Young Rae Kim
New America Media

Smoking rates have been steadily declining for decades in the United States, thanks to increased restrictions, higher taxes on tobacco products and effective anti-smoking campaigns in the media and at schools. But for Korean Americans, as well as other Asian communities, the rates have remained at high levels.

That is reason for concern because the three leading causes of death for Korean Americans—cancer, heart disease and stroke—are all associated with smoking. Smoking is also the leading cause of preventable illness and death in the U.S., accounting for one in five deaths, according to the national Centers for Disease Control and Prevention. The harmful health effects of smoking are common knowledge, and though an estimated 80 percent of Korean American smokers want to quit, according to a recent survey, the addiction has a stronger grip than people realize.

“It’s a tough habit to break. Tobacco use and smoking are an addiction, and I think for the Asian American community, in particular, there are a lot of challenges,” said Rod Lew, the founder and executive director of Asian Pacific Partners for Empowerment, Advocacy and Leadership (APPEAL), a group that aims to reduce health disparities in the Asian Pacific American community. APPEAL has been working with APA communities across the country for 20 years, said Lew, trying to build their expertise on why there is high tobacco use and ways to counter the trend.

“We need to be able to get messages to them through resources that are culturally appropriate,” he said. Lew’s group recently released an 88-page report that provides new data and insights about tobacco use among Asian American and Pacific Islander communities, and also discusses effective approaches to combating smoking in these communities.

The special journal supplement, Promising Practices to Eliminate Tobacco Disparities Among Asian American, Native Hawaiian and Pacific Islander Communities, was done in collaboration with the bimonthly health journal Health Promotion Practice.

This is only the second time a report of this kind, dedicated to AAPI communities, has been released, said Lew.

“It’s a historic document that has within it several articles that talk about what works around tobacco prevention and control in our communities,” he said.

One of the more alarming statistics in the report is that Asian Americans had the highest rates of smoking out of any ethnic group surveyed in New York City in 2009. While most ethnic groups experienced a significant drop in smoking rates between 2002 to 2010, the smoking rate for Asian men stayed relatively the same, at 17 percent.

Lew noted, in reality, this number could actually be much higher. Mainstream research studies have estimated that only 9 percent of Asian Americans (men and women) smoke nationally, but Lew says the figure is inaccurate because it is based on surveys usually conducted in English, with a small number of Asians included.

Mainstream studies also tend to lump all Asian groups together, despite the great diversity within the Asian Pacific Islander communities. That’s why, he said, it’s important that research also looks at the distinct profiles of AAPI sub-ethnic groups, as the APPEAL report did.

According to that report, an estimated one-third of Korean Americans today are smokers. The study also revealed that second-generation Korean Americans are more likely to be smokers than first-generation Korean Americans. This figure was surprising, given the fact that second-generation Korean Americans, having been raised in the U.S., were exposed to aggressive anti-smoking campaigns in the past decades and, it is assumed, would have a higher awareness of the health consequences of tobacco use than the immigrant generation.

Lew believes this high rate among the second generation can be explained, in part, by a notable spike in the number of female Korean American smokers over the years, and that increased the overall number. During the height of the tobacco industry’s campaign to target Asian American females, a 1990s Lorillard Tobacco Company internal memo revealed its corporate strategy to capture this emerging market: “The literature suggests that Asian American women are smoking more as they believe they should enjoy the same freedom as men.” Lew suggested that we are now experiencing the consequences of the tobacco industry’s successful marketing to Asian American females.

Anti-tobacco efforts meanwhile are not effectively reaching segments of the Asian American community, said Lew. “We need to be able to get messages to them through resources that are culturally appropriate,” he said. Informing parents about the harmful impact that smoking has on children has proven an effective tool with Asian American communities. Lew also said APPEAL provides a smokers’ quit phone line that is available in different Asian languages. This development is fairly new outside of California and has allowed smokers to call in and get information, telephone coaching and, often, access to free nicotine replacement medicines that help smokers end their addiction.

The group also advocates for legislation banning smoking in public places. Almost half of all states currently require smoke-free indoor air, a policy that experts say is an effective deterrent to tobacco use. However, a challenge for the Korean American community has been the lax enforcement of secondhand smoking laws. Despite regulations prohibiting smoking in public places in California, it is not uncommon to walk into a Koreatown restaurant or bar and see patrons unabashedly lighting up.

Yet, that picture contrasts sharply with Korean American public opinion at large. According to the APPEAL report, 83.4 percent of Korean Americans strongly prefer to eat in a smoke-free restaurant, and 96 percent strongly agree or slightly agree that second-hand smoke is harmful.

While having the laws in place is a good step forward in reducing secondhand smoke, Lew emphasizes that it is also important to do grassroots education.

“I think that is a combination of working with Korean community leaders, as well as doing what we call ‘changing the community norms’ around smoking, so that members within the Korean communities recognize that it is not safe or appropriate to smoke in a public place,” he said.

“This takes strong leadership and courage,” said Lew, “and saying no to traditions that need to be broken.”


This story originally appeared in Koream Journal.

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