***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVES To measure the prevalence and patterns of , and risk factors for , smoking and other tobacco use among Vietnamese men in Massachusetts ( United States ) . METHODS Data were obtained via a telephone interview of 774 Vietnamese men in 1994 . DESIGN Cross-sectional survey administered via telephone in 1994 . SETTING Massachusetts , United States . SUBJECTS R and omly selected Vietnamese men ( n = 774 ) . MAIN OUTCOME MEASURES Present and past use of tobacco products , knowledge and attitudes regarding tobacco , and risk factors for tobacco use . Results were compared with data from the Massachusetts general population . RESULTS Vietnamese men  smoked at a rate 1.9 times that of the Massachusetts general men ’s rate ( 43 % vs24 % ) . The smoking rate did not decrease with increasing length of residence in the United States . In a logistic regression , risk factors for current smoking were : age in the thirties ; history of parental smoking ; lower educational level ; higher depression score ; low level of exercise ; lack of health insurance ; and geographical origin from the south coast of Vietnam . Smoking cessation declined with increasing depression score . Most smokers ( 76 % ) had no plans to quit smoking . CONCLUSIONS Vietnamese men smoke at much higher rates than the general population , and are much less likely to be planning cessation . High rates of depression and sociocultural barriers to smoking cessation must be addressed in efforts to reduce tobacco use among this high-risk population Abstract Objective To compare the hazards of cigarette smoking in men who formed their habits at different periods , and the extent of the reduction in risk when cigarette smoking is stopped at different ages . Design Prospect i ve study that has continued from 1951 to 2001 . Setting United Kingdom . Participants 34 439 male British doctors . Information about their smoking habits was obtained in 1951 , and periodically thereafter ; cause specific mortality was monitored for 50 years . Main outcome measures Overall mortality by smoking habit , considering separately men born in different periods . Results The excess mortality associated with smoking chiefly involved vascular , neoplastic , and respiratory diseases that can be caused by smoking . Men born in 1900 - 1930 who smoked only cigarettes and continued smoking died on average about 10 years younger than lifelong non-smokers . Cessation at age 60 , 50 , 40 , or 30 years gained , respectively , about 3 , 6 , 9 , or 10 years of life expectancy . The excess mortality associated with cigarette smoking was less for men born in the 19th century and was greatest for men born in the 1920s . The cigarette smoker versus non-smoker probabilities of dying in middle age ( 35 - 69 ) were 42 % ν24 % ( a twofold death rate ratio ) for those born in 1900 - 1909 , but were 43 % ν 15 % ( a threefold death rate ratio ) for those born in the 1920s . At older ages , the cigarette smoker versus non-smoker probabilities of surviving from age 70 to 90 were 10 % ν 12 % at the death rates of the 1950s ( that is , among men born around the 1870s ) but were 7 % ν 33 % ( again a threefold death rate ratio ) at the death rates of the 1990s ( that is , among men born around the 1910s ) . Conclusion A substantial progressive decrease in the mortality rates among non-smokers over the past half century ( due to prevention and improved treatment of disease ) has been wholly outweighed , among cigarette smokers , by a progressive increase in the smoker ν non-smoker death rate ratio due to earlier and more intensive use of cigarettes . Among the men born around 1920 , prolonged cigarette smoking from early adult life tripled age specific mortality rates , but cessation at age 50 halved the hazard , and cessation at age 30 avoided almost all of it Vietnamese population s in Vietnam and the United States have a high prevalence of smoking . The associations among behavioral risk factors , acculturation , and smoking among the Vietnamese population living in the United States are not well documented . The present study aim ed to identify the factors associated with smoking behavior among Vietnamese men living in Santa Clara County , California .  A cross-sectional r and om-digit-dialed telephone survey was conducted . The sampling frame consisted of 27 Vietnamese surnames from the Santa Clara County telephone directory . A total of 660 adult respondents were interviewed to collect information on general health status , alcohol and tobacco use , HIV/AIDS , sexual behavior , injury control , hypertension , cholesterol screening , and acculturation . Of the 660 adults interviewed , 364 ( 55.2 % ) were male and 296 ( 44.8 % ) were female . Among males , 31.9 % were current smokers , and among females , only one woman reported smoking . Univariate analyses revealed that having less than a college education , having poor English language skills , using Vietnamese at home and with friends , being less acculturated , not having a routine physical or blood cholesterol check  , and being a binge drinker were significantly associated with an increased likelihood of smoking . Multivariate analysis revealed two independently associated factors : Respondents who were more acculturated were less likely to smoke ( OR = 0.38 , 95 % CI = 0.18 - 0.83 ) , and those not having cholesterol checked were more likely to smoke ( OR = 2.48 , 95 % CI = 1.30 - 4.71 ) . Acculturation level was inversely associated with  smoking among Vietnamese adult men in Santa Clara County . Other health risk behaviors coexisted with smoking behavior and should be considered in prevention programs CONTEXT In recent decades , there has been a rapid and substantial increase in tobacco consumption in China , particularly by men , but little is known from local epidemiologic studies about the pattern of smoking-related deaths . OBJECTIVE To assess the current health effects of cigarette smoking in Shanghai , China . DESIGN Prospect i ve observational study of mortality in relation to cigarette smoking . SETTING Eleven factories in urban Shanghai . SUBJECTS A total of 9351 adults ( 6494 men and 2857 women ) aged 35 to 64 years at baseline survey during the 1970s . OUTCOME MEASURES All-cause and cause-specific mortality . RESULTS During an average follow-up of 16 years , 881 men and 207 women died . Among men , 61 % had described themselves as current cigarette smokers at baseline , and their overall mortality was significantly greater than that of nonsmokers ( relative risk [ RR ] , 1.4 ; 95 % confidence interval [ CI ] , 1.2 - 1.7 ; P<.001 ) . The excess was almost twice as great ( RR , 1.8 ; 95 % CI , 1.5 - 2.2 [ corrected ] ; P<.001 ) among the men who had begun smoking before the age of 25 years and was significantly associated with the number of cigarettes smoked ( P<.001 for trend ) after adjustment for other major risk factors . The chief sources of the excess were lung cancer ( RR , 3.8 ; 95 % CI , 2.1 - 6.8 ; P<.001 ) , esophageal cancer ( RR , 3.6 ; 95 % CI , 1.2 - 10.5 ; P=.02 ) , liver cancer ( RR , 2.0 ; 95 % CI , 1.1 - 3.7 ; P=.03 ) , coronary heart disease ( RR , 1.8 ; 95 % CI , 1.0 - 3.2 ; P=.04 ) , and chronic obstructive pulmonary disease ( RR , 2.5 ; 95 % CI , 1.4 - 4.4 ; P<.01 ) . Among the men in this Chinese population , about 20 % ( 95 % CI , 12%-29 % ) of all deaths during the study period could be attributed to cigarette smoking . Of these deaths , one third involved lung cancer , one third involved other cancers , and one third involved other diseases . Only 7 % of women described themselves as current cigarette smokers at baseline , but among them there was also a statistically significant excess of overall mortality ( RR , 1.7 ; 95 % CI , 1.2 - 2.5 ; P<.01 ) . CONCLUSIONS Cigarette smoking is already a major cause of death in China , and among middle-aged Shanghai men , about 20 % of all deaths during the 1980s were due to smoking . The excess was greatest among men who began smoking before the age of 25 years , about 47 % of whom would , at 1987 mortality rates , die between the ages of 35 and 69 years ( compared with only 29 % of nonsmokers ) . These estimates reflect the consequences of past smoking patterns . The future health effects of current smoking patterns are likely to be greater because of the recent large increase in cigarette consumption , particularly at younger ages , in China This study presents population estimates of cigarette use among adults of Korean descent residing in California . Data were drawn from telephone interviews  with adults ( N=2,830 ) developed from a r and om sampling of listed persons in California with Korean surnames . A total of 86 % of attempted interviews were completed , and 85 % of the interviews were conducted in Korean . Less acculturated men and more acculturated women reported higher present and predicted future rates of smoking after multivariate statistical controls were applied . Sharply divergent rates of cigarette use were found between the genders . Although men did not smoke their first cigarette or smoke cigarettes regularly earlier than women , both groups began smoking later than adults born in the United States . To be effective , tobacco intervention efforts must be tailored specifically to cultures of each minority . Results suggest that acculturation processes influence tobacco use differentially by gender , and future research is needed to identify the implication s of processes in tobacco initiation and cessation Background This study examined two main hypotheses : a ) Polish immigrants ' smoking estimates are greater than their Irish counterparts ( b ) Polish immigrants purchasing cigarettes from Pol and smoke " heavier " ( ≥ 20 cigarettes a day ) when compared to those purchasing cigarettes from Irel and . The study also set out to identify significant predictors of ' current ' smoking ( some days and everyday ) among the Polish immigrants . Methods Dublin residents of Polish origin ( n = 1,545 ) completed a previously vali date d Polish question naire in response to an advertisement in a local  Polish lifestyle magazine over 5 weekends ( July – August , 2007 ) . The Office of Tobacco Control telephone-based monthly survey data were analyzed for the Irish population in Dublin for the same period ( n = 484 ) . Results Age-sex adjusted smoking estimates were : 47.6 % ( 95 % Confidence Interval [ CI ] : 47.3 % ; 48.0 % ) among the Poles and 27.8 % ( 95 % CI : 27.2 % ; 28.4 % ) among the general Irish population ( p < 0.001 ) . Of the57 % of smokers ( n = 345/606 ) who purchased cigarettes solely from Pol and and the 33 % ( n = 198/606 ) who purchased only from Irel and , 42.6 % ( n = 147/345 ) and 41.4 % ( n = 82/198 ) were " heavy " smokers , respectively ( p = 0.79 ) . Employment ( Odds Ratio [ OR ] : 2.89 ; 95 % CI : 1.25–6.69 ) , lower education ( OR : 3.76 ; 95%CI : 2.46–5.74 ) , and a longer stay in Irel and ( > 24 months ) were significant predictors of current smoking among the Poles . An objective validation of the self-reported smoking history of a r and omly selected sub- sample immigrant group , using expired carbon monoxide ( CO ) measurements , showed a highly significant correlation coefficient ( r = 0.64 ) of expired CO levels with the reported number of cigarettes consumed ( p < 0.0001 ) . Conclusion Polish immigrants ' smoking estimates are higher than their Irish counterparts , and particularly if employed , with only primary -level education , and are overseas > 2 years OBJECTIVE The Operant Model of Acculturation predicts that health behaviors that have a low prevalence ( < 20 % ) among Traditional ( low-acculturated ) minorities increase in prevalence with acculturation and hence have a higher prevalence among their Acculturated counterparts . Alternatively , health behaviors that have a high prevalence ( > 45 % ) among Traditional minorities decrease with acculturation and thereby have a lower prevalence among their acculturated cohorts . The purpose of this study was to test this model for the first time . DESIGN Data on the 7,249 Mexican American adults in the 2001 California Health Interview Survey ( CHIS ) , a statewide , r and om-digit-dial telephone survey , were used . MAIN OUTCOME MEASURES Two proxies for acculturation ( nativity , language spoken at home ) were predictors in analyses of cigarette smoking , exercise , and 5 + daily fruit/vegetable consumption . RESULTS For all three health behaviors , results were fully supportive of the Operant Model irrespective of acculturation-proxy and demographic variables . CONCLUSION The Operant Model may provide a coherent framework for predicting and underst and ing the role of 
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Conclusion Immigrants ’ countries of origin and host countries have reached different stages of the ‘ smoking epidemic ’ where , in addition , smoking among women lags behind that in men .
Immigrants might ‘ move ’ between the stages as ( I ) the ( non-western ) countries of origin tend to be in the early phase , ( II ) the ( western ) host countries more in the advanced phase of the epidemic and ( III ) the arrival in the host countries initiates the acculturation process .
This could explain the ‘ imported ’ high (men)/low ( women ) prevalence among less acculturated immigrants .
The low (men)/high ( women ) prevalence among more acculturated immigrants indicates an adaptation towards the social norms of the host countries with ongoing acculturation