Abstract
The present exploratory study examined the role of acculturation in the perception of the risks of smoking following a smoking cessation induction intervention among Latino caregivers of children with asthma. The sample consisted of 131 Latino smokers (72.9 % female; 18.3 % born in the U.S.) who were caregivers of a child with asthma. Caregivers were randomized to one of two smoking cessation interventions that were part of a home-based asthma program. Self-report measures of risk-perception were assessed at baseline, end of treatment (2 months after baseline), and 2- and 3-months post-treatment. At baseline, caregivers, regardless of level of acculturation, reported moderate to high levels of concern about the effects of secondhand smoke on their child’s health as well as perceived risk regarding the effect of smoking on their own health. However, caregivers who were low in acculturation had a greater increase in concern about the effects of smoking on their child from pre-to post treatment compared to those who were high in acculturation (p = .001). Lastly, level of acculturation moderated the association between caregivers’ concern about smoking on their child’s health and their motivation to quit smoking (p < .05), but not cessation rates or reduced secondhand smoke exposure (p > .05). Specifically, motivation to quit at 3 months was greater for those with low acculturation. Though exploratory, these findings suggest that risk perception may be more easily influenced in low versus high acculturated populations and this should be considered in the design of clinical interventions and potentially mass media campaigns seeking to influence risk of caregiver behavior on child health with ethnic and racial minorities.
Similar content being viewed by others
References
Abraido-Lanza, A. F., Chao, M. T., & Florez, K. R. (2005). Do healthy behaviors decline with greater acculturation? Implications for the Latino mortality paradox. Social Science and Medicine, 61, 1243–1255. doi:10.1016/j.socscimed.2005.01.016.
Bethel, J. W., & Schenker, M. B. (2005). Acculturation and smoking patterns among Hispanics: A review. American Journal of Preventive Medicine, 29, 143–148. doi:10.1016/j.amepre.2005.04.014.
Bock, B. C., Niaura, R. S., Neighbors, C. J., Carmona-Barros, R., & Azam, M. (2005). Differences between Latino and non-Latino White smokers in cognitive and behavioral characteristics relevant to smoking cessation. Addictive Behaviors, 30, 711–724. doi:10.1016/j.addbeh.2004.08.017.
Borrelli, B., McQuaid, E. L., Becker, B., Hammond, K., Papandonatos, G., Fritz, G., et al. (2002). Motivating parents of kids with asthma to quit smoking: The PAQS project. Health Education Research, 17, 659–669.
Borrelli, B., McQuaid, E. L., Novak, S. P., Hammond, S. K., & Becker, B. (2010). Motivating Latino caregivers of children with asthma to quit smoking: A randomized trial. Journal of Consulting and Clinical Psychology, 78, 34–43. doi:10.1037/a0016932.
Boudreaux, E. D., Sullivan, A., Abar, B., Bernstein, S. L., Ginde, A. A., & Camargo, C. A, Jr. (2012). Motivation rulers for smoking cessation: A prospective observational examination of construct and predictive validity. Addiction Science & Clinical Practice, 7, 8. doi:10.1186/1940-0640-7-8.
Caka, F. M., Eatough, D. J., Lewis, E. A., Tang, H., Hammond, S. K., Leaderer, B. P., et al. (1990). An intercomparison of sampling techniques for nicotine in indoor environments. Environmental Science and Technology, 24, 1196–1203.
Castro, Y., Reitzel, L. R., Businelle, M. S., Kendzor, D. E., Mazas, C. A., Li, Y., et al. (2009). Acculturation differentially predicts smoking cessation among Latino men and women. Cancer Epidemiology, Biomarkers and Prevention, 18, 3468–3475. doi:10.1158/1055-9965.EPI-09-0450.
Codern, N., Pla, M., de Ormijana, A. S., Gonzalez, F. J., Pujol, E., Soler, M., et al. (2010). Risk perception among smokers: A qualitative study. Risk Analysis, 30, 1563–1571. doi:10.1111/j.1539-6924.2010.01462.x.
Constantine, M. L., Rockwood, T. H., Schillo, B. A., Castellanos, J. W., Foldes, S. S., & Saul, J. E. (2009). The relationship between acculturation and knowledge of health harms and benefits associated with smoking in the Latino population of Minnesota. Addictive Behaviors, 34, 980–983. doi:10.1016/j.addbeh.2009.05.008.
Corral, I., & Landrine, H. (2008). Acculturation and ethnic-minority health behavior: A test of the operant model. Health Psychology, 27, 737–745. doi:10.1037/0278-6133.27.6.737.
Graves, K. D., Huerta, E., Cullen, J., Kaufman, E., Sheppard, V., Luta, G., et al. (2008). Perceived risk of breast cancer among Latinas attending community clinics: Risk comprehension and relationship with mammography adherence. Cancer Causes and Control, 19, 1373–1382. doi:10.1007/s10552-008-9209-7.
Hammond, S. K., & Leaderer, B. P. (1987). A diffusion monitor to measure exposure to passive smoking. Environmental Science and Technology, 21, 494–497.
Heatherton, T. F., Kozlowski, L. T., Frecker, R. C., & Fagerstrom, K. O. (1991). The Fagerstrom Test for Nicotine Dependence: A revision of the Fagerstrom Tolerance Questionnaire. British Journal of Addiction, 86, 1119–1127.
Helweg-Larsen, M., & Stancioff, L. M. (2008). Acculturation matters: Risk perceptions of smoking among Bosnian refugees living in the United States. Journal of Immigrant and Minority Health, 10, 423–428. doi:10.1007/s10903-007-9107-1.
Joseph, G., Burke, N. J., Tuason, N., Barker, J. C., & Pasick, R. J. (2009). Perceived susceptibility to illness and perceived benefits of preventive care: An exploration of behavioral theory constructs in a transcultural context. Health Education & Behavior, 36, 71S–90S. doi:10.1177/1090198109338915.
Kumar, R., Curtis, L. M., Khiani, S., Moy, J., Shalowitz, M. U., & Sharp, L., et al. (2008). A community-based study of tobacco smoke exposure among inner-city children with asthma in Chicago. Journal of Allergy & Clinical Immunology, 122, 754–759 e751. doi: 10.1016/j.jaci.2008.08.006.
Landrine, H., & Klonoff, E. A. (2004). Culture change and ethnic minority health-behavior: An operant theory of acculturation. Journal of Behavioral Medicine, 27(6), 527–555.
Lara, M., Akinbami, L., Flores, G., & Morgenstern, H. (2006). Heterogeneity of childhood asthma among Hispanic children: Puerto Rican children bear a disproportionate burden. Pediatrics, 117, 43–53. doi:10.1542/peds.2004-1714.
Leaderer, B. P., & Hammond, S. K. (1991). Evaluation of vapor-phase nicotine and respirable suspended particle mass as markers for environmental tobacco smoke. Environmental Science and Technology, 25, 770–777.
Liem, J. J., Kozyrskyj, A. L., Benoit, C. M., & Becker, A. B. (2007). Asthma is not enough: Continuation of smoking among parents with an asthmatic child. Canadian Respiratory Journal, 14, 349–353.
Marín, G., Sabogal, F., Van Oss Marín, B., Otero-Sabogal, F., & Pérez-Stable, E. J. (1987). Development of a short acculturation scale for Hispanics. Hispanic Journal of Behavioral Sciences, 9, 183–205.
Marin, G., & Van Oss Marin, B. (1991). Research with Hispanic populations. Newbury Park, CA: Sage.
Miller, W. R., & Rollnick, S. (1991). Motivational interviewing: Preparing people to change addictive behavior. New York: Guilford Press.
Pew Hispanic Center. (2012). Unauthorized Immigrants: 11.1 Million in 2011. Website accessed July 22, 2013. http://www.pewhispanic.org/2012/12/06/unauthorized-immigrants-11-1-million-in-2011/.
Robinson, J., & Kirkcaldy, A. J. (2007). ‘You think that I’m smoking and they’re not’: Why mothers still smoke in the home. Social Science and Medicine, 65, 641–652. doi:10.1016/j.socscimed.2007.03.048.
Stewart, D. W., & Martin, I. M. (1994). Intended and unintended consequences of warning messages: A review and synthesis of empirical research. Journal of Public Policy and Marketing, 13, 1–19.
Strachan, D. P., & Cook, D. G. (1998). Health effects of passive smoking. 6. Parental smoking and childhood asthma: Longitudinal and case-control studies. Thorax, 53, 204–212.
Verification, SRNT Subcommittee on Biochemical. (2002). Biochemical verification of tobacco use and cessation. Nicotine & Tobacco Research, 4, 149–159. doi: 10.1080/14622200210123581.
Wagener, T. L., Gregor, K. L., Busch, A. M., McQuaid, E. L., & Borrelli, B. (2010). Risk perception in smokers with children with asthma. Journal of Consulting and Clinical Psychology, 78, 980–985. doi:10.1037/a0021094.
Weinstein, N. D. (1999). Accuracy of smokers’ risk perception. Nicotine & Tobacco Research, 1, S123–S130.
Conflict of interest
Authors Theodore L. Wagener, Andrew M. Busch, Shira I. Dunsiger, Karl S. Chiang and Belinda Borrelli declare that they have no conflict of interest.
Informed Consent
All procedures followed were in accordance with ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Wagener, T.L., Busch, A.M., Dunsiger, S.I. et al. Changes in risk perception following a smoking cessation intervention: the role of acculturation in a sample of Latino caregivers. J Behav Med 37, 1000–1008 (2014). https://doi.org/10.1007/s10865-014-9554-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10865-014-9554-9