NEW YORK (Reuters Health) - Chinese-American men are more likely to smoke cigarettes if they are poorly educated, have little access to Western healthcare and have no knowledge of cancer warning signs, researchers report.

"Chinese men that did not have a usual source of healthcare or were just going to non-Western-trained healers to meet their health needs were more likely to be current smokers," lead author Dr. Elena S. Yu, a professor of epidemiology at San Diego State University's Graduate School of Public Health in California, told Reuters Health. Yu and her colleagues surveyed 644 Chinese Americans aged 40 to 69 living in Chicago's Chinatown section. Cigarette use was defined as having smoked at least 100 cigarettes within the course of one's lifetime and to be a current smoker. The findings are published in the June issue of the American Journal of Public Health, the journal of the American Public Health Association (news - web sites). Thirty-four percent of the Chinese men surveyed admitted to being current smokers, a prevalence rate higher than that among American males in general, but lower than that in mainland China, where three quarters of men over age 40 reportedly use cigarettes. The researchers found only 2% of Chinese-American women in this age group reported smoking, so they focused their research on the male population. One significant factor associated with being a current smoker was educational status, Yu said. "Those who have less than an elementary school education were more than twice as likely as those with more education to be a current smoker," she stated. Yu's team also found that men who had no knowledge of any early warning signs of cancer were 2.5 times more likely to be current smokers than other men. And Chinese-American men who lacked contact with mainstream medicine were more than twice as likely to smoke. "The anti-smoking campaign has been waged for some time in the mainstream society, and mainstream physicians are aware of the magnitude of the problem," Yu said. "But traditional healers might not be aware of the health promotion going on." However, the majority of the men lacked the information on the dangers of smoking not because they visited only Chinese herbalists but probably because they had no regular access to healthcare, Yu said. Many Chinatown workers do not receive health insurance through their jobs, she noted. "The problem here is simply that a lot of Chinese have no usual source of care," she said. "That's a sign of their being underprivileged and disadvantaged." Yu recommended that Chinese-American men and women be targeted in their native language with information about early cancer warning signs and smoking cessation. "Our study showed that many men tried to quit, but the only method they knew was cold turkey, and they would always fail," she said. "Chinese groceries, community centers and local schools may the best place to spread word about smoking cessation programs and how to prevent cancer. This may be where you can reach the people."

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