Growing up with smokers doubles smoking risk for adult Hispanics

The UIC study is the first to look at the link between childhood exposure to cigarette smoking behavior and adult smoking rates in Hispanics/Latinos.

For Hispanics/Latinos living in the United States, growing up in a home with a regular smoker nearly doubled their chances of becoming an adult smoker. The findings are based on data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), the largest ongoing study of this ethno-culturally diverse population in the U.S.

The study was published online in the journal Preventive Medicine and is the first to look at the association between childhood exposure to cigarette smoking behavior and adult smoking rates in Hispanics/Latinos.

“We know that exposure to cigarette smoking as a child is a risk factor for adult smoking because it’s a learned behavior, and our study results corroborate this theory,” said Dr. Elena Navas-Nacher, a researcher in the University of Illinois at Chicago’s Institute for Minority Health Research and lead author on the paper.

The researchers looked at data collected through questionnaires from 13,231 adults ages 18-74 living in Chicago, San Diego, Miami and the Bronx who self-identified as being of Central American, Cuban, Dominican, Mexican, Puerto Rican or South American background. The questionnaires were part of Phase 1 of the study, which took place between 2008 and 2011, and collected information on demographic factors, smoking and exposure to household cigarette smoking behaviors, defined as “having lived with a regular smoker who smoked in your home.”

The majority of participants (73 percent) had lived in the U.S. for 10 or more years, and 76 percent preferred to speak Spanish. Seventy-eight percent of participants were foreign born, and the average age of immigration to the United States was 27 years old.

Forty percent of participants reported being exposed to smoking in their homes as children and adolescents, and 20 percent of all participants were current cigarette smokers.

Childhood exposure to household smoking nearly doubled the risk of being a current smoker compared to those never exposed to household smoking, even after controlling for sociodemographic and cultural factors including age, gender, education level, language preference and length of stay in the U.S.

The association was strongest for Cubans and Puerto Ricans, who had the highest prevalence of exposure to household smoking as children, 59 percent and 47 percent, respectively. These groups also had the highest prevalence of adult smokers — 26 percent of Cubans and 32 percent of Puerto Ricans — compared with other Hispanic/Latino groups.

“There are stricter anti-smoking policies and lower levels of social acceptance for smoking in the United States compared to most Latin American countries,” Navas-Nacher said.

There is also more awareness of the negative health effects of second hand smoke in the U.S., said Navas-Nacher. But even among those who have lived in the U.S. for many years, they “are more than twice as likely to be adult smokers if they grew up in a home with a smoker. Acculturation was not a moderating factor in this association.”

Navas-Nacher said that efforts to reduce exposure to smoking at home among children and adolescents are needed, both in the U.S. and in Latin America.

Michele Kelley, UIC School of Public Health; Orit Birnbaum-Weitzman, University of Miami; Patricia Gonzalez, San Diego State University; Aida Giachello, Northwestern University; Robert Kaplan, Albert Einstein College of Medicine; David Lee, University of Miami; Frank Bandiera, University of Texas; Shrikant Bangdiwala, University of North Carolina, Chapel Hill; Dr. R. Graham Barr, Columbia University Medical Center; and Dr. Martha Daviglus, University of Illinois at Chicago, are co-authors on the study.

This research was supported by contracts from the National Heart, Lung, and Blood Institute to the University of Illinois at Chicago (N01-HC65236), University of North Carolina (N01-HC65233), University of Miami (N01-HC65234), Albert Einstein College of Medicine (N01-HC65237), and San Diego State University (N01-HC65237).