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A Transnational Study of Migration and Smoking Behavior in the Mexican-Origin Population
Authors:Elisa Tong  Naomi Saito  Daniel J Tancredi  Guilherme Borges  Richard L Kravitz  Ladson Hinton  Sergio Aguilar-Gaxiola  Maria Elena Medina-Mora  Joshua Breslau
Abstract:Objectives. We examined migration-related changes in smoking behavior in the transnational Mexican-origin population.Methods. We combined epidemiological surveys from Mexico (Mexican National Comorbidity Survey) and the United States (Collaborative Psychiatric Epidemiology Surveys). We compared 4 groups with increasing US contact with respect to smoking initiation, persistence, and daily cigarette consumption: Mexicans with no migrant in their family, Mexicans with a migrant in their family or previous migration experience, migrants, and US-born Mexican Americans.Results. Compared with Mexicans with a migrant in their family or previous migration experience, migrants were less likely to initiate smoking (odds ratio OR] = 0.56; 95% confidence interval CI] = 0.38, 0.83) and less likely to be persistent smokers (OR = 0.41; 95% CI = 0.26, 0.63). Among daily smokers, the US-born smoked more cigarettes per day than did Mexicans with a migrant in their family or previous migration experience for men (7.8 vs 6.5) and women (8.6 vs 4.3).Conclusions. Evidence suggests that smoking is suppressed among migrants relative to the broader transnational Mexican-origin population. The pattern of low daily cigarette consumption among US-born Mexican Americans, noted in previous research, represents an increase relative to smokers in Mexico.Epidemiological studies have found large differences in smoking between Latinos and non-Hispanic Whites in the United States. Latinos are less likely than non-Hispanic Whites to initiate smoking. For instance, in the 2003 Tobacco Use Supplement to the Current Population Survey (CPS), a large nationally representative sample, the lifetime prevalence of smoking was 25% among Latinos and 44% among non-Hispanic Whites.1 Among smokers, Latinos are more likely to be nondaily smokers2–4 and smoke fewer cigarettes per day3 than non-Hispanic Whites. The 2003 CPS found that 36% of Latino smokers were nondaily smokers, compared with 17% of non-Hispanic White smokers and that among daily smokers 63% of Latinos smoked 10 or fewer cigarettes per day, compared with only 29% of non-Hispanic Whites.3 A recent study suggests that differences in smoking account for close to three quarters of the advantage in life expectancy at age 50 years that Latinos have relative to non-Hispanic Whites.5The immigrant origins of a large portion of the Latino population may be one factor contributing to these differences. Immigrant Latinos are less likely to be current smokers than are US-born Latinos,6–9 leading some to suggest that there may be positive selection among immigrants. However, our previous study found that in the years before arrival in the United State, migrants were more likely to have smoked than the general Mexican population.10 In addition, the increase in smoking in 2nd and higher generations of Latinos suggests that the distinctive patterns among immigrants become less common with assimilation and, therefore, that the differences in lifetime smoking patterns may narrow or disappear as the US-born portion of the Latino population grows.11 However, no information is available on the extent to which the distinctive patterns of smoking among Latinos reflect continuity with the source population in the countries of origin of Latino immigrants or environmental influences on migrants and their US-born descendants that occur in the context of assimilation.We examined the trajectory of smoking behaviors related to migration and assimilation to the United States across the transnational Mexican-origin population of Mexico and the United States. Mexican Americans constitute more than 60% of the US Latino population, and about 40% of Mexican Americans were born in Mexico.12 Immigrants from Mexico are by far the largest group of immigrants in the United States, constituting about 30% of the total foreign-born population.12 Combining population-based surveys from both countries, we examined differences in initiation and cessation of smoking and in cigarette consumption among daily smokers across a series of groups with increasing contact with the United States, from Mexicans with no familial connection to migration at one extreme, through US-born Mexican Americans at the other.
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