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BMC Public Health
Published in: BMC Public Health 1/2014

Open Access 01-12-2014 | Research article

How immigrants adapt their smoking behaviour: comparative analysis among Turkish immigrants in Germany and the Netherlands

Authors: Katharina Reiss, Odile Sauzet, Jürgen Breckenkamp, Jacob Spallek, Oliver Razum

Published in: BMC Public Health | Issue 1/2014

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Abstract

Background

Smoking behaviour among immigrants is assumed to converge to that of the host country’s majority population with increasing duration of stay. We compared smoking prevalence among Turkish immigrants residing in two different countries (Germany (DE)/the Netherlands (NL)) between and within countries by time spent in Turkey and DE/NL.

Methods

The German 2009 micro-census and the Dutch POLS database (national survey, 1997–2004) were analysed. An interaction variable with dichotomised length of stay (LOS) in Turkey (age: 0–17; 18+) and categorised LOS in the host country (immigration year: 1979 and earlier, 1980–1999, 2000–2009; the latter only for Germany) was generated. Age standardised smoking prevalences and sex-specific logistic regression models were calculated.

Results

6,517 Turkish participants were identified in Germany, 2,106 in the Netherlands. Age-standardised smoking prevalences were higher among Turkish immigrants in the Netherlands compared to those in Germany: 62.3% vs. 53.1% (men/lower education); 30.6% vs. 23.0% (women/lower education). A similar trend was observed for the majority population of both countries. The chance of being a smoker was lower among Turkish men with short LOS in Turkey and middle LOS in Germany/the Netherlands compared to those with short LOS in Turkey and long LOS in Germany/the Netherlands (NL: OR = 0.57[95% CI = 0.36-0.89]; DE: OR = 0.73[95% CI = 0.56-0.95]). Contrary to that, the chance of being a smoker was higher among Turkish men with long LOS in Turkey and middle LOS in Germany/the Netherlands compared to those with long LOS in Turkey and long LOS in Germany/the Netherlands (NL: OR = 1.35[95% CI = 0.79-2.33]; DE: OR = 1.44[95% CI = 1.03-2.02]). The effects for Turkish women were similar, but smaller and often non-significant.

Conclusion

Turkish immigrants adapt their smoking behaviour towards that of the Dutch/German majority population with increasing duration of stay. This was particularly obvious among those who left Turkey before the age of 18 years – a group that needs tailored interventions to prevent further increases in smoking. Those who left Turkey as adults and spent a short time in the host countries show ‘imported’ smoking patterns. A limitation of this study is the use of cross-sectional data: a cohort effect cannot be ruled out. Our findings have to be confirmed with longitudinal data.
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Literature
1.
Doll R, Peto R, Boreham J, Sutherland I: Mortality in relation to smoking: 50 years’ observations on male British doctors. BMJ. 2004, 328 (7455): 1519-1528.CrossRefPubMedPubMedCentral
2.
Vineis P, Alavanja M, Buffler P, Fontham E, Franceschi S, Gao YT, Gupta PC, Hackshaw A, Matos E, Samet J, Sitas F, Smith J, Stayner L, Straif K, Thun MJ, Wichmann HE, Wu AH, Zaridze D, Peto R, Doll R: Tobacco and cancer: recent epidemiological evidence. J Natl Cancer Inst. 2004, 96 (2): 99-106.CrossRefPubMed
3.
Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, McQueen M, Budaj A, Pais P, Varigos J, Lisheng L, INTERHEART Study Investigators: Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case–control study. Lancet. 2004, 364 (9438): 937-952.CrossRefPubMed
4.
Hiscock R, Bauld L, Amos A, Fidler JA, Munafò M: Socioeconomic status and smoking: a review. Ann N Y Acad Sci. 2012, 1248: 107-123.CrossRefPubMed
5.
Wilson LM, Avila Tang E, Chander G, Hutton HE, Odelola OA, Elf JL, Heckman-Stoddard BM, Bass EB, Little EA, Haberl EB, Apelberg BJ: Impact of tobacco control interventions on smoking initiation, cessation, and prevalence: a systematic review. J Environ Public Health. 2012, 2012: 961724-CrossRefPubMedPubMedCentral
6.
Federal Statistical Office of Germany: Bevölkerung und Erwerbstätigkeit. Bevölkerung mit Migrationshintergrund – Ergebnisse des Mikrozensus 2011 [Population andoccupation. People with migration background – results from the micro census 2011]. 2012, Wiesbaden, Germany: Federal Statistical Office of Germany
7.
8.
9.
10.
The Ministry of Health of Turkey: Global Adult Tobacco Survey (GATS) - Turkey Report. 2010, Ankara, Turkey: The Ministry of Health of Turkey
11.
12.
Nagelhout GE, De Korte-de BD, Kunst AE, van der Meer RM, De Vries H, Van Gelder BM, Willemsen MC: Trends in socioeconomic inequalities in smoking prevalence, consumption, initiation, and cessation between 2001 and 2008 in the Netherlands. Findings from a national population survey. BMC Public Health. 2012, 12: 303-CrossRefPubMedPubMedCentral
13.
Lampert T, von der Lippe E, Müters S: Prevalence of smoking in the adult population of Germany: results of the German Health Interview and Examination Survey for Adults (DEGS1). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2013, 56 (5–6): 802-808.CrossRefPubMed
14.
15.
16.
Reeske A, Spallek J, Razum O: Changes in smoking prevalence among first- and second-generation Turkish migrants in Germany - an analysis of the 2005 Microcensus. Int J Equity Health. 2009, 8: 26-CrossRefPubMedPubMedCentral
17.
Gebhardt R, Cassens S, Liecke F, Rohde G, Gün AK, Brücker R, Pankow W: Smoke-free by ramadan: experience with a low-threshold prevention offer on smoking cessation for persons with migration background. MMW Fortschr Med. 2012, 154 (2): 33-40.PubMed
18.
Nierkens V, De Vries H, Stronks K: Smoking in immigrants: do socioeconomic gradients follow the pattern expected from the tobacco epidemic?. Tob Control. 2006, 15 (5): 385-391.CrossRefPubMedPubMedCentral
19.
Acartürk CZ, Nierkens V, Agyemang C, Stronks K: Depressive symptoms and smoking among young Turkish and Moroccan ethnic minority groups in The Netherlands: a cross-sectional study. Subst Abuse Treat Prev Policy. 2011, 6: 5-CrossRefPubMedPubMedCentral
20.
Nierkens V, Stronks K, Van Oel CJ, De Vries H: Beliefs of Turkish and Moroccan immigrants in The Netherlands about smoking cessation: implications for prevention. Health Educ Res. 2005, 20 (6): 622-634.CrossRefPubMed
21.
Van Oort FV, van der Ende J, Crijnen AA, Verhulst FC, Mackenbach JP, Joung IM: Determinants of daily smoking in Turkish young adults in the Netherlands. BMC Public Health. 2006, 6: 294-CrossRefPubMedPubMedCentral
22.
23.
Schooling M, Kuh D: A life course perspective on women’s health behaviours. A life course approach to women’s health. Edited by: Kuh D, Hardy R. 2002, Oxford: Oxford University Press, 279-303.CrossRef
24.
Razum O, Twardella D: Time travel with Oliver Twist – towards an explanation for a paradoxically low mortality among recent immigrants. Trop Med Int Health. 2002, 7 (1): 4-10.CrossRefPubMed
25.
Berry JW: Immigration, Acculturation, and Adaptation. ApplPsycholInt Rev. 1997, 46 (1): 5-34.
26.
Rudmin FW: Catalogue of acculturation constructs: Descriptions of 126 taxonomies, 1918–2003. Online Readings in Psychology and Culture (Unit 8, Chapter 8). Edited by: Lonner WJ, Dinnel DL, Hayes SA, Sattler DN. 2003, Bellingham, Washington DC: Center for Cross-Cultural Research, Western Washington University
27.
Chakraborty BM, Chakraborty R: Concept, measurement and use of acculturation in health and disease risk studies. Coll Antropol. 2010, 34 (4): 1179-1191.PubMed
28.
Cabassa LJ: Measuring Acculturation: Where We Are and Where We Need to Go. Hispanic J Behav Sci. 2003, 25 (2): 127-146.CrossRef
29.
Abraído-Lanza AF, Armbrister AN, Flórez KR, Aguirre AN: Toward a theory-driven model of acculturation in public health research. Am J Public Health. 2006, 96 (8): 1342-1346.CrossRefPubMedPubMedCentral
30.
Chun KM, Organista PB, Marin G: Acculturation: Advances in Theory, Measurement, and Applied Research. 2002, Washington DC: American Psychological Association
31.
An N, Cochran SD, Mays VM, McCarthy WJ: Influence of American acculturation on cigarette smoking behaviors among Asian American subpopulations in California. Nicotine Tob Res. 2008, 10 (4): 579-587.CrossRefPubMedPubMedCentral
32.
Bethel JW, Schenker MB: Acculturation and smoking patterns among Hispanics: a review. Am J Prev Med. 2005, 29 (2): 143-148.CrossRefPubMed
33.
Choi S, Rankin S, Stewart A, Oka R: Effects of acculturation on smoking behavior in Asian Americans: a meta-analysis. J Cardiovasc Nurs. 2008, 23 (1): 67-73.CrossRefPubMed
34.
Kim SS, Ziedonis D, Chen KW: Tobacco use and dependence in Asian Americans: a review of the literature. Nicotine Tob Res. 2007, 9 (2): 169-184.CrossRefPubMed
35.
Marin G, Perez-Stable EJ, Marin BV: Cigarette smoking among San Francisco Hispanics: the role of acculturation and gender. Am J Public Health. 1989, 79 (2): 196-198.CrossRefPubMedPubMedCentral
36.
Parker ED, Solberg LI, Foldes SS, Walker PF: A surveillance source of tobacco use differences among immigrant populations. Nicotine Tob Res. 2010, 12 (3): 309-314.CrossRefPubMed
37.
Pérez-Stable EJ, Ramirez A, Villareal R, Talavera GA, Trapido E, Suarez L, Marti J, McAlister A: Cigarette smoking behavior among US Latino men and women from different countries of origin. Am J Public Health. 2001, 91 (9): 1424-1430.CrossRefPubMedPubMedCentral
38.
Tang H, Shimizu R, Chen MS: English language proficiency and smoking prevalence among California's Asian Americans. Cancer. 2005, 104 (12 Suppl): 2982-2988.CrossRefPubMedPubMedCentral
39.
Spallek J, Zeeb H, Razum O: What do we have to know from migrants' past exposures to understand their health status? A life course approach. Emerg Themes Epidemiol. 2011, 8 (1): 6-CrossRefPubMedPubMedCentral
40.
Nierkens V, van der Ploeg MV, Van Eer MY, Stronks K: How do psychosocial determinants in migrant women in the Netherlands differ from these among their counterparts in their country of origin? A cross-sectional study. BMC Public Health. 2011, 11: 397-CrossRefPubMedPubMedCentral
41.
Rechel B, Mladovsky P, Ingleby D, Mackenbach JP, McKee M: Migration and health in an increasingly diverse Europe. Lancet. 2013, 381 (9873): 1235-1245.CrossRefPubMed
42.
43.
44.
Federal Statistical Office of Germany: Qualitätsbericht Mikrozensus 2009 [Quality report micro census 2009]. 2010, Wiesbaden, Germany: Federal Statistical Office of Germany
45.
46.
Griffiths MA, Ford EW: Hookah smoking: behaviors and beliefs among young consumers in the United States. Soc Work Public Health. 2014, 29 (1): 17-26.CrossRefPubMed
47.
Mackenbach JP, Karanikolos M, McKee M: The unequal health of Europeans: successes and failures of policies. Lancet. 2013, 381 (9872): 1125-1134.CrossRefPubMed
48.
49.
Reiss K, Spallek J, Razum O: 'Imported risk' or 'health transition'? Smoking prevalence among ethnic German immigrants from the Former Soviet Union by duration of stay in Germany - analysis of microcensus data. Int J Equity Health. 2010, 9: 15-CrossRefPubMedPubMedCentral
50.
Twisk JWR, Kemper HCG, Van Mechelen W, Post GB: Tracking of risk factors for coronary heart disease over a 14-year period: a comparison between lifestyle and biologic risk factors with data from the Amsterdam Growth and Health Study. Am J Epidemiol. 1997, 145 (10): 888-898.CrossRefPubMed
51.
Kelder SH, Perry CL, Klepp KI, Lyte LL: Longitudinal tracking of adolescent smoking, physical activity, and food choice behaviors. Am J Public Health. 1994, 84 (7): 1121-1126.CrossRefPubMedPubMedCentral
52.
Yilmaz Y, Glodny S, Razum O: Social networking as an alternative concept for the recruitment of Turkish migrants for scientific studies. The example of the saba project. Hallesche Beiträge zur Gesundheits- und Pflegewissenschaft. 2009, 8 (1): 636-653.
53.
Schenk L: Migrant-specific participation barriers and accessiblity in The Child and Adolescent Health Survey. Gesundheitswesen. 2002, 64 (1): 59-68.CrossRef
54.
Poonia J: Smoking cessation and ethnic minority communities. Findings of qualitative research project with Turkish, Polish, and Somalian communities in London. 2009, NHS Commissioning Support for London: London, England
Metadata
Title
How immigrants adapt their smoking behaviour: comparative analysis among Turkish immigrants in Germany and the Netherlands
Authors
Katharina Reiss
Odile Sauzet
Jürgen Breckenkamp
Jacob Spallek
Oliver Razum
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2014
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-14-844

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