Hispanic women are smoking cigarettes in the United States more than they do in their native countries

More Hispanic women are smoking cigarettes in the United States than they do in their native countries, most likely due to cultural influences. Similar smoking increases are not seen in Hispanic men, according to a new systematic review of studies.

The exact reasons for the increase are unclear, according to the review in the August issue of the American Journal of Preventive Medicine, but studies show a clear association between acculturation to the United States and higher smoking rates. The researchers define acculturation as changes in values, attitudes and behavior in individuals as a result of continuous interaction with people of a different ethnic group.

Review co-author Marc B. Schenker, M.D., M.P.H., of the Department of Public Health Sciences at the University of California, says that the change in culture for Mexican women who relocate to the United States is greater than it is for men. "Men in Mexico are pretty independent and their culture facilitates their independence," he says. "When men come to the U.S., you don't see a dramatic change. But women often assert their independence. Smoking may also be a status issue in that it shows sophistication and an income level that can afford cigarettes."

The review encompassed 11 studies of a total of 26, 611 men and women of predominantly Mexican origin. Nine studies showed a significant positive association between acculturation and current smoking status. Smoking rates in women considered more acculturated increased markedly in comparison to rates in less acculturated women. Smoking rose from 19 percent to 28 percent in one study and 13.6 percent to 22.6 percent in another, and in some studies even doubled - from 11 percent to 25.1 percent.

Norman H. Edelman, M.D., chief medical officer for the American Lung Association, said the findings are alarming but not surprising. "When you acculturate, you pick up the bad habits of a culture along with the good ones," Edelman says. "Cultures who are traditionally thin come to the U.S. and get fat. People who don't traditionally smoke start smoking. It's yet another health threat that women will have to deal with."

"Gender-specific and immigrant-specific approaches are necessary to halt the increase in smoking among Hispanics before it begins," the review authors conclude.