Tobacco smoking between immigrants and non-immigrants in Australia: a longitudinal investigation of the effect of nativity, duration of residence and age at arrival

ISSUE ADDRESSED: Earlier research evidence suggests that there is a difference and over time change in the prevalence of tobacco smoking between immigrants and native-born population. This study investigates the differences in smoking among immigrants from English speaking (ESC) and non-English speaking (NESC) countries relative to native-born (NB) Australians, and how those differences change with duration of residence (DoR) and age at arrival (AA). METHODS: Information on 12 634 individuals from the first twelve waves (2001-2012) of Household, Income and Labour Dynamics in Australia (HILDA) longitudinal survey was analysed using multilevel group-mean-centred mixed logistic regression models. Smoking status as an outcome was dichotomized as current vs non-current smokers. RESULTS: After adjusting for covariates, relative to native-born respondents, there was no difference in the odds of smoking for English speaking countries immigrants, while immigrants from non-English speaking countries had lower odds of smoking. The smoking prevalence of immigrants from non-English speaking countries converged towards the native-born after 20 years of residence in Australia. The association between duration of residence and smoking was modified by age at arrival, with immigrants (combined ESC and NESC) who arrived as children or adolescents and had lived 20 years or longer were significantly more likely to smoke than native-born Australians. CONCLUSION: The results suggest that the initially lower smoking prevalence among non-English speaking countries immigrants converges with that of native-born Australians after twenty years of residence, and immigrants (combined ESC and NESC) who arrived as children or adolescents more than 20 years ago were more likely to be smokers. SO WHAT?: Current health promotion and anti-smoking programs should ensure that immigrants from non-English speaking background have access to education and information about the hazards of tobacco consumptions and are aware of the available smoking cessation services. Efforts to prevent smoking uptake among NESC immigrants and those who arrive as children or adolescents and live longer than 20 years is especially important for tobacco control interventions.