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

Reiss K, Sauzet O, Breckenkamp J, Spallek J, Razum O - BMC Public Health (2014)

Bottom Line: The effects for Turkish women were similar, but smaller and often non-significant.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.

View Article: PubMed Central - PubMed

Affiliation: Department of Epidemiology & International Public Health, Bielefeld School of Public Health (BiSPH), Bielefeld University, P,O, Box 10 01 31, 33501 Bielefeld, Germany. katharina.reiss@uni-bielefeld.de.

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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Related in: MedlinePlus

Comparison of age standardised smoking prevalences (in%) between Turkish participants in Germany (DE) and the Netherlands (NL)/Non-Turkish participants in Germany and the Netherlands (between-country-comparison).
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Fig2: Comparison of age standardised smoking prevalences (in%) between Turkish participants in Germany (DE) and the Netherlands (NL)/Non-Turkish participants in Germany and the Netherlands (between-country-comparison).

Mentions: The same trend became apparent when additionally stratifying the results by educational level (see Figure 2). The age standardised smoking prevalence was significantly higher among Turkish men and women with lower educational level in the Netherlands compared to their counterparts in Germany (men: 62.3% vs. 53.1%; women: 30.6% vs. 23.0%). The following pattern, in turn, was similar between Turkish immigrants in Germany and the Netherlands: there were indications of a higher smoking prevalence among less educated men compared to more educated men but a lower prevalence among less educated women compared to more educated women. Moreover, smoking prevalence was significantly higher among men than among women in both countries (not significant among higher educated persons in the Netherlands). Concerning the age standardised smoking prevalence among the non-Turkish population there were also indications of a higher smoking prevalence among persons from the Netherlands compared to their counterparts from Germany (e.g. women with low education: 42.7% vs. 36.6%; exception: men with higher education) (see Figure 2).Figure 2


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

Reiss K, Sauzet O, Breckenkamp J, Spallek J, Razum O - BMC Public Health (2014)

Comparison of age standardised smoking prevalences (in%) between Turkish participants in Germany (DE) and the Netherlands (NL)/Non-Turkish participants in Germany and the Netherlands (between-country-comparison).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4150979&req=5

Fig2: Comparison of age standardised smoking prevalences (in%) between Turkish participants in Germany (DE) and the Netherlands (NL)/Non-Turkish participants in Germany and the Netherlands (between-country-comparison).
Mentions: The same trend became apparent when additionally stratifying the results by educational level (see Figure 2). The age standardised smoking prevalence was significantly higher among Turkish men and women with lower educational level in the Netherlands compared to their counterparts in Germany (men: 62.3% vs. 53.1%; women: 30.6% vs. 23.0%). The following pattern, in turn, was similar between Turkish immigrants in Germany and the Netherlands: there were indications of a higher smoking prevalence among less educated men compared to more educated men but a lower prevalence among less educated women compared to more educated women. Moreover, smoking prevalence was significantly higher among men than among women in both countries (not significant among higher educated persons in the Netherlands). Concerning the age standardised smoking prevalence among the non-Turkish population there were also indications of a higher smoking prevalence among persons from the Netherlands compared to their counterparts from Germany (e.g. women with low education: 42.7% vs. 36.6%; exception: men with higher education) (see Figure 2).Figure 2

Bottom Line: The effects for Turkish women were similar, but smaller and often non-significant.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.

View Article: PubMed Central - PubMed

Affiliation: Department of Epidemiology & International Public Health, Bielefeld School of Public Health (BiSPH), Bielefeld University, P,O, Box 10 01 31, 33501 Bielefeld, Germany. katharina.reiss@uni-bielefeld.de.

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.

Show MeSH
Related in: MedlinePlus