5.10 Cultural background

 Last updated April 2012

5.10.1 Uptake of smoking among children from culturally and linguistically diverse environments

Australian research has shown consistently that young people living in households where English is spoken are more likely to smoke than those living in households where a language other than English is the first language.1,2 Although some groups of adult males speaking a language other than English (LOTE) at home may have a higher prevalence of smoking than English-speaking adult males (see Chapter 1, Section 1.8), these patterns are not (or not yet) apparent in the early years of secondary school (years 7 and 8).1 Rissel and colleagues3 found that in a group of year 10 and 11 pupils (aged approximately 15–17 years) in Sydney, students from an English-speaking background were much more likely to be current regular smokers (27%) than teenagers from Arabic (16%), Vietnamese or Southeast Asian backgrounds (8%). Teenagers from Vietnamese, Southeast Asian and Chinese backgrounds were also more likely to report that their families had rules at home about smoking, that they were usually supervised, and that they had lesser amounts of pocket money than other ethnic groups. Each of these factors independently correlates with a lower uptake of smoking (see Sections 5.12 and 5.14).

An earlier Sydney-based study by Tang and colleagues also showed that young adolescents (aged 12–13) who spoke a LOTE at home were much less likely to smoke than children from an English-speaking background.1 This study found that the factor of greatest influence in smoking uptake among children speaking a LOTE at home was whether their close friends smoked. The authors speculate that these lower rates may be due to stricter cultural attitudes opposing smoking among adolescents; students may be more likely to socialise with other children speaking the same LOTE at home and sharing the same cultural attitude, hence reducing the likelihood of peer smoking pressures; and/or that tobacco advertising had failed to reach these groups.

Prevention programs targeted for culturally and linguistically diverse populations in Australia are discussed in Chapter 7, Section 7.19.7.

There is some evidence that acculturation (a process in which migrants adopt mainstream values and behaviours of their new location while retaining elements of their own cultural practices) is associated with increased smoking rates among young people from Asian backgrounds living in Western countries.4 Acculturation may influence patterns of family socialisation and parenting practices.5 However, research from New Zealand among a nationally representative sample of secondary students aged 12–18 years found strong family influences in relation to the risk of regular smoking among participants from an Asian background: spending time with parents, having parents who did not smoke, and having parents who disapproved of the student smoking were associated with significantly lower risks of adolescent smoking. It was found that indicators of acculturation (such as self-identified ethnicity, country of birth, length of time living in New Zealand, main language at home and participation in New Zealand European traditional activities) did not weaken this relationship between protective family factors and significantly reduced risks of regular smoking among Asian youth.5

5.10.2 Uptake of smoking among Aboriginal peoples and Torres Strait Islanders

The prevalence of smoking among Aboriginal peoples and Torres Strait Islanders is more than twice that of the total Australian population.6 As well as taking up smoking at a greater rate than non-Indigenous children, there is evidence that Aboriginal and Torres Strait Islander children begin smoking at an earlier age.7

Young Indigenous children report similar influences on uptake of smoking to children everywhere. Being part of a peer group that smokes, smoking among other family members and parents, and having a positive attitude towards smoking are strong indicators of smoking behaviour, which are shared by Indigenous and non-Indigenous children.8,9 Research from Western Australia shows that young Indigenous people are more likely to describe overt peer pressure in relation to taking up smoking, and to report smoking as a more normal occurrence among their peers.10,11 Smoking may also be an expression of rebellion, a way of risk taking, a means of offsetting boredom, or used to achieve stress relief among young Indigenous people.12,11 Australian research suggests experimentation with other substances such as alcohol and cannabis also correlates with the adoption of smoking among Indigenous and non-Indigenous primary schoolchildren.9

The higher prevalence of smoking in Aboriginal and Torres Strait Islander adults means that many young Indigenous people live in settings in which smoking is the norm. It is also likely that factors such as poorer school connectedness and other socio-demographic issues connected with disadvantage contribute to higher rates of uptake.13 Smoking among Aboriginal and Torres Strait Islander children and teenagers, including influences on smoking behaviour, is discussed in greater detail in Chapter 8, Section 4.

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1. Tang L, Rissel C, Bauman A, Fay K, Porter S, Dawes A, et al. A longitudinal study of smoking in year 7 and 8 students speaking English or a language other than English at home in Sydney, Australia. Tobacco Control 1998;7(1):35–40. Available from: http://tobaccocontrol.bmj.com/cgi/content/abstract/7/1/35

2. Rissel C, Ward J and Jorm L. Estimates of smoking and related behaviour in an immigrant Lebanese community: does survey method matter? Australia and New Zealand Journal of Public Health 1999;23:534-7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/10575779

3. Rissel C, McLellan L and Bauman A. Factors associated with delayed tobacco uptake among Vietnamese/Asian and Arabic youth in Sydney, NSW. Australian and New Zealand Journal of Public Health 2000;24(1):22–8. Available from: http://www3.interscience.wiley.com/journal/119012648/abstract

4. Ma GX, Tan Y, Toubbeh JI, Su X, Shive SE and Lan Y. Acculturation and smoking behavior in Asian-American populations. Health education research 2004;19(6):615. Available from: http://her.oxfordjournals.org/content/19/6/615.full

5. Wong G, Ameratunga SN, Garrett NK, Robinson E and Watson PD. Family influences, acculturation, and the prevalence of tobacco smoking among Asian youth in New Zealand: findings from a national survey. Journal of Adolescent Health 2008;43(4):412-6. Available from: http://www.sciencedirect.com/science/journal/1054139X

6. Trewin D. 4715.0 National Aboriginal and Torres Strait Islander Health Survey, Australia 2004-05 Canberra: Australian Bureau of Statistics, 2006. Available from: http://www.ausstats.abs.gov.au/ausstats/subscriber.nsf/0/B1BCF4E6DD320A0BCA25714C001822BC/$File/47150_2004-05.pdf

7. Australian Bureau of Statistics. 4722.0.55.004 Tobacco smoking - Aboriginal and Torres Strait Islander people: a snapshot, 2004-05. Canberra: ABS, 2007. Available from: http://www.abs.gov.au/ausstats/abs@.nsf/mf/4722.0.55.004#

8. Tyas S and Pederson L. Psychosocial factors related to adolescent smoking: a critical review of the literature. Tobacco Control 1999;7(4):409–20. Available from: http://tobaccocontrol.bmj.com/cgi/content/full/7/4/409

9. Dunne M, Yeo M, Keane J and Elkins D. Substance use by Indigenous and non-Indigenous primary school students. Australia and New Zealand Journal of Public Health 2000;24:546-9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/11109696

10. Wood L, Lang A and Coase P. Smarter than Smoking Qualitative Research. A research report. West Perth, Australia: TNS Social Research, 2005.

11. Leavy J, Wood L, Rosenberg M and Phillips F. Try and try again: qualitative insights into adolescent smoking experimentation and notions of addiction. Health Promotion Journal of Australia 2010;21(3):208-14. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21118068

12. Lindorff K. Tobacco – time for action. National Aboriginal and Torres Strait Islander Tobacco Control Project - final report. Canberra: National Aboriginal Community Controlled Health Organisation, 2002. Available from: http://www.weftweb.net/naccho/Files/NACCHO_Tobacco_report.pdf

13. Forero R, Bauman A, Chen J and Flaherty B. Substance use and socio-demographic factors among Aboriginal and Torres Strait Islander school students in New South Wales. Australian and New Zealand Journal of Public Health 1999;23:295-300. Available from: http://www.ncbi.nlm.nih.gov/pubmed/10388175