This cross-sectional study examined the relationships between household smoking restrictions and intentions to quit smoking among Korean American male smokers in California. We used data from the California Korean American Tobacco Use Survey (CKATUS), which was conducted in 2004 using computer-assisted telephone interviewing. Among the 2,545 respondents who participated in the CKATUS, the 387 male smokers who answered a question assessing their intention to quit smoking were included in the final analyses. In univariable analyses, smokers who reported having household smoking restrictions were more likely to intend to quit smoking as compared with those who did not (
As secondhand smoke has been found to be a health risk to non-smokers, household smoking bans as well workplace smoking bans have become common in the United States. The prevalence of household smoking bans has increased from 43% in 1993 to 61% in 1999 (
According to the 2005 California Health Interview Survey (CHIS), 31% of Korean American (KA) men were current smokers (
Given this higher smoking rate among KA men, household smoking restrictions could be of particular relevance to this community. The aim of this study was to estimate the prevalence of household smoking restrictions and to examine the relationship between them and the intention to quit smoking among KA male smokers in California, using data from the California Korean American Tobacco Use Survey (CKATUS), which was conducted to identify tobacco use behavior among adults of Korean descent residing in California (Korean Californians) (
The CKATUS was conducted between 2003 and 2004 to assess tobacco knowledge, attitudes, and behavior among 2,545 adults of Korean descent residing in California, using computer-assisted telephone interviewing (CATI) (
The methodology for this survey has been presented elsewhere (
The sample was modified to reflect gender proportions by region only, because the number of second generation Koreans residing in California was too small to locate enough individuals to achieve the original sampling design. To compensate for selection bias (which is the unequal probability of one person being selected into the sample over another person), and provide representative population estimates, we used a weighting technique. Data were weighted by number of adults per household, number of residential telephone lines, and region to represent the population characteristics of KAs in California.
The survey included questions from the California Tobacco Survey (CTS) (
We used the CKATUS data for the current study and received an exemption from the Institutional Review Board at the University of California, Berkeley because these data are publicly available and individual data are not identifiable.
Among the 2,545 total respondents (i.e., men and women) who participated in the CKATUS, 15.3% were current smokers. Of the current smokers, 387 adult men were included in the final analysis based on smoking at least 100 cigarettes in their lifetime, smoking everyday or some days at the time of the interview, and having responded to a question about their quitting intentions.
We evaluated participants' intention to quit smoking with the question, "What best describes your intentions regarding quitting? Would you say you...," "Are planning to quit in the next 30 days," "Contemplating quitting in the next 6 months," "May quit in the future, but not in the next 6 months," or "Never expect to quit." For the analysis, this was coded as a binary variable: any of the first three response categories was defined as having an "intention to quit," and the last response category was defined as "not having an intention to quit."
Household smoking restrictions were evaluated with the question, "What are the smoking rules or restrictions in your household, if any?" The four possible responses were, "Smoking is completely prohibited," "Smoking is generally banned for everyone with few exceptions," "Smoking is allowed in some rooms only," or "There is no restriction on smoking." This was coded as a binary variable: the first three response categories were defined as having "complete or partial ban on smoking," and the last response category was defined as "no restrictions on smoking."
Acculturation can be broadly defined as the cultural modification of an individual, group, or people by adapting to, or borrowing, traits from another culture (
We used weighted data to compensate for non-response bias and to provide representative population estimates. A Pearson chi-square test for categorical variables and a two-sample t-test for continuous variables were used in the univariable analyses to evaluate the association between smoking restrictions (complete or partial restriction vs. no restriction on smoking) or sociodemographic variables and intention to quit. We also conducted a multiple logistic regression to adjust for potential confounding including age (>45 yr vs. 18-44 yr), annual household income (>US$ 50,000 vs. ≤US$ 50,000), education (≥college graduate vs. <college graduate), proportion of life spent in the US (>50% vs. ≤50%), and number of smokers in the household (1 vs. 0, 2 or more vs. 0). Considering the multicollinearity among proportion of life spent in the US, generation, and acculturation, only the variable of proportion of life spent in the US, which was considered to be more objective and significant, were included in the final model. Odds ratios (OR) and 95% confidence intervals (CIs) were calculated using Stata SE 10.0 svy commands to adjust standard errors for the complex survey sample design (StataCorp, College Station, TX, USA). All statistical tests were two-sided, and we considered
Forty-one percent reported that they might quit smoking in the future, but not in the next 6 months, while 19.8% never expected to quit. Regarding smoking restrictions, 17.4% had households with no restriction on smoking, while 82.6% lived in households where smoking was completely or partially prohibited (40.2% and 42.4%, respectively; data not shown in
As shown in
In this cross-sectional survey of KA adult male smokers in California, we found that household smoking restrictions were associated with having an intention to quit smoking. This finding is similar to those of previous studies (
We also found that those who lived with 2 or more other smokers were less likely to intend to quit smoking, and those who were more educated were more likely to intend to quit smoking. Other significant factors associated with an intention to quit from univariable analyses included age and proportion of life spent in the US. Also, higher education and younger age had marginally significant associations with intentions to quit smoking. Several previous studies have reported that the intention to quit smoking was more prevalent among those who were younger, had higher income, and smoked fewer cigarettes per day (
Smokers who were linguistically assimilated and spent more than half of their life in the US were more likely to have an intention to quit smoking. These findings may be due to different social norms about smoking in the US and their country of origin (in this case, Korea). According to the Organisation for Economic Cooperation and Development (OECD) 2001 Health Data, current smoking prevalence of adult men in Korea (52.9%) was much higher than in the US (20.3%) (
Also, we performed univariable analyses and a multiple logistic regression analysis based on a different operationalization for the outcome variable (i.e., intention to quit in the next 6 months-stages of contemplation and preparation vs. no intention to quit in the next 6 months-stage of precontemplation). However, there was no significant association between household smoking restrictions and having an intention to quit smoking (
Our study had several limitations. First, due to the cross-sectional nature of the survey, we are unable to assess whether the smoking restrictions in the household led to having an intention to quit smoking or vice versa. We were neither able to evaluate the causal direction between household smoking restrictions and intention to quit smoking, nor test the relationship between household smoking restrictions and successful smoking cessation. Although two longitudinal studies (
In conclusion, we found that household smoking restrictions are associated with an intention to quit smoking among KA adult male smokers in California. The results suggest that the adoption of smoking bans in the household could encourage smokers to quit.
The present article has been revised of its references based upon the erratum record in JKMS 2010;25(6):984.
This project was funded by the Centers for Disease Control and Prevention through Cooperative Agreement #U48/DP000033. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention.
Sample characteristics and comparison by intention to quit*(n=387)
*Participants were adult men current smokers among the 2,545 respondents in the California Korean American Tobacco Use Survey; †The relationship between this variable and 'intention to quit' variable was evaluated for only 298 subjects due to missing data.
Percentages (%) and
Independent correlates of having an intention to quit smoking from the multiple logistic regression analysis (n=387)*
*OR and 95%CI were calculated from analyses of complex survey design and were adjusted for age, annual income, education, proportion of life spent in the US, smoking restrictions in the household, and number of smokers in the household, using weighted data.
OR, odds ratio; CI, confidence interval.