Disaggregating Asian American and Native Hawaiian and Other Pacific Islander (AANHOPI) Adult Tobacco Use: Findings from Wave 1 of the Population Assessment of Tobacco and Health (PATH) Study, 2013–2014

  • Anh B. NguyenEmail author



Tobacco studies often combine data for Asian American and Native Hawaiian and Other Pacific Islander (AANHOPI) subgroups, masking subgroup differences. This study describes tobacco use (ever use and past 30-day use) among some disaggregated AANHOPI subgroups.


Data are from Wave 1 of the 2013–2014 Population Assessment of Tobacco and Health (PATH) Study, a nationally representative, longitudinal cohort study of civilian non-institutionalized adults and youth in the USA. The dataset contains a sample of 32,320 adults, of which 1623 identified as being of AANHOPI origin. Asian Americans further identified as being Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese, or other Asian. Those who identified as Native Hawaiian, Guamanian or Chamarro, Samoan, and Other Pacific Islander were combined into an NHOPI group. Tobacco measures included ever and past 30-day use of cigarettes, e-cigarettes, cigars (traditional cigar, cigarillos, filtered cigar), hookah, and smokeless tobacco including snus pouches, and pipe tobacco. Unadjusted and adjusted estimates for tobacco use are reported by AANHOPI membership and sex.


In general, Asian Indians and Chinese had the lowest and NHOPI had the highest tobacco use prevalence compared to other AANHOPI subgroups. Males generally had higher prevalence compared to females. Prevalence varied by AANHOPI membership and tobacco product. Adjusted prevalence estimates were higher compared to unadjusted estimates for many subgroups, attenuating some unadjusted differences found between AANHOPI subgroups.


Tobacco use varies by AANHOPI subgroup and product type. Unadjusted and adjusted analyses can be conducted as tobacco use differences in AANHOPI subgroups may be attributed to socio-economic status differences. Treating these distinct subgroups as a monolithic group may contribute to reliance on tobacco prevention and control strategies that may have limited impact on specific subgroups.


Tobacco Tobacco-related disparities Asian American Native Hawaiian and other Pacific islander Disaggregated data Population health 



This project is supported with federal funds from the National Institute on Drug Abuse, National Institutes of Health, and the Center for Tobacco Products, Food and Drug Administration, Department of Health and Human Services under a contract to Westat (Contract Nos. HHSN271201100027C and HHSN271201600001C).

Compliance with Ethical Standards

Conflict of Interest

Anh B. Nguyen declares that she has no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

40615_2018_532_MOESM1_ESM.docx (27 kb)
ESM 1 (DOCX 27 kb)


  1. 1.
    Srinivasan S, Guillermo T. Toward improved health: disaggregating Asian American and native Hawaiian/Pacific islander data. Am J Public Health. 2000;90(11):1731–4.CrossRefPubMedCentralGoogle Scholar
  2. 2.
    Nguyen AB, Chawla N, Noone AM, Srinivasan S. Disaggregated data and beyond: future queries in cancer control research. Cancer Epidemiol Biomark Prev. 2014;23(11):2266–72. Scholar
  3. 3.
    Holland AT, Palaniappan LP. Problems with the collection and interpretation of Asian-American health data: omission, aggregation, and extrapolation. Ann Epidemiol. 2012;22(6):397–405. Scholar
  4. 4.
    Lew R, Tanjasiri SP. Slowing the epidemic of tobacco use among Asian Americans and Pacific islanders. Am J Public Health. 2003;93(5):764–8. Scholar
  5. 5.
    Kagawa Singer M, Dressler W, George S. Culture: the missing link in health research. Soc Sci Med. 2016;170:237–46. Scholar
  6. 6.
    Pew Research Center. The Rise of Asian Americans. Social Trends. Washington, DC; 2013. Retrieved October 12, 2018 at
  7. 7.
    Gomez SL, Noone AM, Lichtensztajn DY, Scoppa S, Gibson JT, Liu L, et al. Cancer incidence trends among Asian American populations in the United States, 1990-2008. J Natl Cancer Inst. 2013;105(15):1096–110. Scholar
  8. 8.
    Miller BA, Chu KC, Hankey BF, Ries LA. Cancer incidence and mortality patterns among specific Asian and Pacific islander populations in the U.S. Cancer Causes Control. 2008;19(3):227–56. Scholar
  9. 9.
    Torre LA, Sauer AM, Chen MS Jr, Kagawa-Singer M, Jemal A, Siegel RL. Cancer statistics for Asian Americans, Native Hawaiians, and Pacific Islanders, 2016: converging incidence in males and females. CA Cancer J Clin. 2016;66(3):182–202. Scholar
  10. 10.
    Chen JY, Diamant AL, Kagawa-Singer M, Pourat N, Wold C. Disaggregating data on Asian and Pacific islander women to assess cancer screening. Am J Prev Med. 2004;27(2):139–45. Scholar
  11. 11.
    U.S. Department of Health and Human Services. U.S. Department of health and human services implementation guidance on data collection standards for race, ethnicity, sex, primary language, and disability status. Office of the Assistant Secretary for Planning and Evaluation; 2011. Retrieved October 12, 2018 at
  12. 12.
    Office of Management and Budget. Revisions to the standards for the classification of federal data on race and ethnicity. Executive Office of the President, Office of Management and Budget, Office of Information and Regulatory Affairs; 1997. Retrieved October12, 2018 at
  13. 13.
    Hu SS, Neff L, Agaku IT, Cox S, Day HR, Holder-Hayes E, et al. Tobacco product use among adults - United States, 2013–2014. MMWR Morb Mortal Wkly Rep. 2016;65(27):685–91. Scholar
  14. 14.
    U.S. Department of Health and Human Services. Tobacco use among U.S. racial/ethnic minority groups—African Americans, American Indians and Alaska natives, Asian Americans and Pacific Islanders, and Hispanics: a report of the surgeon general. MMWR Recomm Rep. 1998;47(RR-18):1–16.Google Scholar
  15. 15.
    Jamal A, Phillips E, Gentzke AS, Homa DM, Babb SD, King BA, et al. Current cigarette smoking among adults - United States, 2016. MMWR Morb Mortal Wkly Rep. 2018;67(2):53–9. Scholar
  16. 16.
    Mukherjea A, Wackowski OA, Lee YO, Delnevo CD. Asian American, Native Hawaiian and Pacific Islander tobacco use patterns. Am J Health Behav. 2014;38(3):362–9. Scholar
  17. 17.
    Asian & Pacific Islander American Health Forum. Demographic and socioeconomic profiles of Asian Americans, Native Hawaiians, and Pacific Islanders in the United States. San Francisco, CA; 2011. Retrieved October 12, 2018 at
  18. 18.
    Hyland A, Ambrose BK, Conway KP, Borek N, Lambert E, Carusi C, et al. Design and methods of the population assessment of tobacco and health (PATH) study. Tob Control. 2017;26(4):371–8. Scholar
  19. 19.
    Yi SS, Kwon SC, Sacks R, Trinh-Shevrin C. Commentary: persistence and health-related consequences of the model minority stereotype for Asian Americans. Ethn Dis. 2016;26(1):133–8. Scholar
  20. 20.
    WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004;363(9403):157–63.
  21. 21.
    Yi SS, Kwon SC, Wyatt L, Islam N, Trinh-Shevrin C. Weighing in on the hidden Asian American obesity epidemic. Prev Med. 2015;73:6–9. Scholar
  22. 22.
    Gupta LS, Wu CC, Young S, Perlman SE. Prevalence of diabetes in New York City, 2002-2008: comparing foreign-born South Asians and other Asians with U.S.-born whites, blacks, and Hispanics. Diabetes Care. 2011;34(8):1791–3. Scholar
  23. 23.
    King GL, McNeely MJ, Thorpe LE, Mau ML, Ko J, Liu LL, et al. Understanding and addressing unique needs of diabetes in Asian Americans, Native Hawaiians, and Pacific Islanders. Diabetes Care. 2012;35(5):1181–8. Scholar
  24. 24.
    Chen MS Jr, Tang H. Review of smoking cessation research among Asian Americans: the state of the research. Nicotine Tob Res. 2007;9 Suppl 3:485–93. Scholar
  25. 25.
    Lawrence D, Fagan P, Backinger CL, Gibson JT, Hartman A. Cigarette smoking patterns among young adults aged 18-24 years in the United States. Nicotine Tob Res. 2007;9(6):687–97. Scholar
  26. 26.
    King BA, Dube SR, Tynan MA. Current tobacco use among adults in the United States: findings from the National Adult Tobacco Survey. Am J Public Health. 2012;102(11):e93–e100. Scholar
  27. 27.
    National Cancer Institute. A Socioecological Approach to Addressing Tobacco-Related Health Disparities. Bethesda: U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute; 2017.Google Scholar
  28. 28.
    Baluja KF, Park J, Myers D. Inclusion of immigrant status in smoking prevalence statistics. Am J Public Health. 2003;93(4):642–6.CrossRefPubMedCentralGoogle Scholar
  29. 29.
    Castaneda H, Holmes SM, Madrigal DS, Young ME, Beyeler N, Quesada J. Immigration as a social determinant of health. Annu Rev Public Health. 2015;36:375–92. Scholar
  30. 30.
    Wade B, Lariscy JT, Hummer RA. Racial/ethnic and nativity patterns of U.S. adolescent and young adult smoking. Popul Res Policy Rev. 2013;32(3):353–71. Scholar
  31. 31.
    Nguyen AB, Zhao X, Hoffman L, Morse AL, Delahanty J. Nicotine and addiction beliefs and perceptions among the US-born and foreign-born populations. Prev Med. 2018;114:107–14. Scholar

Copyright information

© This is a U.S. government work and its text is not subject to copyright protection in the United States; however, its text may be subject to foreign copyright protection 2019

Authors and Affiliations

  1. 1.Center for Tobacco Products (CTP), Food and Drug Administration, Office of ScienceSilver SpringUSA

Personalised recommendations