These findings are consistent with other studies of Vietnamese male current smokers (Chan et al., 2007; Rahman et al., 2005; Wiecha et al., 1998). For the ��how�� component of developing comprehensive action strategies, this study suggests that strengthening Multiple myeloma community outreach may have a greater effect than reorienting health services; this outreach should include Vietnamese doctors. Although Vietnamese male current smokers are more likely to be employed than their never-smoker counterparts, they less often have health insurance and make fewer doctor visits. Community outreach in places where smokers congregate is perhaps a better potential strategy. This study suggests that socializing with friends and smoking in coffee shops, restaurants, or bars are the two most frequently reported triggers for smoking.
This common trigger of social situations and after meals was also reported in another study in Seattle (Chan et al., 2007). The fact that media exposure was not significantly associated with smoking status in this study may be limited by the period of recall to the past month. Regarding the ��for whom�� component of which level of society to target, besides acting directly on individuals, families and community groups may be also targeted. Vietnamese male current smokers were more likely than their never-smoker counterparts to be married or (among age-eligible men) to have had a Vietnamese military/police or reeducation camp experience. Social relationships, both close and distant ties, are thought to be important mediators of smoking behavior and facilitators of cessation (Christakis & Fowler, 2008).
Men who served in the Vietnamese military/police or had reeducation camp stays had a social norm of smoking during those periods; these groups may be targeted through community programs. For younger men, other social dynamics, including influence of this older generation of smokers, should be investigated. Although targeting the recent immigrant community makes sense given the greater male smoking social norm in Vietnam, the fact that the number of years of residence in the United States was not significantly associated with current or former smoking compared with never smoking, requires further exploration.
The role of years of residence in the United States may be complicated in that recent immigrants may be more likely to quit than their counterparts in the countries of origin (Zhu, Wong, Tang, Shi, & Chen, 2007), but longer term residents in the United States are also more likely to start smoking (U.S. Department of Health and Human Services, 1998). The complex relationship among length of time, social factors, and smoking status for Vietnamese American men is also highlighted in our interaction analysis. One of the interactions with increasing age was with the Vietnamese military/reeducation Anacetrapib camp experience variable.