Risk of smoking initiation among Mexican immigrants before and after immigration to the United States

Abstract

Research has suggested that Latinos are less likely to initiate smoking than non-Latino whites. This advantage may be due in part to social and structural factors that deter smoking initiation among Latino immigrants, such as entry into the restrictive regulatory environment surrounding smoking in the U.S. and decreased exposure to family smoking influences, given that immigrants often leave parents and siblings behind in countries of origin. Although available data do not support a direct test of this hypothesis this study conducts an indirect test by comparing risk of initiation among Mexican immigrants before and after immigration to the U.S. If such factors influence initiation among Mexican immigrants, their risk should decline after immigration, relative to risk before immigration, since they are subject to these forces only after moving to the U.S. Using data from the National Health Interview Survey, discrete-time hazards analysis is used to estimate risk of initiation of regular smoking from ages 10 to 30, based on retrospective reports of age of smoking initiation. Retrospective data on age at immigration are used to create a time-varying variable indicating country of residence (U.S. or Mexico) during each person year of risk. Through this approach, risk in the person years before immigration is determined only among those who will eventually immigrate, which discounts health selection as an explanation for changes in risk after immigration. Consistent with the social and structural perspective, results indicate that the odds of smoking initiation decline among Mexican immigrants after immigration, relative to risk before immigration. This decline is unlikely due to alternative factors often cited to explain patterns of health behaviors among Mexican immigrants, such as health-protective cultural characteristics, since such characteristics are presumably in place before immigration. Findings suggest that Mexican immigrants may be particularly receptive to smoking prevention efforts after immigration.