Why Asian Culture May Be Promoting Social Smoking

January 7, 2019

Editor’s Note: This post is sponsored by TobaccoFreeCA.

Smoking is becoming a big problem for Asian Americans. All the leading causes of death for Asian Americans and Pacific Islanders (AAPIs) — lung cancer, heart disease and stroke — can be caused by smoking cigarettes, according to the CDC.

But what many don’t often realize is that AAPIs are particularly vulnerable to social or occasional smoking, where many don’t consider themselves smokers, but will have a cigarette, vape, or smoke hookah once in a while with friends or at parties. So what is it that draws Asian Americans into this unhealthy social trend?

We spoke to the experts at Asian Smoker’s Quitline to learn more about why Asian Americans start smoking in the first place.

First a little background: ASQ is a completely free service funded by the CDC and based at the University of California, San Diego. ASQ counselors provide their services in Chinese, Vietnamese, and Korean, and work by identifying the caller’s reasons to quit to create a tailored plan for them. ASQ also provides a free starter kit of nicotine patches for those who are eligible.

Since 2012, ASQ has worked with over 13,600 smokers, most of whom are men.

ASQ told us that the majority of Asian Americans start smoking because their family or friends do. Curiosity, because it “looked cool,” and stress were also other reasons that led Asian Americans to become regular smokers. They explained:

“In Asian culture, there is a strong social connection which can carry an expectation of smoking, whether at a family or social gathering, or in a work setting. For example, it is common for business partners to make deals while they smoke and drink together. There can also be expectations based on age or position in the workplace. Younger or junior-level staff are expected to accept cigarettes offered by elders or senior staff. Whether at work or in social situations, people who reject the offer of cigarettes may not be treated as part of the group.”

In many Asian countries, tobacco products are still heavily glamorized and have become a big part of the culture to the point where cigarettes are seen as valuable gifts — rejecting cigarettes can often be seen as rude, making it all the more difficult for people trying to quit. What was most shocking, however, was when the ASQ staff revealed that many Asians have serious misconceptions about the health effects of smoking — they don’t view smoking cigarettes as dangerous:

“Some see smoking as protective, and quitting as something that causes illness. Withdrawal symptoms like fatigue, coughing, irritability and gastrointestinal discomfort can be misconstrued evidence that quitting causes illness, rather than a natural course for the body becoming healthier.”

By this point, we get this sobering realization that it might be Asian culture that makes Asian Americans more vulnerable to developing smoking habits.

While smoking trends in Asia don’t match those in America, the acceptance of cigarettes and smoking has still found its way here in the U.S. among Asian immigrants who are responsible for Asian Americans being the fastest growing ethnicity in America. Studies have proven that Asian men in particular who are less acculturated had higher smoking rates than Asian men who were more familiar with American culture.

Those who don’t consider themselves smokers still find themselves in social smoking settings like going to hookah bars with friends, smoking just one or two cigarettes at a party or club, trying a friend’s vape, or sharing a cigarette with a coworker or family member. The most dangerous part about it, however is that many social smokers don’t consider that “once in a while” smoking habit to have harmful health effects.

Dr. Shu-Hong Zhu, Professor of Family Medicine and Public Health at the University of California, San Diego, reinforced the fact that smoking just one cigarette triples the risk of cancer:

“Every cigarette can be harmful to cardiovascular health. And, even if people smoke only a little, they are still exposing themselves to nicotine, the addictive substance in tobacco.”

But just as the social and family-oriented nature of Asian culture makes it easy for Asians to start smoking, it can also be their greatest strength in quitting. Dr. Gary Tedeschi, a Clinical Director for ASQ at UCSD explains how positive social support from families is the greatest weapon in helping Asian Americans to stop smoking:

“Valuable strategies include asking the smoker what would be most helpful and expressing empathy and understanding. If a friend or family member can become a supportive companion, it will help smokers to make quit attempts and stay quit!”

In California, anti-smoking programs have helped the state to have the second-lowest smoking rate in America after Utah. California also has the highest number of Asian Americans by state and the second-highest percentage after Hawaii, according to 2015 Census Bureau estimates. Education and counseling on the harmful effects of smoking and other addictive nicotine products must be tailored for Asian American communities to spread awareness and change cultural norms for the better, ASQ explained:

“Even if the smoker is not dependent on the nicotine, they are still dependent on smoking in some way.

“They can begin to see that even occasional smoking can get in the way of having the healthiest lifestyle possible. And even more, by quitting altogether they can be a great example for their children, grandchildren or other family members.”

Stop before you have to quit. Learn more about the dangers of social smoking at NeverJustaSmoke.org.

For help quitting, visit ASQ online or call their phone service available Monday – Friday 7:00 a.m. to 9:00 p.m. Pacific Time in Chinese (1-800-838-8917), Korean (1-800-556-5564), or Vietnamese (1-800-778-8440). You can also visit the California Smokers’ Helpline at www.nobutts.org or call 1-800-NO-BUTTS.

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