Original Research Article

A systematic review study on common determinants of smoking among Pacific countries

Dr. Masoud Mohammadnezhad,

Masoud Mohammadnezhad1,*, Nasser Salem Alqahtani2, Tamara Mangum3, Ben Jackson Jr Amor4
1Associate Professor, School of Public health and Primary Care, Fiji National University, Fiji
2Assistant Professor, Department of Clinical Nutrition, Northern Borders University, Saudi Arabia
3Assistant professor, School of Public Health and Primary Care, Fiji national University, Fiji
4Bachelor of Public Health, Ministry of Health, Department of Public Health, Weno, Federated States of Micronesia

The high prevalence of smoking and its adverse health consequences are known as one of the main public health issues worldwide. Smoking is currently responsible for the deaths of one in ten adults, worldwide. The current and increasing trend of smoking in Pacific countries beats the bell to health planners to prevent smoking through recognizing its determinants.

*Corresponding author:

Masoud Mohammadnezhad, School of Public health and Primary Care, Fiji National University, Fiji, Tel: +679-9726127; E-mail: masoud.m@fnu.ac.fj

Keywords:

Determinants; Pacific countries; Smoking; Systematic review study

Introduction

The high prevalence of smoking and its adverse health consequences are known as one of the main public health issues worldwide. Smoking is currently responsible for the deaths of one in ten adults, worldwide. The current and increasing trend of smoking in Pacific countries beats the bell to health planners to prevent smoking through recognizing its determinants. This study is aimed at understanding common determinants of smoking consumption among Pacific countries using a systematic review method.

Method

A broad systematic search of published articles was applied using the Cochrane Systematic Review Guideline. Studies searched were published between 1st January 2000 to 1st January 2017, written in the English language, and in Pacific countries. Pacific, smoking, tobacco, cigar, and determinants were the keywords used to achieve the relevant studies using databases such as Medline, Embase, Web of Science, PsychInfo, and Scopus. After screening the titles of the articles and omitting some, the abstracts of the remaining studies were reviewed by two independent reviewers, omitting more, and finally the full text of the remaining articles were printed for more reading and extracting of the essential information to build the data extraction sheet. Descriptive analysis was applied and the results were shown and frequency of the studies was reported using tables and graphs.

Results

Twenty-seven articles met the study inclusion and exclusion criteria. Ethnicity (22.2%) was the most common determinant of smoking, followed by gender (males) in 4 studies (14.8%), age (older age) in 3 studies (11.1%), and influence of family and peers in 3 studies (11.1%), as determinants of smoking. Pacific is the most common determinant of being a smoker, according to the studies. Environmental factors was the most common determinant of smoking among Pacific communities, while ethnicity was the most common determinant in schools among Pacific island students. Pregnancy, English fluency, and acculturation (adaptation to the host countries ways) as determinants of smoking status were more common determinants of smoking in the hospital based studies.

Conclusion

Despite the growing trend of smoking prevalence in Pacific countries, there is limited research focusing on the potential determinants of smoking in Pacific. Considering the results of this study, encouraging the health planners to develop healthy policies, along with smoking prevention programs with a focus on building an awareness of the dangers of smoking, are essential. Further research into how to provide effective smoking prevention and intervention programs for the Pacific can assist health promotion professionals in providing targeted and more effective programs.

Globally, tobacco use ranks first as the leading cause of preventable death and is responsible for a death toll of nearly 6 million deaths per year, with the current trend showing it to cause more than 8 million deaths annually by 2030 [1]. The East Asia, South East Asia, and Eastern European regions have the highest prevalence of smoking among males, while Europe has the highest prevalence of smoking among women [2]. It has been found that in developed countries, smoking is more common among ages 30-40, while in developing countries it is more common among ages 45-49 [3].
Although smoking prevalence has reduced in high-income countries, there is an exponential rise of tobacco consumption in low and middle income nations [4]. This places a huge constraint on the health care system. The dangers of smoking impact the Pacific peoples’ health including cancer, heart disease, stroke, lung diseases, diabetes, and chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis. Smoking is also known to cause tuberculosis, certain eye diseases, and problems with the immune system, including rheumatoid arthritis. A couple of studies also show smoking as a risk factor for erectile dysfunction in males [5, 6].
In New Zealand alone, tobacco smoking or second-hand smoke, is directly attributed to approximately 5,000 deaths each year. The Pacific peoples, Maoris, and those with lower socioeconomic status, carry a greater burden of smoking-related illness [7]. Smoking is common in Niue, with rates of 31% to 38% among men and 14% to 16% among women. With its harm to health and expenditure on tobacco, it is also likely to be holding back the social and economic development of Pacific communities [8].
To date, there have been no systematic review studies published, hence this study aims to understand the common determinants and health consequences of smoking in the Pacific. It is imperative that more studies are needed to be conducted within the Pacific to identify the common determinants of smoking among the Pacific people so that possible control measures can be addressed and implemented to reduce the impact among the health of the Pacific people.

This systematic review study was conducted based on the Cochrane Library guidelines. The articles were searched for in different databases which are more frequently used for other systematic review studies in the field of smoking. They were Medline, Embase, Web of Science, PsychInfo, and Scopus. Studies published between 1st January 2000 to 1st January 2017 and written in English language were included; while those that did not meet those criteria were excluded. A broad time period was used to include all published articles, to give us an insight into the determinants of smoking in Pacific countries. All types of studies, including quantitative and qualitative studies, were included. Keywords were used to find the articles and were chosen based on the main objectives of the study and medical subject headings (MeSH), which were suggested by some databases. Pacific, smoking, cigar, tobacco, and determinants were the main keywords and were combined using AND and OR to help search for all relevant studies. The studies were reviewed by two coders to remove the selection bias. All titles of the studies were scanned at the first stage and those not relevant were omitted. The abstract of the remaining articles was reviewed and some articles were removed at the second stage. Finally, the full text of the remaining articles (23 studies), which met the study inclusion and exclusion criteria, were reviewed to make the data extraction sheet (Figure 1). After gathering the final articles, the bibliography of the those studies were searched to find articles which were related to our search, that had not been found within the searched databases (4 studies).

Clyto Access
Figure 1: Article selection process

The information related to the study, participants, methodology, and results of each article were inserted into the data extraction sheet for further analysis (Table 1). Descriptive analysis, using percentage of the studies, was used and the results were reported using tables and graphs.

As the results of Table 1 show, more than half of the studies (55.6%) were conducted after 2011. Most of studies (74.1%), were quantitative studies, while two-thirds were conducted in South Pacific countries.

Table 1: General characteristic of studies

Variable

Number

Percentage

Year of the studies

2000-2005

2006-2010

2011-2016

 

4

8

15

 

14.8

29.6

55.6

Type of the studies

Quantitative

Mixed Method

Qualitative

 

20

1

6

 

74.1

3.7

22.2

Region of conducting studies

American Pacific

South Pacific

 

10

17

 

37

63


The pool number of participants who participated in 27 studies was 864,788 people. Table 2 shows the results of sampling methods and data collection tools, which were used in the 27 studies. Most studies (66.7%) were applied purposive sampling and 74% used questionnaire for collecting the data. In-depth interview was a common data collection method where a qualitative study was applied.
Table 2: Frequency of studies based on the sampling and data collection methods

Variable

Number

Percentage

Sampling method

Purposive sampling

Random sampling

Stratified sampling

Snowball Sampling

Not specified

 

18

6

1

1

1

 

66.7

22.2

3.7

3.7

3.7

Data Collection Method

Questionnaire

Focus group discussion

In-depth interview

In-depth and focus group discussion

Questionnaire and interview

 

20

1

4

1

1

 

74.1

3.7

14.8

3.7

3.7


Approximately 50% of the studies were conducted among participants aged less than 18, and only 7.4% of the studies were over 31 years old (Figure 2).
Clyto Access
Figure 2: Frequency of studies based on age of participants

The results of the study also show that 45.5% of the studies were conducted as community based, which was followed by school based studies (40.5%), and hospital based or community and school based (7.5%, respectively).
Clyto Access
Figure 3: Frequency of studies based the study setting

From the 27 articles reviewed, several factors have been found to be the most common determinants of smoking among Pacific islanders. Overall, it was found that ethnicity (Pacific) is the most common determinant of being a smoker in the Pacific region. Six studies (22.2%) stated ethnicity as the most common determinant of smoking, followed by gender (males) 4 studies (14.8%), age (older age) 3 studies (11.1%), and influence of family and peers in 3 studies (11.1%), as determinants of smoking.
The determinants are distributed accordingly, based on the study setting; community based, school based, hospital based, and both school and community based. For the 12 community based studies, 3 studies (25%) found that an environmental factor (peers, family, accessibility to cigarettes) is the most common determinant of smoking among Pacific communities. Ethnicity comes in second, as stated by 2 studies (16.7%). The remaining 8 (66.7%) of the overall community based studies have determinants that occur only once. These include gender, alcohol and drugs, and diabetes mellitus (those with the disease smoke less).
In the school based studies, 4 out of 10 studies (40%) found ethnicity to be the most common determinant in schools among Pacific island students. Ethnicity was followed by gender (males) and age (17 and older), found in 3 studies (30%), then family and peers in 2 studies (20%), lack of awareness and students having weekly allowance of NZ$20 or more per week in 1 study (10%).
For the 3 hospital based studies, it was found that pregnancy, English fluency, and acculturation (adaptation to the host countries ways) are determinants of smoking status. All determinants are homogenous in their occurrence, each constituting 33.33% of the overall hospital based studies.
Furthermore, 2 studies (66.7%) were conducted in both community and school and 1 study (33.33%) was conducted in a workplace. For studies conducted in both community and schools, the determinants found included larger social network sizes and ethnicity (Pacific).
In addition, several of the studies were focused on barriers or determinants affecting the development and implementation of smoking and tobacco control policies. The determinants found to be associated with the development and implementation of smoking and tobacco control policies include; limited resources of Pacific Island Governments, a limited anti-tobacco coalition, and limited support and political commitment.

This study’s results show that ethnicity (Pacific Islander) is a common determinant of smoking. People of Pacific Island descent are more likely to be smokers, as compared to non-Pacific islanders. These findings are consistent with other studies conducted in in the Pacific islands and the United States, which states that Pacific islanders are among the ethnic groups most susceptible to smoking and other health risk behaviors [9, 10]. The results also highlighted that gender (males), age, along with family and peer pressure, are also closely associated with smoking. Studies from all over the world, including Asia and the United States, also confirmed smoking to be more common in males, hence the reason the male gender is a determinant for smoking [11, 12]. Our findings regarding age (older), peer, and family influence as determinants of smoking is consistent with other studies in the US and Australia [13, 14].
The results also show that within communities, environmental factors such as peer pressure, family influence, and accessibility to cigarettes are the primary determinants of smoking among community members, as confirmed by other studies [13-15]. In addition, ethnicity (Pacific islander), gender (males), and alcohol and drugs are other factors which influence smoking among people within communities, as supported by other studies from around the world [9, 11, 16].
Moreover, the results show that smoking among students is commonly linked to ethnicity, gender, peer, and family influence. Other studies also show that ethnicity, gender, peer, and family influence are all determinants of smoking in schools [7, 11, 13, 17].
The result for hospital based studies found pregnancy, English fluency, and acculturation status (adaptation to the host countries ways) to be the main determinants for smoking status. Pregnancy is a determinant of smoking cessation and is supported by other studies [18, 19]. English fluency and acculturation are determinants for smoking consumption, as confirmed.
In addition, the results shows that for studies that were conducted in both schools and communities, the primary determinant for smoking is having a large social network size and ethnicity (Pacific islander) [2, 20].
Furthermore, the results also included the barriers and determinants for smoking policies in Pacific island countries. It was found that the main barriers affecting the development and implementation of smoking cessation policies in the Pacific are limited capacity (resources) of Pacific Island Governments, limited anti-tobacco coalitions, and limited support and political commitment [21]. The finding of this study are consistent with studies conducted in both developed and developing countries from around the world [22, 23].

Table 3. Data Extraction Sheet

N

Article/Study

Participants

Methodology

Results

1

Maglalang et al., [24]

Year: 2016

Type: Quantitative- cross-sectional  

Country: California (USA)

Number: 501

Male: 39 %

Female: 57%

4 % gender not reported

Age: Mean 21 years (SD 2.2)

Range: 18–25 years

Place: School based (College)

Sampling Method: Snowball Sampling

Data Collection: Online Survey

 

Determinants:

Sources of ENDS Awareness:

  • Social venues- Common among Mixed-Ethnic Groups- 30% (p<0.001)

2

 Girin et al.[25]

Year: 2014

Type: Cross-sectional Secondary Analysis

Country: Wallis & Futuna

Number: 487

Male: 222

Female: 265

Age: Mean Age of 45 years (SD= 15.6)

 

Place: Community Based

Sampling Method: Random Sampling

Data Collection: questionnaire and Blood test and HT measurement

Determinants:

  • Individuals with DM were also less likely to smoke on a daily basis than their non-DM (OR=0.58)

 

3

Kaholokula et al.,[26]

ear: 2006

Type: Cross-sectional

Country: Hawaii, USA

Number: 1,158

Male: 535

Female: 623

Age: Mean 18.8 (SD= 13.9)

 

Place: Community Based

Sampling Method: random

selection

Data Collection: Questionnaire, Personal History Data form,

Determinants

  • Ethnicity (OR=0.73)

4

Tareg et al [27]

Year: 2015

Type: Quantitative

Country: Yap, Federated States of Micronesia

Number: 406

Male: 178-44%

Female: 228- 56%

Age: Range 18 to >60

Place:  Community based

Sampling Method: Purposive

Data collection Tool: Questionnaire

Determinant:

  • Older adults felt quitting tobacco or betel-nut use would be significantly more difficult because of social reasons and withdrawal Problems (p<0.001)

5

Erick-Peleti et al [28]

Year: 2007

Type: Cohort

Country: New Zealand

Number: Mothers of 1398 Infants

Male: Not specified

Female: Not specified

Age:  6 weeks-12 Months

Place: Hospital Based

Sampling Method: Purposive Sampling

Data Collection Tool: Questionnaire, Interview

Determinants:

  • English fluency (p<05),
  • association between smoking and cultural alignment (p<0.05),

6

Scragg et al. [29]

Year: 2003

Type: Cross-sectional Survey

Country: New Zealand

Number: 29,271

Male: 14,341

Female: 14,930

Age: 14-15

Place: school-Based

Sampling Method: Not specified

Data Collection Tool: Self-Administered questionnaire

Determinants:

  • Effect of both parents smoking on the risk of daily smoking by students varied significantly (p <0.0001) between ethnic groups,
  • Intermediate for European (RR = 3.11) and Pacific (RR = 3.05) students, and weakest for Maori (RR = 1.74).

 

7

Teevale et al [7]

Year: 2013

Type: Quantitative

Country: New Zealand

Number: 5471

Male: Not specified

Female: Not specified

Age: 13-17 Years

Place: School- Based

Sampling Method: Random Sampling

Data Collection Tool: national Survey, multimedia Questionnaire

Determinants:

  • Ethnicity (p<0.001)
  • Gender (girls p<0.001)
  • Age (17 and older p<0.02)

 

8

Yang et al.[30]

Year: 2013

Type: Cross-sectional

Country: USA

Number: 6,311

Male: Not specified

Female: Not specified

Age: 11-18 years and older

Place: School Based

Sampling Method: Purposive Sampling

Data Collection Tool: Questionnaire

Determinants:

  • Ethnicity (PI p<0.001)
  • smoking in peers increased the odds, while friends disapproval of cigarettes decreases the odds- (p<.001)

9

Nosa et al.,[31]

Year: 2014

Type: Cross-sectional Survey

Country: New Zealand

Number: 2,208

Male: Not specified

Female: Not specified

Age: 10-13 Years

Place: School-Based

Sampling Method: Purposive sampling

Data Collection Tool: Questionnaire

Determinants:

Ethnicity vs Having ever Smoked:

  • Cook Islands- (p<0.0001)

Odds ratio: 1.91 for those children receiving more than $NZ20 per week as pocket money/allowance

 

10

Butler et al.,[32]

Year: 2004

Type: Cohort

Country: New Zealand

Number: 1398

Male: Not specified

Female: Not specified

Age: Infants 6 weeks and older

Place: Hospital based

Sampling Method: Purposive

Data Collection Tool: Questionnaire, Interview

Determinants:

  • reduction of moderate/heavy smokers once pregnant-(p<0.001)

11

Chen et al.,[33]

Year: 2004

Type: Cross-sectional Survey

Country: Marshall Islands

Number: 3,294

Male: 1,558

Female: 1,700

36 non-respondents for gender

Age: 9-20, mean age 14

Place: School based

Sampling Method: Stratified Sampling

Data Collection Tool: Survey Questionnaire

Determinants:

  • Age (p<0.0001)
  • Gender (Male p<0.0001)
  • receiving or wearing tobacco-labelled equipment or clothing and –(p<0.0001)

12

Pokhrel et al.,[34]

Year: 2016

Type: Cross-sectional

Country: Hawaii, USA

Number: 435

Male: 39.4%

Female: 60.6%

Age: Mean age = 25.6, SD = 8.3;

 

Place: Both community and School based

Sampling Method: Purposive sampling

Data Collection: Online Survey

Determinants:

  • larger social network size was directly associated with higher social support and lower recent cigarette use among Native Hawaiians but not among East Asians or Filipinos (P<0.02)

13

Wu et al., [35]

Year: 2013

Type: Cohort

Country:  USA

Number: 355,498

Male: Not specified

Female: Not specified

Age: ≥ 12 Years old

Place: Community

Sampling Method: Multistage area probability sampling

Data Collection: Survey Questionnaire

Determinants:

Native Hawaiian Pacific Islander

  • Gender (Male p<0.05)
  • Alcohol use (p<0.05)
  • Drug use (p<0.05)

14

Wilson et al.,[8]

Year: 2010

Type: Qualitative

Country: New Zealand

Number: 1,376

Male: Not specified

Female: Not specified

Age:

Place: Community based

Sampling Method: Purposive Sampling

Data collection: Survey

Determinants:

  • Ethnicity

15

Price et al [36]

Year: 2002

Type: Mixed

Country: USA

Number: 220,251

Male: Not specified

Female: Not specified

Age: 12-26 and older

Place: Community based and school based

Sampling Method: Purposive sampling

Data collection: Survey

Determinants:

  • Mixed race AAPIs were 1.48 times more likely to have smoked cigarette than unmixed race AAPIs (OR=1.48)

16

Smith et al.[37]

Year: 2007

Type: Cross-sectional survey

Country: Tonga, Pohnpei, FSM and Vanuatu

Number: 8,777 school students

Male: Not specified

Female: Not specified

Age: 11-17

Place: School Based

Sampling Method: Cluster Random Sampling

Data collection: Survey questionnaire

Determinants:

  • Age (Older age p<0.01)
  • Gender (Male p<0.01)

 

17

Tanjasiri et al [38]

Year: 2013

Type: Descriptive

Country: USA

Number: Not specified

Male: Not specified

Female: Not specified

Age: 15-25 years AAPI youths

Place: Community Based

Sampling Method: Purposive sampling

Data collection: Mixed-method of geographic information system (GIS) mapping, Photo voice and individual youth surveys

Determinants:

  • Association between proximity (in miles) pro-tobacco influences and youth smoking (p<0.05)

18

Kim and McCarthy [39]

Year: 2006

Type: Cohort

Country: California, USA

Number: 226,267

Male: Not specified

Female: Not specified

Age: Mean age 14.3 for Pacific Islanders

Place: School-based

Sampling Method: Purposive sampling

Data Collection Tool: Questionnaire, Survey

Determinants:

  • Ethnicity (RR=3.6)

 

19

Gifford et al. [40]

Year: 2016

Type: Qualitative

Country: New Zealand

Number: 10 Maori and 10 Pacific young adults

Male: Not specified

Female: Not specified

Age: 18-26 years who smoked

Place: Community based

Sampling Method: Purposive sampling

Data collection: In-depth interview

Determinants:

  • Environmental factors include:
  • Level of awareness
  • Peer pressure
  • Accessibility

20

Hale et al. [4]

Year: 2012

Type: Qualitative

Country: New Zealand and Niue

Number: 12 (Niue = 4 and New Zealand = 8) public health, tobacco control, public policy experts.

Male: Not specified

Female: Not specified

Age: Not specified

Place: Community based

Sampling Method: Purposive sampling

Data collection: In-depth Interview (face-to-face and online)

Determinants:

  • Political support and community engagement

21

Tautolo et al [41]

Year: 2016

Type: Qualitative

Country: New Zealand

Number: 30 PI in New Zealand (Cook Islands, Samoan and Tongan)

Male: 13

Female: 17

Age: 18-54 years with Pacific smokers and non-smokers.

Mean age: 33.3 years

Place: Community based

Sampling Method: Purposive sampling

Data collection: Focus group discussions

Determinants:

  • Purchase of duty-free cigarettes while traveling.
  • Culture
  • Availability

22

Martin and de Leeuw [42]

Year: 2013

Type: Qualitative

Country: Cook Islands, Vanuatu, Palau & Nauru

Number: 39

Male: Not specified

Female: Not specified

Age: Not specified

Place: Community based

Sampling Method: Purposive sampling

Data collection: Observation, Interview and Document analysis

Determinants:

  • Limited capacity,
  • Limited anti-tobacco coalition and l
  • Limited political commitments.

23

Lanumata et al.[43]

Year: 2010

Type: Qualitative

Country: New Zealand

Number: 18

Male: Not specified

Female: Not specified

Age: Not specified

Place: Community based

Sampling Method: Purposive sampling

Data collection: In-depth interview

Determinants:

  • More focused on the need to change attitudes towards smoking through education rather than government regulations.
  • Families and churches are major avenues for change.

24

Treiber et al. [44]

Year: 2012

Type: Qualitative

Country: Central Los Angeles, USA

Number: 69 apartment complexes/managers

Male: Not specified

Female: Not specified

Age: Not specified

Place: Community based

Sampling Method: Purposive sampling

Data collection: Focus group discussions, Observations, Telephone survey and In-depth phone interview

Determinants:

  • Significant reduction of tobacco litter in parking areas, garages, entrance ways, courtyards, balcony, walkways and community halls after implementation of tobacco policies.

25

Tapp and Thomson, 2009[45]

Year: 2009

Type: Qualitative

Country: New Zealand

Number: 9 MPs

Male: Not specified

Female: Not specified

Age: Not specified

Place: Work based

Sampling Method: Purposive sampling

Data collection: In-depth interview

Determinant:

  • General opposition to giving smoke-free car legislation a current priority

26

Waqa et al.,[46]

Year: 2015

Type: Qualitative

Country: Fiji

Number: 30 Fijian students

Male: 15

Female: 15

Age: 14-17 years

Place: School (High School) based

Sampling Method: Purposive sampling

Data collection: In-depth interview

Determinants:

  • Lack of awareness

27

Diane B. Mitschke et al. [47]

year: 2008

Type: Qualitative

Country: USA and Hawaii

Number: 54 multi-ethnic youth

Male: 19

Female: 35

Age: 10-14 years

Place: School based

Sampling Method: Purposive sampling

Data collection: Focus groups and Demographic surveys

Determinants:

  • Family
  • Peers

 

 

1. Rasanathan K, Tukuitonga CF (2007) Tobacco smoking prevalence in Pacific Island countries and territories: a review. NZ Med J: 120.
2. Islamia F, Stoklosa M, Drope J, Jemal A (2015) Global and regional patterns of tobacco smoking and tobacco control policies. Eur Urol Focus 1: 3-16.
3. Ng M, Freeman MK, Fleming TD, Robinson M, Lindgren LD, et al. (2014) Smoking prevalence and cigarette consumption in 187 countries, 1980-2012. Jama 311: 183-192.
4. Hale M, McCool J, Bullen C, Nosa V (2012) Views From a Small Pacific Island Prospects for Tobacco Control on Niue. Health promotion practice 13: 404-411.
5. Verze AP, Margreiter BM, Esposito CK, Montorsi DP, Mulhall EJ (2015) The Link Between Cigarette Smoking and Erectile Dysfunction: A Systematic Review. European Urol Focus 1: 39-46.
6. Gades NM, Nehra A, Jacobson DJ, McGree ME, Girman CJ, et al. (2005) Association between smoking and erectile dysfunction: a population-based study. Am J epidemiol 161: 346-351.
7. Teevale T, Denny S, Nosa V, Sheridan J (2013) Predictors of cigarette use amongst Pacific youth in New Zealand. Harm reduction J 10: 1-7.
8. Wilson N, Edwards R, Thomson G, Weerasekera D, Talemaitoga A (2010) High support for a tobacco endgame by Pacific peoples who smoke: national survey data. N Z Med J 123: 131-134.
9. Lew R, Tanjasiri SP (2003) Slowing the epidemic of tobacco use among Asian Americans and Pacific Islanders. Am J Public Health 93: 764-768.
10. David AM, Lew R, Lyman AK, Otto C, Robles R, et al. (2013) Eliminating Tobacco-Related Disparities Among Pacific Islanders Through Leadership and Capacity Building Promising Practices and Lessons Learned. Health promotion practice 14: 10S-17S.
11. Tsai YW, Tsai TI, Yang CL, Kuo KN (2008) Gender differences in smoking behaviors in an Asian population. J Women's Health 17: 971-978.
12. Syamlal G, Mazurek JM, Dube SR (2014) Gender differences in smoking among US working adults. Am J Prev Med 47: 467-475.
13. Nargiso JE, Becker SJ, Wolff JC, Uhl KM, Simon V, et al. (2012) Psychological, peer, and family influences on smoking among an adolescent psychiatric sample. J Subst Abuse Treat 42: 310-318.
14. Johnston V, Westphal DW, Earnshaw C, Thomas DP (2012) Starting to smoke: a qualitative study of the experiences of Australian indigenous youth. BMC public health 12: 1.
15. Simons-Morton BG, Farhat T (2010) Recent findings on peer group influences on adolescent smoking. J Prim Prev 31: 191-208.
16. Reed MB, Wang R, Shillington AM, Clapp JD, Lange JE (2007) The relationship between alcohol use and cigarette smoking in a sample of undergraduate college students. Addict Behav 32: 449-464.
17. Teevale T, Robinson E, Duffy S, Utter J, Nosa V et al. (2012) Binge drinking and alcohol-related behaviours amongst Pacific youth: a national survey of secondary school students. N Z Med J 125: 60-70.
18. Giglia RC, Binns CW, Alfonso HS (2006) Which women stop smoking during pregnancy and the effect on breastfeeding duration. BMC Public Health 6:195.
19. Ingall G, Cropley M (2010) Exploring the barriers of quitting smoking during pregnancy: a systematic review of qualitative studies. Women and Birth 23: 45-52.
20. Seo DC, Huang Y (2012) Systematic review of social network analysis in adolescent cigarette smoking behavior. J Sch Health 82: 21-27.
21. Mohammadnezhad M, Jr Amor BJ, Mangum T (2016) Prevalence and Health Consequences of Smoking among Pacific Islanders: A Systematic Review Study. J Epid Prev Med 2: 120-128.
22. Adler NE, Newman K (2002) Socioeconomic disparities in health: pathways and policies. Health Aff 21: 60-76.
23. Abdullah A, Husten C (2004) Promotion of smoking cessation in developing countries: a framework for urgent public health interventions. Thorax 59: 623-630.
24. Maglalang DD, Brown-Johnson C, Prochaska JJ (2016) Associations with E-cigarette use among Asian American and Pacific Islander young adults in California. Prev Med Rep 4: 29-32.
25. Girin N, Brostrom R, Ram S, McKenzie J, Kumar AMV, et al. (2014) Describing the burden of non-communicable disease risk factors among adults with diabetes in Wallis and Futuna. Public health action 4: S39-S43.
26. Kaholokula JK, Braun KL, Chang H, Grandinetti A, Chang H, et al. (2006) Ethnic-by-gender differences in cigarette smoking among Asian and Pacific Islanders. Nicotine & tobacco Res 8: 275-286.
27. Tareg AR, Modeste NN, Lee JW, Santos HD (2015) Health Beliefs About Tobacco With Betel Nut Use Among Adults in Yap, Micronesia. Int Q Community Health Educ 35: 245-257.
28. Erick-Peleti S, Paterson J, Williams M (2007) Pacific Islands Families Study: maternal factors associated with cigarette smoking amongst a cohort of Pacific mothers with infants. N Z Med J 120: U2588.
29. Scragg R, Laugesen M, Robinson E (2003) Parental smoking and related behaviours influence adolescent tobacco smoking: results from the 2001 New Zealand national survey of 4th form students. N Z Med J 116: U707.
30. Yang F, Wendy JYC, Ho MHR, Pooh K (2013) Psychosocial correlates of cigarette smoking among Asian American and Pacific Islander adolescents. Addict Behav 38: 1890-1893.
31. Nosa V, Gentles D, Glover M, Scragg R, McCool J, et al. (2014) Prevalence and risk factors for tobacco smoking among pre-adolescent Pacific children in New Zealand. J Prim Health Care 6: 181–188.
32. Butler S, Williams M, Paterson J, Tukuitonga C (2004) Smoking among mothers of a Pacific Island birth cohort in New Zealand: associated factors. N Z Med J 117: U1171.
33. Chen TH, Ou AC, Haberle H, Miller VP, Langidrik JR et al. (2004) Smoking rates and risk factors among youth in the Republic of the Marshall Islands: results of a school survey. Pac Health Dialog 11: 107-113.
34. Pokhrel P, Fagan P, Cassel K, Trinidad DR, Kaholokula JK, et al. (2016) Social Network Characteristics, Social Support, and Cigarette Smoking among Asian/Pacific Islander Young Adults. Am J Community Psychol 57: 353-365.
35. Wu LT, Swartz MS, Burchett B, NIDA AAPI Workgroup, Blazer DG (2013) Tobacco use among Asian Americans, native Hawaiians/Pacific Islanders, and mixed-race individuals: 2002–2010. Drug and alcohol dependence 132: 87-94.
36. Price RK, Risk NK, Wong MM, Klingle RS (2002) Substance use and abuse by Asian Americans and Pacific Islanders: preliminary results from four national epidemiologic studies. Public Health Rep 117: S39–S50.
37. Smith BJ, Phongsavan P, Bauman AE, Havea D, Chey T (2007) Comparison of tobacco, alcohol and illegal drug usage among school students in three Pacific Island societies. Drug Alcohol Depend 88: 9-18.
38. Tanjasiri SP, Lew R, Mouttapa M, Lipton R, Lew L, et al. (2013) Environmental influences on tobacco use among Asian American and Pacific Islander youth. Health Promot Pract 14: 40S-47S.
39. Kim J, McCarthy WJ (2006) School-level contextual influences on smoking and drinking among Asian and Pacific Islander adolescents. Drug Alcohol Depend 84: 56-68.
40. Gifford H, Tautolo ES, Erick S, Hoek J, Gray R, et al. (2016) A qualitative analysis of Māori and Pacific smokers' views on informed choice and smoking. BMJ open 6: e011415.
41. Tautolo, ES, Edwards R, Gifford H (2015) A gift and a burden: the purchase and distribution of duty-free tobacco and its potential impact upon Pacific people in New Zealand. Tobacco control 24: e59-e64.
42. Martin E, Leeuw DE (2013) Exploring the implementation of the framework convention on tobacco control in four small island developing states of the Pacific: a qualitative study. BMJ open 3: e003982.
43. Lanumata T, Thomson G, Wilson N (2010) Pacific solutions to reducing smoking around Pacific children in New Zealand: a qualitative study of Pacific policymaker views. N Z Med J 123: 54-63.
44. Treiber J, Acosta DV, Kipke R, Satterlund T, Araquel C (2012) Achieving smoke-free apartment outdoor area policies in Asian/Pacific islander neighborhoods of central Los Angeles. J Immigr Minor Health 14: 895-897.
45. Tapp D, Thomson G (2009) Smokefree cars in New Zealand: rapid research among stakeholders on attitudes and future directions. N Z Med J 122: 54-66.
46. Waqa G, McCool J, Snowdon W, Freeman B (2015) Adolescents Perceptions of Pro-and Antitobacco Imagery and Marketing: Qualitative Study of Students from Suva, Fiji. Biomed Res Int 2015.
47. Mitschke DB, Matsunaga DS, Loebl K, Tatafu E, Robinett H (2008) Multi-ethnic Adolescents’ Attitudes Toward Smoking: A Focus Group Analysis. Am J Health Promotion 22: 393-398.

Published: 16 June 2017

Reviewed By : Dr. Marisol Peña-Orellana.Dr. Hui Hu.

Copyright:

Copyright: © 2017 Masoud Mohammadnezhad. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.