Family influences on Asian youth smoking in the context of culture and migration to New Zealand
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The government has an aspirational goal for a smokefree New Zealand by 2025. Low smoking rates among New Zealand Asian youth must be maintained to protect the future health of this growing subpopulation and to contribute to achieving the goal. Family risk and protective factors for smoking among New Zealand Asian youth, and Asian families’ perceptions of tobacco control initiatives, have not been investigated. The ecological framework encompasses the influences of culture, migration, family factors and tobacco control on Asian youth smoking. The aim of the study was to identify family drivers for low smoking rates among New Zealand Asian youth. An ecological perspective and mixed methods research design were used. Findings from an exploratory quantitative descriptive analysis of baseline data from the school-based Keeping Kids Smokefree study were followed up with qualitative descriptive research with Asian students and families. Associations between the key student outcome variable, ever-smoking, and family risk and protective factors were investigated for year seven and eight Asian and non-Asian students. A multivariate analysis was used to explore family factors, acculturation and ever-smoking. The relationship of smoking status and family factors reported by Asian and non-Asian parents was investigated. The processes and beliefs about parenting to protect children from smoking in New Zealand underlying the quantitative results were followed up with in-school Asian student focus groups and home-based qualitative Asian family interviews. The qualitative data was analysed using a general inductive approach. Asian youth in the Keeping Kids Smokefree sample (n=1093) have low ever-smoking rates. Maternal, but not paternal, smoking was a risk factor for youth ever-smoking. Living in a two parent family, smokefree homes and cars, parental monitoring of pocket money and identifying as Asian versus Asian/non-Asian were protective. Parental monitoring of smoking remained protective in the presence of acculturation measured as strength of identity as Asian. Asian children had lower smoking rates than non-Asian students and were more likely to experience protective family factors. Asian parents who do not smoke (n=858) are less likely to expose their children to smoking related risk factors than those who smoke. Seventeen qualitative interviews were conducted with Fijian Indian, Indian, Chinese, Cambodian, Vietnamese, Thai and Filipino families. The key driver for smokefree Asian children was socialisation into their families’ cultural and religious values. These included the primacy of family, respect for elders and education, and valuing children. Family care included teaching about smoking and control in the form of monitoring whereabouts, friends and money. Migration had a minor influence on Asian family socialisation of young adolescent children about smoking. Families and students supported tobacco control initiatives but quit smoking services in Asian language are needed. There was concern about older Asian adolescents taking up smoking. Despite the heterogeneous nature of the sample, the Asian families share key factors which influence low youth smoking rates. In general, the participants’ religious and cultural backgrounds reflect worldviews which emphasise family and community interdependence, morality and duty. These shape parenting practices which engender behaviours in children which protect them from smoking. The role of families in maintaining low Asian youth smoking rates should be recognised and supported. Maternal smoking and concern about protecting older Asian adolescents from smoking should be followed up. Asian parents who smoke need language appropriate services to support quitting.