Differences in Tobacco Use Among a Sample of At-Risk Chinese, Filipino, and Vietnamese Adult Men Living in the SF Bay Area.

BACKGROUND: Smoking among Asian men has been studied, but differences in tobacco and cigarette use among US- and non-US-born Asian subgroups, especially those at risk for substance use or sexually transmitted diseases, has not been well-studied. AIMS: To learn about the smoking of cigarettes or blunts among Asian ethnic groups, and whether place of birth, age, or primary language spoken at home is associated with smoking. METHODS: Study participants were 125 adult (age > 18 years) Chinese, Filipino, or Vietnamese men living in San Francisco, Daly City, or San Jose, California, who self-reported substance use in the past 30 days. Information collected included sexual orientation, past year contact with the criminal justice system, place of birth, and primary language spoken at home. Bivariate analyses were used to compare the differences in self-reported smoking of cigarettes or tobacco-marijuana blunts by ethnicity, age, place of birth, and primary language spoken at home. RESULTS: Filipinos had significantly higher rate of cigarette use (51%; P = .02) and smoking blunts (28%; P = .02) compared with Chinese (23% and 5%, respectively) or Vietnamese (34% and 17%, respectively); US-born Filipinos also had more days of cigarette use in the past 30 days (16 days; P = .05) compared with Chinese (8 days) or Vietnamese (6 days) participants. CONCLUSIONS: This study found differences in self-reported rates of cigarette and blunt use among Asian ethnic groups which suggest opportunities for targeted interventions. Future studies of tobacco or blunts use for these largely immigrant groups should take into account country of birth and language spoken at home in developing tobacco prevention services for this population.

Prevalence and Correlates of Current and Former Smoking among Urban Transit Workers.

Transit workers constitute a blue-collar occupational group that have elevated smoking rates relative to other sectors of employed adults in the United States. This study analyzed cross-sectional tobacco survey data from 935 workers (60% African American; 37% female) employed at an urban public transit agency in California. Prevalence of current and former smoking was 20.3% and 20.6%, respectively. Younger workers were less likely than older workers to be current or former smokers. Having a complete home smoking ban was associated with decreased likelihood of being a smoker [odds ratio (OR) = 0.04, 95% confidence interval (CI) = 0.01-0.17], as were neutral views about whether it is easy for a smoker to take a smoking break during their shift (OR = 0.50, 95% CI 0.28-0.88). Current smoking among the sample is > 50% higher than the adult statewide prevalence. Potential points of intervention identified in this study include perceived ease of worksite smoking breaks and establishing home smoking bans. Tailored cessation efforts focusing on older transit workers more likely to smoke are needed to reduce tobacco-related disparities in this workforce.

Use of Marijuana Edibles by Adolescents in California.

We explored how adolescent marijuana edible users differ in regards to marijuana use and related beliefs from marijuana users who do not use edibles. We analyzed California Healthy Kids Survey data collected in one Northern California school district with a racially and ethnically diverse student population. Survey respondents were youth in grades 9-12. Overall, 33% of respondents reported having used marijuana in their lifetime, and 50% of lifetime marijuana users reported using marijuana in the past 30 days. Seventy-two percent of lifetime marijuana users and 82% of past month marijuana users reported having used edibles in their lifetime. Comparing marijuana users who have never used edibles to those users who have, we found that edible users reported using marijuana more frequently in their lifetime. Edible users were also more likely to have used marijuana in the past 30 days, more frequently in the past 30 days, more likely on school property and more frequently on school property. Edible users and non-users differed in their perceptions of risk; edible users were less likely to agree that edible use is very risky. Edible users also reported a younger age of first marijuana use and more attempts to stop using marijuana than non-edible users. Multi-level regression analyses indicate that prevalence of edible use among marijuana users was related to perceived risk of edible use. Perceived risk of edible use among marijuana users was higher among marijuana users who do not use edibles, females, and those youth who perceive school rules to be clear. The findings indicate that prevalence of edible use is high among marijuana users, especially frequent users.

Teen Use of Marijuana Edibles: A Focus Group Study of an Emerging Issue.

Recent research indicates that marijuana-infused food product (i.e., edible) use is becoming nearly as common as smoking marijuana where medical marijuana is available. This study explores edible use among teens. We conducted four focus groups in the San Francisco Bay Area with youth, ages 15-17. The focus groups were divided by gender and whether they used marijuana. Some teens mentioned edible use at school. Youth reported that teens consume edibles, primarily to reduce the likelihood of getting caught. Edibles are also attractive to those who do not like to smoke or have concerns about smoking. Both male and female respondents suggested that females are more likely than males to prefer edibles over smoking, one reason for which may be to avoid smelling like marijuana smoke. For some young women, edibles may be a way to avoid publicly presenting themselves as marijuana users. Findings also suggest that youth have access to edibles through multiple sources. Youth reported that they can purchase edibles at school from other students who either make the edibles themselves or are reselling edibles obtained from dispensaries. Both users and non-users were aware of potentially negative consequences related to edible use. Some youth mentioned that they have heard of youth dying from edibles, and several reported being concerned about the high produced by edibles. Female non-users appeared to be more concerned than others about edibles and compared them to drinks that could be spiked with drugs. However, sentiment among some male marijuana users was that if you cannot handle edibles you should not be using them. These findings suggest that strategies to curb access to edibles and use among youth, such as restricting sales of edibles with strong youth appeal and educating youth on the risks of edibles, will need to be developed.

Smoking cessation among transit workers: beliefs and perceptions among an at-risk occupational group.

BACKGROUND: Transit workers, in comparison to the general population, have higher rates of smoking. Although smoking cessation programs are often available through workers' HMOs, these programs are frequently underutilized. Quitting practices, including participation in cessation programs, are often associated with beliefs about smoking behaviors and the ability to quit. We analyzed how transit workers' beliefs about cessation might function as barriers to or facilitators of participating in cessation activities. FINDINGS: We conducted 11 focus group discussions with 71 workers (45% female; 83% African American) at an urban public transit agency. Most participants (83%) were bus operators. Only current smokers and former smokers were recruited. Both current and former smokers recognized the need to quit and some were familiar with or at least aware of cessation programs and pharmaceutical aids offered through their HMO. Many, however, believed there were factors, such as smoker's readiness to quit, recognition of the elements of addiction, and personal or observed experience with cessation, that facilitated or impeded successful quit attempts. CONCLUSION: Beliefs play an important role and influence the extent to which transit workers participate in smoking cessation. Being cognizant of and addressing these beliefs so that workers gain an informed understanding is important when designing cessation programs. Doing so may help in creating tobacco cessation efforts that are seen as both attractive and beneficial to transit workers.

Evaluating the implementation process of a citywide smoke-free multiunit housing ordinance: insights from community stakeholders.

We evaluated the implementation process of Richmond, California's citywide smoke-free multiunit housing ordinance. We conducted semistructured focus groups with multiunit housing tenants, owners, and managers. Residents understood the harms of secondhand smoke but lacked accurate information about the ordinance and questioned its enforceability. They shared concerns that the city lacked cessation resources for smokers wishing to quit because of the ordinance. To increase compliance with the ordinance, tenants, owners, and managers need accurate information.

Correlates of HIV and HCV risk and testing among Chinese, Filipino, and Vietnamese men who have sex with men and other at-risk men.

Asian Americans are one of the more under-researched groups in the United States. This holds true with regard to research on risk assessment, screening, and testing for human immunodeficiency virus (HIV) and hepatitis C (HCV). Here, we address that lack by exploring correlates of risk and testing for the two diseases among Chinese, Filipino, and Vietnamese men who have sex with men (MSM) and other at-risk men in the San Francisco Bay Area. We do so by analyzing findings from the study of a community-based prevention program, Project 3-3-3 (P333), designed to address the often comorbid conditions of substance abuse, HIV infection, and HCV infection among underserved and high-risk Chinese, Filipino, and Vietnamese adults, most of whom are MSM. A risk-behavior survey completed at preintervention identified risk factors related to HIV, HCV, and substance use among this population (n = 273). The study of survey data identifies and distinguishes between correlates of HIV and HCV testing. Among our findings, significant differences were found between Asian ethnic subpopulation groups with respect to number of sexual partners (p = .007), and HIV testing rates comparing MSM and heterosexual men differed significantly (p < .002). Those who spoke English at home were more likely to be tested for HIV (p < .008). With HCV testing, the number of partners was positively correlated to getting tested (p < .047), and Filipino men were significantly more likely to get tested for HCV than Chinese men (p < .022).

Substance use among Chinese, Filipino, and Vietnamese adult men living in San Jose, Daly City, and San Francisco, and its implications on ATOD prevention services.

This intervention study collected data on Chinese, Filipino, and Vietnamese high-risk adults to ascertain similarities and differences in drug use patterns. Study participants (N = 126) participated in a 5-week intervention study to mitigate substance abuse and the prevalence of hepatitis C and HIV among high-risk adults in San Francisco, San Mateo, and Santa Clara Counties of California. Data reported were collected at baseline. The National Outcome Measures questionnaire was used to document individual substance use in the past 30 days. Filipinos reported higher use rates for alcohol, cigarettes, marijuana, and crack cocaine in the past 30 days compared with their Chinese and Vietnamese counterparts; these differences proved to be statistically significant (p ≤ .03). Data analysis also showed that the alcohol use of Filipino and Vietnamese homosexual men was significantly greater than their Chinese counterparts (p = .04). A statistically significant inverse association was found for alcohol use for those in the criminal justice system during the past 30 days (odds ratio [OR] = 0.37, p = .03). In addition, a positive association for other tobacco use (OR = 11.98, p = .00) was reported for those in the criminal justice system. Age group analyses indicated a positive association for those between 18-25 years old for alcohol use (OR = 5.40, p = .00). These data confirm the importance of disaggregation of data. If collapsed into a general Asian or Asian and Pacific Islander ethnic group category, as is often the case, the unique behaviors of the individual groups would be lost.

Thizzin'-Ecstasy use contexts and emergent social meanings.

The drug "Ecstasy" has been most commonly associated with raves, or electronic music dance events, and attributed with sexual disinhibition. In an ethnographic investigation of drug use among second-generation Southeast Asian youth in Northern California (2003), respondents described little use of or interest in using Ecstasy; yet in a second study, Ecstasy was the fourth most commonly-used substance. This paper investigates the social contexts for this change in use patterns. Respondents were second-generation Southeast Asian youths and young adults between the ages of 15 and 26 who were currently or recently drug-involved. We compared qualitative data from the two studies and found emerging patterns of meaning and context related to the observed change in use patterns. Ecstasy use among co-resident African American youth within the context of the local "hyphy" hip-hop music subculture had influenced Southeast Asian youths' uptake of the drug, known as "thizz." Respondents referred to the effects of the drug as "thizzin'," described as energizing, disinhibiting, numbing, and emotion enhancing. Reported consequences of "thizzin'" included violence and aggression as well as fun, while sexual disinhibition was rarely mentioned. The meanings assigned to drugs, including the effects ascribed to them, may be relative to the social contexts within which users are exposed to and consume drugs. The findings indicate the susceptibility of youths to local trends in drug use, particularly associated with popular cultural movements and music. Second-generation youths may be particularly susceptible relative to the conditions of their immigration and processes of identity formation unique to them.

Knowledge of tobacco control policies among U.S. Southeast Asians.

Some of the highest smoking rates in the U.S. have been reported among Southeast Asians. The largest numbers of Southeast Asians reside in California. While California has a comprehensive and generally effective tobacco control program, it is unclear how immigrant groups learn of this public health effort. In a study of tobacco norms and practices among two generations of Southeast Asians we collected qualitative data on respondents' knowledge and awareness of tobacco control policies. Data were collected through in-person interviews with 164 respondents aged 15-87, evenly divided by smoking status, gender and generation in the U.S. Due to multiple sources of knowledge, general awareness of tobacco control policies and of secondhand smoke were high among both generations of Southeast Asians and the policies were attributed with changes in smoking behavior. Tobacco control regulations may be an effective means to impact tobacco use among immigrants with limited English proficiency.

Alcohol use among two generations of Southeast Asians in the United States.

This article assesses the drinking norms and practices of two generations of Southeast Asians in the East San Francisco Bay Area. Researchers included quantity and frequency measures of current alcohol use and binge drinking and open-ended questions on drinking norms and behaviors in a mixed-method study of tobacco use. The study generated data through in-person interviews with 164 respondents from two urban East Bay neighborhoods. The findings include normative drinking among women and underage youth, with binge drinking among underage youths particularly troubling. Preventive interventions for this population should consider community-level alcohol problems as well as individual alcohol use disorders.