The Interactive Influence of Gender, Acculturation, and Education on Current Smoking Among Latinos of Differnt National Backgrounds

Introduction: Latinos are the largest racial/ethnic group in the country, diverse in national background and health behaviors, and have a low overall smoking prevalence of 10.4%. However, smoking prevalence is known to differ by gender, national background, acculturation level, and educational attainment. Research has assumed that as Latinos acculturate, they will smoke at higher rates. Efforts to prevent smoking among Latinos may be aided by understanding how acculturation and education interact with gender and national background. The present study investigated the relationship between acculturation level, educational attainment, and cigarette smoking by gender and national background among diverse Latinos.

Methods: Data from the 2009-2012 National Health Interview Survey were analyzed and included gender, national background, acculturation level, educational attainment, and current smoking. Participants included 1,111 Cubans, 813 Dominicans, 13,281 Mexicans, and 2,197 Puerto Ricans. Multivariable logistic regression, adjusted for age and marital status, was used to model acculturation and educational predictors of current smoking, stratified by gender and national background. Independent variables included acculturation level and educational attainment. Stratifying variables included gender and national background. The main dependent variable was current smoking, as defined by self-reported cigarette smoking every day or some days among those who ever smoked at least 100 cigarettes. Survey data analysis procedures, using sample weights, were conducted in Stata, Version 11.2.

Results: Most respondents were interviewed in English (62%) and had a high school education or less (60%), but only 39% were U.S. born. Overall, 17.8% men and 9.6% women reported current smoking. By national background, smoking prevalence was highest among Puerto Ricans (16% of women and 23% of men) and lowest among Dominicans (6% of women and 10% of men). More acculturated Mexican women and men had significantly higher odds of current smoking (aOR=2.94; 95% CI=2.01, 4.31 and aOR=1.62; 95% CI=1.23, 2.14; respectively). Mexican men who were more acculturated and educated had lower odds of smoking (aOR=0.66; 95% CI=0.48, 0.92) compared to their less acculturated and educated counterparts.

Conclusions: The relationship between acculturation and health behaviors among Latinos is influenced by education and both factors, in addition to gender and national background, and should be considered by prevention practitioners when developing or adapting tobacco control strategies.

Acknowledgments (Required by NIH): This study was funded in part by the Intramural Research Program of the National Heart, Lung, and Blood Institute, National Institutes of Health.