Smoking Among Immigrants: How Moving Countries Affects Smoking Rates

When immigrants come to the U.S., they leave behind their home culture and become immersed in the American way of life. Along with that way of life comes social attitudes to things like smoking, and this can mean more smoking for women and less for men.

In 2014, over a million immigrants moved to the U.S., and the total immigrant population stands at around 81 million. People come from countries all over the world, and each brings their unique culture and attitudes along with them. Over time, though, they become more and more accustomed to life in the U.S., and their attitudes, values and even their behavior starts to change.

This process of change makes smoking among immigrants an interesting topic, and there has been a lot of study into what happens. There is a lot of good news for immigrants when it comes to smoking, but there are also several challenges that still need to be addressed if we want to move towards a tobacco-free world.

Smoking Rates for Immigrants in the U.S.

Several studies have investigated the smoking rates among immigrants in the U.S., and in general they show that those who move to the U.S. smoke less than U.S.-born citizens. A study including over 100,000 migrants found that their smoking rates – 14.2% of men and 4.1% of women – were notably lower than smoking rates in the U.S., which were 21.4% of men and 18.1% of women. It’s also clear that the “gender gap” in smoking is much higher in immigrants than in U.S. citizens.

In addition, smoking among immigrants in the U.S. is less common than it is in their countries of origin, where (on average) 39.4% of men and 11% of women smoke. The gender gap is much bigger in their countries of origin, but both men and women smoke less than other in their home countries. There are some exceptions to most of the findings, but the gender gap in smoking decreased for all of the countries included.

Why Do People Smoke Less When They Migrate?

The consistent finding that migrants smoke less when in the U.S. than in their countries of origin has spawned many possible explanations. The authors of the study referenced in the previous section proposed that the “healthy migrant effect” could have a role to play. This is the idea that people who migrate generally have more money and healthier lifestyles than people who don’t migrate. This could translate to smoking patterns, so the results wouldn’t imply that people were more likely to quit smoking when they migrated, but that the people who didn’t smoke are more likely to migrate.

Smoking among immigrants probably isn’t entirely explained by this, though. The fact that the gender gap closes also suggests cultural norms have a role to play. In many countries, it is seen as less acceptable for a woman to smoke than for a man, and this is why there is such a stark gap in smoking rates. In the U.S., this disparity has evened out, and now women smoke at a similar rate to men.

Other researchers have suggested that “acculturation” has a part to play in this. This is the process of integrating into U.S. culture, where there is little difference in the social expectations for men and women when it comes to smoking. This difference appears to disappear over time, which supports this theory.

Another cultural factor responsible for the changes could be the overall attitude towards smoking in the U.S., as well as the robust tobacco control policies. With more of a focus on the risks of smoking in the U.S. than in some other countries and more restrictive rules, this could lead some immigrants to quit smoking when coming to the U.S..

Reducing Smoking Among Immigrants – Challenges and Opportunities

Despite the generally lower rates of smoking among immigrants, there is still work to be done to help more stop smoking. One challenge is ensuring that immigrants access services that are available, and the Partnership for a Tobacco-Free Maine points out that there could be confusion about whether they are eligible for health services that would include stop-smoking programs, problems with communication and concerns about how accessing services could affect their status. Outreach programs for minority communities could help with this, especially for those with the highest smoking rates.

Once these barriers have been overcome, all of the usual stop-smoking treatments are just as effective for immigrants, so the same approaches can be used to help them quit. Medications, nicotine replacement therapies and alternative nicotine products can help immigrants stop smoking, and these could be offered as part of any outreach programs for minority groups. However, arguably the most important step that could be taken is to ensure anti-smoking messages and stringent tobacco control policies remain a part of life in the U.S..