A horrible Chinese American habit

Chinese Americans have much to be thankful for, but a low rate of lung cancer is not one of them.

Chinese Americans have the highest rate of lung, liver and colorectal cancer in the Asian American population. Chinese American women are the most likely among Asian American women to die of lung cancer; Chinese American men have the third-highest mortality rate from lung cancer among their Asian American peers.

The high prevalence of cancer in the Chinese American community can be linked to higher smoking rates. Immigrant Chinese men have among the highest smoking rates among Asian Americans.

Why do so many Chinese Americans smoke, especially when it's the most preventable cause of death in this country?

One factor may be cultural norms in China-the world's largest consumer of cigarettes. As in other Asian countries, Chinese grow up in an atmosphere in which smoking is allowed and even encouraged. Given that 70 percent of all Asian Americans are born outside of the United States, it is no surprise that many Chinese immigrants bring the acceptance of smoking with them when they emigrate. In fact, the number of cigarettes Chinese men smoke daily rises the longer they live in the US, according to the American Lung Association.

Tobacco companies are also at fault because they target Asian Americans with pro-smoking marketing. Internal industry documents show that since at least the mid-1980s, American tobacco companies have targeted Asian Americans and Pacific Islanders specifically. The tobacco industry views Asian Americans as a "potential gold mine" because of Asian countries' high smoking rates, because Asian Americans are highly concentrated geographically and because of the high proportion of Asian retailers.

Tobacco companies also market heavily in Asian countries. China is an especially ripe market for tobacco companies, given that the country represents the largest market of smokers internationally. While China has publicly acknowledged the dangers of tobacco - through its ratification of the World Health Organization Framework Convention on Tobacco Control - the country has yet to pass strong anti-smoking policies.

Smoking also takes a toll on nonsmokers. Each year, adults who have never smoked still develop lung cancer because of their exposure to second-hand smoke, which may explain the high lung-cancer mortality rate of Chinese women. In California, Asian Americans and Pacific Islanders together have the second-highest rate of second-hand smoke exposure in the workplace of any ethnic or racial group (10.5 percent). People working in stores, warehouses, plants, factories, restaurants and bars have the highest rates of exposure to second-hand smoke.

It is critical to stop and prevent our young people from smoking. Studies in the US show that nearly 100 percent of daily smokers try their first cigarette as minors or young adults. In addition, Asian American youth are more likely to smoke menthol cigarettes-the only flavor left out of the cigarette smoking ban in the 2009 Tobacco Control Act.

Efforts are underway to lessen tobacco use among Asian Americans.

The Asian Smokers' Quitline (operated by the Moores Cancer Center at the University of California, San Diego) is a free, nationwide Asian-language smoking cessation service that offers smokers or concerned family members self-help materials, referral to local programs, one-on-one telephone counseling and a free, two-week starter kit of nicotine patches. Services are available in four languages (Vietnamese, Cantonese, Mandarin and Korean).

I founded Asian Pacific Partners for Empowerment Advocacy and Leadership 19 years ago to bring down tobacco use in the Asian American community. Back then, few tobacco-control resources existed and there was no national movement advocating tobacco-control policies, including creating smoke-free public areas. There was no big push to build awareness of the dangers of tobacco use nor much leadership on the issue.

Now, there is a national network of organizations representing the Asian American community dedicated to raising awareness of the detriments of tobacco use. We all need to support policy changes curbing tobacco use and access to ensure a tobacco-free community. Please join our network of advocates working to eliminate tobacco use.

Rod Lew is executive director of Asian Pacific Partners for Empowerment, Advocacy and Leadership. Founded in 1994, APPEAL is a national organization working toward social justice and a tobacco-free Asian American, Native Hawaiian and Pacific Islander community.