Study explores link between smoking status and health conditions in older Chinese American men

Reviewed by James Ives, M.Psych. (Editor)Oct 11 2019

Cigarette smoking has long been known to cause lung cancer, but older Chinese American men are at an even greater risk. That knowledge prompted researchers at Rutgers Institute for Health, Health Care Policy and Aging Research (IFH) to study whether smoking is related to elevated risks of other health conditions in this vulnerable population.

Researchers hypothesized that among older Chinese American men, current or former smokers would be in poorer health than those who never smoked. That was true, but researchers were surprised to find that former smokers –– not current smokers –– appeared to have the worst health among the three groups.

Compared to former smokers, current smokers were less likely to have heart disease, hypertension, high cholesterol, thyroid disease, depression and anxiety. However, on average, study participants in all three groups reported at least one chronic illness, such as hypertension or diabetes. Current smokers also were more likely to be younger, less educated, and uninsured.

These partially conflicting results raise additional questions about the health outcomes and other potential health behaviors of former smokers. We don't fully understand why they may have quit smoking, or what other factors may be contributing to their poor health status. Ultimately it's important to make sure strategies to prevent and reduce tobacco are targeting this population."

Dr. Chien-Ching Li, Ph.D., M.P.H., associate professor at Rush University and the lead researcher

The study is one of the first of its kind. Researchers drew data from the Population Study of Chinese Elderly (PINE) Study in Chicago, the most extensive epidemiological cohort study of Chinese older adults in the United States.

Like other studies, the results confirm that despite overall declines in smoking rates in the United States in recent years, there are still significant disparities among some immigrant populations, especially older Chinese American men. Approximately a quarter of older Chinese American men are current smokers, compared with only 8.8% of the general US population aged 65 and older.

Researchers also noted that further studies are warranted into the overall causes of smoking among older Chinese American men. Such information could lead to more effective interventions and smoking cessation tools that could help to reduce poor outcomes among this population and others exposed to secondhand smoke.

The study is one of 17 published in August in a special issue of the Journal of the American Geriatrics Society. The others, which also draw data from the Filial Piety Study, a study of the PINE Study participants' adult children, address issues including elder abuse, cognitive function, oral health, and social relationships.

While the studies contribute to the overall body of research into the health and wellness of this vulnerable population, particularly related to smoking, information is still insufficient, IFH Director Dr. XinQi Dong, M.D., M.P.H., added.

Chinese Americans often are reluctant to participate in research and other federally sponsored activities, or they may face linguistic and cultural barriers. Federal funding for research also is lacking, and federal health data on diverse Asian groups often is grouped into the same racial category.

"A growth rate almost four times higher than that of the overall US older adult population necessitates a thorough understanding of older Chinese Americans' health needs," Dong said. "This research will help promote healthy aging adequately, prevent health disparities, and inform the development of culturally sensitive healthcare."