixed effects logistic regression models accounting for enclaves were not significant. However, individual-level characteristics in logistic regressions showed variation in tobacco use by gender. All models controlled for age, educational status, religion, and language. For women, odds increased with greater percent of life in the US (TTU: OR=1.01; CTU: OR=1.02; p<.05). Mental health was not a significant predictor for women. For men, mental health was related to use (TTU: OR =1.68; CTU: OR=2.13; p<0.05). Religiosity was related to lower odds for both men (CTU: OR=0.873; p<.05) and women (TTU: OR=0.855; CTU: OR=0.703; p<.05).

Conclusion: Public health efforts designed to reduce tobacco use in immigrant populations should take into account the influence of religiosity, mental health status, gender, and the degree of acculturation on tobacco use by Asian Indian immigrants. Considering these factors may improve community-level health services and programs for immigrants.