Objectives: Provide comprehensive data on smoking behavior among Samoans.
Design: Cross-sectional, using systematic random sampling procedures, and in-person interviews.
Setting: US Territory of American Samoa, Hawaii, and Los Angeles, California.
Participants: 1834 adult, non-institutionalized Samoans.
Main outcome measures: Prevalence and independent predictors of smoking.
Results: Approximately one fourth (26.6%) of Samoans were current smokers, with 31.4% of men and 22.5% of women currently smoking. More current smokers were found in American Samoa (28.9%), followed by Hawaii (26.9%) and Los Angeles (24.1%, P<.001). At each site, Samoan men compared with the women were significantly more likely to smoke (P<.001), initiate smoking earlier (P<.05), and smoke more cigarettes (P<.05). Cessation rates for the sample were very low. Predictors of smoking included being younger, male, married, less educated, with lower income, and more acculturated.
Conclusion: The high smoking and low cessation rates indicate that smoking-related diseases will be significant causes of morbidity and mortality for Samoans for many years. The findings further underscore the importance of documenting smoking patterns and their determinants for subgroups rather than aggregates such as Asian American and Pacific Islanders. If Samoans are to meet the Healthy People 2010 tobacco goals, there is a need to: 1) develop tailored tobacco awareness and cessation programs based on the recommendations made by the Taskforce on Community Preventive Services; 2) understand the complex interactions between social, cultural, and psychological determinants of smoking and cessation behaviors; and 3) develop policies to limit availability of tobacco, environmental exposure from tobacco, and increase cessation efforts.