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Understanding the effects of acculturation on Chinese-Canadian female youth smoking 2007

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Understanding the Effects of Acculturation on Chinese-Canadian Female Youth Smoking b y L i Shun A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF Master of Arts in The Faculty of Graduate Studies ^ H u m a n K i n e t i c s ^ T H E U N I V E R S I T Y O F B R I T I S H C O L U M B I A August 2007 @ L i Shun, 2007 ABSTRACT In a recent report, the Canadian Counci l on Social Development emphasized the importance of acculturative influences on substance use by immigrant youth, including smoking (Kunz and Hanvey, 2000). Nevertheless, research on youth smoking in response to acculturation is quite l imited in Canada, especially concerning recent immigrants from East As i a , who represent 23% of the total immigrant population in the country (Census Canada, 2001). The majority of the literature and research on ethnic youth and tobacco use comes out of the United States (Ma , 1999; Chen, 2004). Considering Canada and Amer ica have been pursuing different immigration policies which have resulted in dissimilar socio-cultural environments and subsequently, dissimilar acculturation processes, the lack of studies in this area in Canada constitutes a gap that need to be addressed by researchers. In addition, most of the study carried out in the Uni ted States drew on surveys, yet qualitative interview methods are critical for learning about the role of acculturation in youth adoption of host country cultural practices such as smoking. The research investigated how acculturation processes affect smoking uptake among recent immigrant girls from China. The purpose of the research was to explore how the smoking behavior of this specific population might be l inked to the transformational processes young Chinese immigrant girls go through in negotiating their ethnic identities and adjusting their cultural values to life in Canada. In-depth interviews were conducted with 20 Chinese-Canadian girls (10 smokers/10 non-smokers) currently attending university or college in the Greater Vancouver area ii during 2007. Interview questions addressed acculturation, cultural values, ethnic identity, peer pressure and parenting style. The Vancouver Index of Acculturation was used to measure participants' levels of acculturation. Results show that the Chinese-Canadian female smokers demonstrated strong 'cultural hybridity' in adopting strategies that accommodated values from both their home and host communities. The study found that the smokers experienced a number of acculturative stresses in their lives, and that smoking was used in part as a coping strategy to manage cultural differences, moderate identity confusion, and reduce feelings of isolation, particularly during the early phase of immigration. Disrupted and problematic immigrant family structure was identified as another major factor contributing to so-called "downward assimilation" in which situation immigrant youth had higher chance of initiating smoking. iii T A B L E O F C O N T E N T S ABSTRACT » TABLE OF CONTENTS iv LIST OF TABLES vi LIST OF CHARTS vii 1 INTRODUCTION 1 1.1 BACKGROUND 1 1.1.1 Heterogeneity of Female Smoking Cultures 2 1.1.2 Migration and Globalization 4 1.2 RESEARCH QUESTIONS AND OBJECTIVES 5 1.3 SIGNIFICANCE OF RESEARCH 5 1.4 SUMMARY OF METHODS 6 2 THEORETICAL PERSPECTIVES 8 2.1 ACCULTURATION THEORY 8 2.1.1 Negotiation of Ethnic Identity 10 2.1.2 Change of Cultural Values , 13 2.1.3 Acculturation in Multicultural Canada 15 2.2 THEORY OF CULTURAL HYBRIDITY 17 2.3 YOUTH SMOKING CULTURE, PEERS AND PARENTS 19 2.4 EXISTING RESEARCH GAPS 22 3 RESEARCH METHODS 25 3.1 THE QUALITATIVE APPROACH AND RETROSPECTIVE RESEARCH DESIGN 25 3.2 DATA COLLECTION 26 3.2.1 Semi-structured Interviews 26 Sampling Design 28 Questions 29 3.2.2 The Vancouver Index of Acculturation 29 3.3 DATA ANALYSIS 30 3.4 ETHICAL ISSUES 31 4 RESULTS 33 4.1 PARTICIPANT CHARACTERISTICS 33 4.2 VANCOUVER INDEX OF ACCULTURATION (VIA) RESULTS 36 4.3 ROLE OF SOCIAL ENVIRONMENT 37 4.3.1 Physical and Demographic Environment 38 4.3.2 Different Cultural Environments 38 4.3.3 Family Environment 40 4.3.4 Secondary School Environment 42 4.4 SMOKING PATTERNS 42 iv 4.4.1 Self-identified as Social Smokers 43 4.4.2 "Closet Smoking" 45 4.4.3 Smoking among Groups of Chinese Youth 46 4.5 FUNCTIONAL VALUES OF SMOKING 47 4.5.1 Acculturation Coping Strategy 47 4.5.2 Empowerment 52 4.5.3 A Way to De-stress 53 4.5.4 Rebellion 54 4.6 CULTURAL HYBRIDITY AND IDENTITY CONFUSION 55 4.6.1 Swinging between Two Cultural Domains 55 Rigid Chinese Family VS. Liberal Western Society 55 Participants' Own Interpretation of Chinese Values and Western Values 58 4.6.2 Identity Confusion 59 4.7 MODERATED ACCULTURATION IN CANADA 60 5 DISCUSSION AND IMPLICATIONS 62 5.1 ROLE OF ACCULTURATION 62 5.1.1 Identity Negotiation 63 5.1.2 Cultural Value Changes 64 5.2 ROLE OF HYBRIDITY 65 5.2.1 Acceptance of Female Smoking 66 5.2.2 Hiding Games 67 5.3 EFFECTS OF GROWING UP IN IMMIGRANT FAMILY 68 5.3.1 "Astronaut Family" 68 5.3.2 Intergenerati onal Communicati on 70 5.3.3 Rigid Parenting Style and Rebellion 72 5.4 IMPLICATIONS FOR YOUTH HEALTH PROMOTION 72 5.5 IMPLICATIONS FOR CANADIAN GOVERNMENT HELATH DEPARTMENT ... 73 5.6 IMPLICATIONS FOR THE IMMIGRATION POLICY MAKERS 74 6 CONCLUSIONS 75 6.1 A N ETHNOGRAPHIC VIEW OF IMMIGRANT YOUTH SMOKING 75 6.2 LIMITATIONS 75 REFERENCES 77 APPENDIX 81 Appendix 1 81 Appendix 2 82 Appendix 3 85 Appendix 4 88 V LIST OF TABLES Table 4.1-1: Age (Smokers) 34 Table 4.1-2: Age (Non-Smokers) 34 Table 4.1-3: Place of Bir th (Smokers) 34 Table 4.1-4: Place of Bir th (Non-smokers) 34 Table 4.1-5: Language Spoken at Home and Parent's Engl ish A b i l i t y (Smokers) 35 Table 4.1-6: Language Spoken at Home and Parent's Engl ish Ab i l i t y (Non-smokers) 35 Table 4.1-7: Family Members Smoking (Smokers) 35 Table 4.1-8: Fami ly Members Smoking (Non-smokers) 35 Table 4.1-9: Astronaut Fami ly (Smokers) 36 Table 4.1-10: Astronaut Fami ly (Non-smokers) 36 L I S T O F C H A R T Chart 4.2-1: The V I A Evaluation ACKNOWLDGEMENTS First and foremost, I would like to send my utmost gratitude to U B C School of Human Kinetics for giving me an opportunity to further my studies in my desired area. M y supervisor Dr. Robert Sparks has given the greatest support and motivation on my thesis project. I not only learned from his dedication to academic research as a scholar, I also greatly appreciated for the extra patience and encouragement he has been giving to the foreign students in the department. Besides, I want to give rhy special thanks to my other two committee members, D r Wendy Frisby and Dr. M i u Chueng Yan, their professional guidance made this research project turn out successfully. Last but not least, my personal achievement always belongs to my parents back in China who never stopped supporting me in my whole life. viii 1 INTRODUCTION 1.1 BACKGROUND Adolescent female smoking is a serious health concern and has been studied by researchers across many disciplines. In a cultural and socioeconomic context, significant effort has been made by tobacco researchers to investigate the factors that contribute to female adolescent smoking. These factors include female youth's own interpretations of smoking, peer influences, and women-targeted advertising strategies of the tobacco industry. However, research on female smoking initiation in response to acculturation is quite limited, particularly research on ethnic minority females in Canada. A recent report by the Canadian Council on Social Development has highlighted the importance of acculturative influences on substance use, including smoking, by immigrant youth, (Kunz and Hanvey, 2000), and further research on this population of smokers is warranted. Immigrant girls display quite different behavior patterns from their white, majority counterparts in Canada in terms of cultural traditions, ethnic identities, social resources, and family environments. To find out the specific smoking behavior patterns among immigrant youth and the reasons for these behavior patterns, it is critical to understand the difference in their life experiences as compared to their non-immigrant, majority counterparts. In addition, female smoking, per se, is imbued with different connotations in different societies according to their cultural norms. Due to these cultural differences, female smoking tends to respond to acculturation, and it is potentially fruitful to link up female smoking and acculturation to understand how acculturation might contribute to smoking uptake by recent immigrant girls. < l For the above reasons, I was greatly encouraged to conduct research on the smoking behaviors of immigrant female adolescents in Canada from an acculturative perspective. M y research focused on the acculturation process that occurs when Chinese-Canadian female youth who were born in China immigrate to Canada in their childhood. The study used a retrospective design to trace back the life experiences of the research participants (university and college students) in order to examine a potential relationship between acculturation and smoking initiation and continuance. The purpose of the study is to explore how the smoking behavior of this specific population might be l inked to the transformative processes they have gone through in adjusting their cultural values and negotiating their ethnic identities in response to immigration to Canada. 1.1.1 Heterogeneity of Female Smoking Cultures One of the vital premises that underpin this research is the heterogeneity of female smoking cultures. Female smoking, as a socially constructed phenomenon, is not uniformly acceptable throughout the world, and social norms regarding female tobacco use vary across different cultures. For example, female smoking rates in developing countries are different from those in industrialized countries. A s Greaves (1996) notes, "only 2% to 10% of women l iv ing in developing countries smoke cigarette," whereas rates in developed countries are higher. The low percentage of tobacco use among women in developing countries compared to those in developed countries, however, does not typically reflect health awareness, but rather a behavior code shaped by cultural standards and traditions. Historically, having been under the control of different feudal regimes for thousands of years, China steadily framed a dominant gender ideology of women's obedience to men. From a Chinese philosophical perspective, Confucianism believed that, between the two principles that govern the universe, Yang which represents men is superior to Yin which represents woman. ( L i , 2000). Fo l lowing this basic dogma, today, women are expected to follow a set of rigorous behavior guidelines to demonstrate their submission to men. Female smoking, positioned on the top of the taboo list, has long been considered enormously inappropriate. Even nowadays, female smoking is still associated with extremely negative images, especially from a male perspective. A recent study found that 62.9 percent of Chinese males think smoking creates a bad image for women. The smoking culture based on gender inequality is undoubtedly one of the factors that contribute to the relatively low female smoking prevalence rate in China. Accord ing to the 2002 national survey carried out by China's Public Health Department, 6 1 % of males and 3% of females smoked cigarettes in the country (Yang, 2002). A newly conducted study (Chinese Consumer Association, 2004) reported an increased smoking rate of 5.6% among female urbanites due to rapid modernization and westernization processes taking place in some major cities. However, compared to a 21% female smoking rate in Canada ( C T U M S 2006), there is still a significant gap in acceptability of female smoking between the two societies. A s a consequence of this particular cultural difference, people who move from one cultural domain to the other w i l l be exposed to a condition that challenges their perceptions of female smoking as wel l potentially as their personal attitudes and 3 behavior. This is the key point through which female smoking and acculturation can be connected. It is also the logical basis on which this study is conceived. 1.1.2 Migration and Globalization Considering that the cultural differences surrounding female smoking are objectively constituted, population migration and economic globalization potentially can serve as important vehicles to transport cultures internationally v ia processes of acculturation and westernization. Historically, waves of immigration (here focusing particularly from Asian countries to western countries) that emerged during the 19 t h and 20th centuries created immigrant masses who left their communities of origin in search of new locations as they looked for accepting political climates and improved economic conditions. This diaspora and subsequent ethnic contact led to inevitable acculturation of immigrant populations to the host society. Acculturation can be formally defined as " A merger of two or more independent cultural systems, leading to dynamic processes that include the adaptation of value systems and transformation within relationship and personality traits." (Social Science Counci l , 1954) These dynamic processes include the way that individuals and groups of individuals adapt their beliefs and cultural practices to accommodate the values and practices of a host country. Female smoking, viewed in this light, demonstrates fundamental conflicts between western and eastern value systems and merits an investigation in a cross- cultural context. Values and beliefs also travel by virtue of cultural hegemony caused by globalization and not only as a consequence of immigration. Dominant ideologies can diffuse globally without a geographic migration of people, because economic globalization has facilitated a tendency towards cultural homogeneity 4 around the world. Through consumer marketing and the mass media, this helps to explain the gradually increasing female smoking rates in many of the eastern countries nowadays. This thesis is focused on the former form of cultural changes resulting from immigration and its effects on female smoking. 1.2 RESEARCH QUESTIONS AND OBJECTIVES In my research, a primary goal has been set to identify the socio-cultural forces and conflicts involved in the process of acculturation, and to find out how they jointly work to stimulate some Chinese-Canadian girls to take up smoking. "What is the relationship between acculturation and Chinese- Canadian female youth smoking?" remains the major research question for my study. The lead question can be broken down into 4 sub-questions as follow: 1) What role does acculturation play in immigrant youth smoking, particularly in smoking initiation? 2) Where do Chinese-Canadian girls position themselves culturally and does their self-positioning affect their smoking. 3) How do Chinese-Canadian girls identify themselves with regard to their "hyphenated" status and is smoking behavior related to certain identity preferences? 4) As powerful social and environmental forces, how do peer pressure and parenting style contribute to cultural value formations and behavior changes that occur in the adolescents? 1.3 SIGNIFICANCE OF RESEARCH My research will make two major contributions to extant research on female smoking. The first one is situated at a theoretical and methodological level. In Canada, very little tobacco-related research has focused on Asian immigrants and particularly on the acculturation process. A few studies have been done in the United States (Chen et al., 5 1999; M a et al. , 2004; M a et al. , 2002; Shelley et al. 2004.) For example, Chen and Unger (1999) demonstrated that Chinese-American girls who are more acculturated are more l ikely to be smokers. Yet, none of the studies provide an ethnographic view regarding the operation of acculturation, and as a result, it is unclear how a young female's acculturation level might affect her uptake of smoking. M y research continued the efforts of previous scholars to understand immigrant smoking behavior by further exploring the processes of acculturation from an ethnographic perspective. A t a practical level, the project was also intended to focus the attention of health promoters on adolescent female smokers within immigrant populations. Statistically, Chinese are now the largest visible minority group in Canada, having reached a total of more than one mi l l ion (Statistics Canada 2003a). In Vancouver, 49% of the population are members of visible minority groups (most of them are Chinese and South Asian) ( B C immigration Statistics, 1999). The potential implications of the prospective findings from this research are significant i n view o f the fact that Canada has been pursuing an open immigration policy. Understanding the association between acculturation and smoking in the As ian immigrant population is an important step toward constructing more effective prevention, intervention and cessation programs specifically designed for this group, and consequently it can help the Canadian government to successfully reduce smoking rates and medical costs nationally. 1.4 SUMMARY OF METHODS There are two major justifications for adopting a qualitative research methodology i n my thesis project. Firstly, little is known about the topic, and previous research from an ethnographic perspective is scarce. This supports using qualitative methods generally, and ethnographic methods in particular, in order to expand an understanding of the basic social pressures at the play. Secondly, a study focusing on the acculturation process necessitates a methodological approach that can help capture the social context and field of meanings that surround the topic. Here again, a qualitative approach is we l l suited. Semi-structured interviews were the main method of data collection for the project. 20 interviews were conducted individually with 20 Chinese-Canadian girls (10 smokers/10 non-smokers) who are currently attending university or college in the Greater Vancouver area. Interview questions covered areas pertaining to acculturation, cultural values, ethnic identity, peer pressure and parenting style. Particularly, the questions were designed to find out how each of these conditions was related to the smoking behaviour of the targeted female youth. 7 2 THEORETICAL PERSPECTIVES 2.1 ACCULTURATION THEORY The concept of acculturation has a long history in the social and behavioral sciences, particularly among anthropologists and sociologists. Ear ly in the 2 0 t h century, anthropologists started to recognize the importance of cultural contact between disparate groups. Redfield, Lin ton and Herskovits (1936) initially proposed the term 'acculturation' and defined it as, "phenomena which result when groups of individuals having different cultures come into continuous first-hand contact with subsequent changes in the original culture patterns of either or both groups." Since then, acculturation has become an increasingly important concept for explaining the varied experiences of ethnic and cultural minorities as international migration i n response to economic globalization and polit ical conflicts have supported the creation of multicultural societies. Berry (2003) has suggested that there are four types of acculturation strategies, or cultural orientations that can occur as an outcome of the acculturation process: assimilation, separation, integration and marginalization. Individuals who are assimilated have completely adopted the behaviors and thinking of the dominant host culture to which they have migrated. In contrast, individuals who are separatists remain completely immersed in the language, activities, and beliefs of their culture of origin. Integrated individuals are those who are more f luid between both their culture of origin and the new host culture. Finally, marginalists are isolated from both their culture of origin and the dominant society. To link the past acculturation-smoking research to this model, it is necessary to clarify that individuals who wittingly or unwittingly adopted assimilation 8 and integration strategies in the process of acculturation are considered "acculturated" or "more acculturated" (Chen, 1999. & X u , 2004) than those who are separated or marginalized. A s part of my research, the Vancouver Acculturation Index was utilized as an evaluation tool to measure the acculturation levels of the research participants. The Vancouver Acculturation Index is a 20-question, self-report instrument that assesses several domains relevant to acculturation (Ryder et al. 2000). Questions cover a variety of topics including values, social relationships and adherence to traditions and are arranged in pairs to measure both the heritage (Chinese) and mainstream (Canadian) dimensions of acculturation. A s stated by many Acculturation theorists, behavioral changes as an observable outcome of acculturation begin early in the process. Accord ing to Berry, "culture shedding, culture learning, and culture conflict" (1992) are the three sub-processes involved in behavior change. The first two processes involve the selective, accidental, or deliberate loss of behaviors and their replacement by behaviors that al low the individual a better fit with the society of settlement. This process is usually called adjustment, because virtually all the adaptive changes take place in the acculturating individual, with few changes occurring among members of the larger society. Mos t of these adjustments are typically made with minimal difficulty, in which cases, the acculturation experiences appear to be non problematic. However, some degree of conflict may occur, which is usually resolved by the acculturating person yielding to the behavioral norms of the dominant group. Consistent empirical findings allow for the fol lowing generalizations. Concerning behavioral changes, the fewest changes result from the separation strategy, 9 and most result from the assimilation strategy. Berry and Sam (1997) also pointed out that "Integration involves the selective adoption of new behaviors from the host society and retention of valued features from the heritage culture. Marginalization is often associated with major heritage culture loss and the appearance of many dysfunctional and deviant behaviors." Accord ing to this framework, Chinese-Canadian, young, female smokers who fall into either an assimilation strategy or integration strategy would be expected to follow the acculturation flow illustrated above, with smoking considered a typical behavior that is adopted from the host culture by the Chinese-Canadian girls who acculturate. However, although my research is not designed to focus on those who engage a marginalization strategy, it is still worth mentioning that the chance of starting tobacco use might be even higher for them than the other types of acculturative cases because adaptive stress is much more l ikely to affect the psychological well-being and social status of the marginalized individuals, which relates to smoking as wel l . 2.1.1 Negotiation of Ethnic Identity Ethnic identity is an indispensable concept for understanding and explaining the processes of acculturation. A s Phinney (2003) notes "ethnic groups are subgroups within a larger context that c la im a common ancestry and share one or more of the fol lowing elements: culture, phenotype, religion, language, kinship, or place of origin." Bu i ld ing on the perception of ethnic groups, ethnic identity was defined as a dynamic, multidimensional construct that refers to one's identity or sense of self as a member of an ethnic group. 1 0 Phinney (2003) also pointed out that changes in acculturation and ethnic identity can be conceptualized in terms of at least two dimensions: (a) retention of or identification with the ethnic, or original, culture and (b) adaptation to or identification with a dominant, host or "new" culture (Berry & Sam, 1997), including identification with a third culture (Oetting & Beauvais, 1991) or multiple cultures (Root, 1996). This multidimensional conceptualization highlights the fact that identity negotiation, especially the negotiation between identifications with original culture and host culture, occurs over time and continuously during the acculturation process among immigrant populations who are granted citizenship in a receiving country. Identity adjustment is considered as one facet of the overall acculturation process which differs from other aspects, in part because identity is negotiable at a subjective level. Whi l e identity negotiation and cultural value changes (to be discussed later) serve as the most significant forces emerging from the acculturation process ultimately leading to behavioral changes in individuals, they affect change in different ways. Identity negotiation is more associated with "psychological acculturation" and is also considered "a force residing at an emotional level" (Phinney, 2003). However, cultural value change to a great extent reflects an individual 's cognition and influences an individual 's behavior in a much more far-reaching and consistent way. Previous research also found that immigrants have to go through a process in which their ethnic identity becomes muted but eventually gets re-expressed. Leong and Chou (1994) proposed a model l inking ethnic identity development and acculturation. They suggested that the earliest stage (unexamined, or pre-encounter) is equivalent to n assimilation in that individuals at this stage would l ike to and perhaps try to be part of the larger society and may deny or downplay their own ethnicity. During the second stage (moratorium, or immersion), individuals become deeply involved in exploring and understanding their own culture and thus may seem separated from the larger society. Final ly, with ethic identity achievement (or internalization), individuals accept and value their own group and the larger society, and so they seem to be integrated. The above concepts and models show that under the influence of a desire for assimilating to the host culture, ethnic identity is not clearly articulated for potentially a long period. Wi th diluted ethnic identity, some of the immigrants, especially those who adopted an assimilation acculturation strategy, may pursue an identity with the host culture which can be interpreted as a national identity based on citizenship. In this case, as suggested by Tajfel's social identity theory (1986), immigrant individuals have to completely immerse themselves in the host society and modify their cultural values and behaviors in everyday life in order to fit into the group and obtain a sense of belonging to the dominant group. Adolescence is a period when transition from childhood to adulthood is taking place, and cognitive and mental development w i l l gradually guide youth to a secure self-identity. But according to Phinney (1989), before adulthood is reached, immigrant youth tend to remain uncertain about their ethnic identity. Adolescence is the most recognizable pre-encounter stage of ethnic identity development. A direct consequence of this k ind of identity confusion is that immigrant youth w i l l intentionally downplay their original cultural manifestations in order to satisfy their identity preference. Specifically in this 12 study, attitudes towards female smoking help set a clean-cut boundary between western and eastern value systems. Thus, as a meaningful and symbolized behavior in a cross-cultural contest, taking up smoking could serve as a means for the immigrant girls to conceal their ethnic identity. 2.1.2 Change of Cultural Values Cultural values are another critical factor, that affects people's behavior. Changes in values can dictate changes in behavior among members of an ethnic or cultural group undergoing acculturation. In view of the significant impacts a person's cultural values can have on his or her behaviors, understanding cultural values is essential in my study in order to address the kinds of values changes that directly or indirectly contribute to smoking among Chinese-Canadian female youth. Cultural values are an essential component in Kluckhohn 's (1951) definition of culture: "Culture consists in patterned ways of thinking, feeling and reacting, acquired and transmitted by symbols, constituting the distinctive achievements of human groups, including their embodiments in artifacts; the essential core of culture consists of traditional (i.e., historically derived and selected) ideas and especially their attached values." Cultural values and beliefs are often used to identify specific ethnic or cultural groups. For example, collectivism is widely believed as the essential value of the eastern cultural system, whereas, individualism is situated in the center of the western value structure. The question is, how do these two opposite principles guide people's other cultural values and subsequently shape their different behaviors? In the context of my study, this relates to how an individualistic culture might contribute to female smoking 13 and reversely, whether adherence to collectivism might somehow prevent or l imit smoking uptake. Chinese philosophical systems contribute significantly to Chinese collectivist cultures. For example, Confucianism is a philosophy of human nature that "considers proper human relationships as the basis of society" (Samovar, 2001). It sees f i l ia l piety as the foundation for achieving ultimate humanity, stability and peace. Through respecting seniority within a family unit, one learns to free oneself from being self-opinionated, dogmatic, obstinate and egotistical, thus becoming more humble and considerate of others. This internalized family ethic could enhance family relations which have been found to be an important factor in preventing youth smoking. There is another cultural value controversy between the east and the west that also leads to different ways of understanding female smoking. In western societies, the rise of smoking among women in the latter half of the 20th century was partly a consequence of the parallel rise of the feminist movement of the 1960s. Female smoking was marketed to women as an act of resistance to convention and the cigarette was presented as a 'symbol of female emancipation' (Jacobson, 1981). Many girls who take up smoking today are trying to show that they can be as rebellious, tough, and daring as boys. Female smoking in industrialized countries was promoted as a feminist issue. W h i l e in the east, without a parallel feminist movement, the stereotypical image set by the society for a girl remained being quiet, cooperative and obedient. Smoking was not removed from the list of taboos for women in the East. Ironically, western feminist values to some extent lent themselves to exploitation in support of women's smoking. Having said this, however, I also do not want to oversimplify this relationship or to imply that "western" culture is somehow 14 uniform. There are many cultures, discourses and initiatives concerned with female smoking in Canadian society, however, the point I am making here refers to the specific framework of female liberation that was promoted by the feminist movements at the time and to the fact that these meanings lent themselves to the transgression of taboos which in some cultural contexts included the taboo against female smoking. Currently there are a number of initiatives in Canada that target women's smoking directly, both with respect to preventing smoking uptake and promoting smoking cessation. The above cultural value discrepancies were selected as topics of discussion in the interviews formulated for my study in order to help identify the value conversions that might have a bearing on smoking initiation and continuance of Chinese-Canadian girls. It is worth noting that this research focuses on the values and beliefs that are used to characterize a culture or an ethnic group, not the particular personal values (e.g. religious, ethical) that individuals may have. Although cultural and personal values both influence behavior and may be modified by acculturation, the emphasis in this study is placed on cultural values and beliefs (i.e., macrosocial values such as 'being family oriented'). The distinction is made because of the lack of relevant research on the correlation between acculturation and personal values. In addition, cultural values are perceived by researchers as "directly relevant to the description and identification of cultural and ethnic groups and the design of large scale behavior change interventions." (Marin , 1992) 2.1.3 Acculturation in Mult icultural Canada Berry's model (2003) conveys the assumption that acculturation is a tough, one way process where immigrants have little to say about being heavily socialized as members of 15 a particular cultural group. A s it implies, the only successful strategies are either entirely assimilating to the host culture or selectively integrating both cultures, and those who choose to stay out of the mainstream cultures are doomed to fail in their immigrant lives, at least culturally and socially. This hypothesis leaves little room for agency, free w i l l , or autonomy. Berry's acculturation model has been critiqued by other acculturation theorists. For example, Bhatia (2002) used the notion of diaspora as a basis to question Berry's "integration strategy". She argued that acculturation is better understood as a "dialogical negotiation between the I positions of feeling simultaneously assimilated, separated and marginalized" than a process of rectifying oneself and one's cultural knowledge with that of a receiving culture (Bhatia, 2002). In a study focused on Canadian immigrant youth, Yvonne Hebert (2005) challenges this view and suggests that i f "the principle of equality is situated at the very heart of theories of cultural differences in multicultural Canada, the individual also has an ability to determine social structure. It is important to change the way of conceiving of social relations, cultural differences and acculturation, so as to account for the power of agency." Hebert's work overturns conventional understandings of acculturation and expresses limitations of previous research that found a positive correlation between Chinese-Canadian female youth smoking and their acculturation level. In particular, a l l previous research that has proved such a relationship was based in the United States, a typical 'melting pot' society where people from different cultures are ultimately reshaped to fit into a standard American value system. In that case, acculturation is more l ikely to be a r igid and demanding process in which immigrants are required to demonstrate stronger adaptability to the host culture and willingness to detach 16 from their culture of origin. In Canada, a multicultural country constructed largely by immigration, it makes sense that the acculturation process could function in a different way and invokes a different line of questioning. Amids t a plurality of identities and cultural groups, how do Canadian immigrant youth weave their own cultural elements to create a new cultural belonging and identity formation? Similarly, how do particular cultural origins and identity formations l ink up to smoking initiation and continuance among Chinese-Canadian girls? 2.2 THEORY OF CULTURAL HYBRIDITY Dallaire (2005) recently used the concept of hybridity to help account for how Acadian Francophone youth in Canada are socialized into a f luid cultural identity that combines Francophoness and Anglophoness. The youth are able to move within and between these two cultures and express themselves in ways which reflect culturally specific sensitivities and competencies in both distinctive and integrative ways. Dallaire(2005) defines identity as "a performance constituted by discursive practices". This definition implies that identity has a fluid characteristic and can be negotiated and shaped over time depending on what cultural practices are drawn upon and performed. Forming an identity is a largely unnoticed process of social learning and practice. The more an individual performs particular cultural practices, such as the language, food, expressions and mannerisms of an ethnic group, the more the person is able to integrate these cultural attributes and express them as a collectively relevant yet personal cultural identity. Dallaire (2005) challenges the idea that culturally vulnerable and unstable identities 17 are weakened and damaged by a strong stable majority identity. She argues that the identities of dominant groups are themselves "unstable, changing, interacting and mix ing with other identities". The concept of hybridity is integral to this framework and refers specifically to "the intersection and transformation of two relatively (un)stable identities into a new one also (un)stable." (Dallaire, 2005) This conceptualization of hybridity helps to broaden my research framework which mainly draws on acculturation theories. Hybridi ty helps to shift the focus to the multiple influences of youths' varied cultural experiences and the different "discursive environments] in which they decide who they are and who they w i l l be" (Dallaire, 2005), which is what the acculturation models have been unable to offer. In a purely definitional sense, hybridity involves the fusion of two or more diverse forms, styles, or identities. Cross-cultural contact, which often occurs across national borders as wel l as across cultural boundaries, is a requisite for hybridity, thus hybridization shares similar conditions and features with acculturation. They both take place under the condition of exchange of people, ideas and practices, and they can both be referred to as the inevitable phenomenon of cultural adapting when people move from one culture to another. A s conventionally theorized, acculturation conveys an implication of passive and forced assimilation to the host community by the immigrant population. Hybridity, on the other hand, particularly as described by Dallaire (2005), connotes a more balanced and neutral status of cultural amalgamation without requiring that one culture is more empowering or powerful than the other. In this respect, the concept of hybridity can be used to help enrich the concept of acculturation by highlighting the varied ways that people adapt to 18 changing cultural contexts and environments and demonstrating the dynamic and changing character of this adaptive process. 2.3 Y O U T H S M O K I N G C U L T U R E , P E E R S A N D P A R E N T S M y study also drew on the literature of youth culture, particularly relating to adolescent smoking. Mos t researchers agree that the factors which drive a ch i ld to try cigarettes are quite distinct from those which compel an adult to continue smoking. They also agree that the reasons a chi ld takes a puff are largely social. A n ethnographic study conducted by McCracken (1992) with a specific focus on examining the cultural meaning adolescents attached to smoking reported that teens use smoking as a means of identity construction just as they use other cultural resources l ike music, clothing and posters. Furthermore, McCracken ' s research was based on 30 in-depth interviews with girls and boys from different backgrounds, and identified 8 types of cultural meanings associated with smoking that were important to teens, including meanings associated with gender, age, social status, nationality, sexuality, mood/emotion, brand image and group stereotype. He explained how cigarette smoking is connected to each of these cultural formations in the daily lives of western youth. Although McCracken ' s research was not focused on immigrant youth, the report has potential value for helping to conceptualize cultural meanings and practices relating to youth smoking. Understanding the particular cultural meanings youth attach to smoking in western societies is no less important than delving into the concept of acculturation in this thesis. Youth smoking culture and acculturation are ultimately interconnected concepts in the context of immigrant youth smoking uptake. For example, a Chinese-Canadian girl , breaking away from conventional values and 19 accepting a youth smoking sub-culture is truly part of the acculturation process. W i t h industrialization in western countries since early last century, the conditions in which adults l ive and children are raised are shifting. " N o groups in society are more profoundly affected by these changes than are adolescents and young adults." (Resnick, 2004). Calabrese (1987) pointed out that adolescence in itself is a growth period that is conducive to alienation, primarily due to the "betwixt and between" nature of this particular position in the life course. Dur ing this period, adolescents experience a transition from childhood to adulthood, from appropriate dependence on other people to self determination in numerous areas. Youth culture is a broad collection of knowledge addressing a wide array of problems emerging in this particular period of human life. Peer pressure and parent-child relationships are underlying conditions in youth culture that both help shed light on my thesis research. Peer pressure has been studied in various ways with reference to youth culture. Peers typically replace the family as the center of a young person's socializing activities and source of consultation when they grow, develop, and move into early adolescence. Dur ing this period, they begin to question adult standards and the need for parental guidance. A t the same time, involvement with their peers and the attraction of peer identification increases. They find it comforting to turn for advice to friends who are in the same position themselves and who understand and sympathize with their situation. They enjoy "trying on" new values and testing their ideas with their peers. Peer pressure hence has been studied in a variety of kinds of tobacco research focusing on adolescent smoking, and has been found as an important factor in adolescent smoking onset. 20 Parent-adolescent relationships are another essential factor that has been widely researched in the youth culture literature. Adolescents establish their individuality while they retain, but alter their relationship with their parents (Grotevant & Cooper, 1986). A l s o , adolescents may successfully differentiate themselves as distinct persons while remaining open to parental advice and seeking parental endorsement. F rom their side, "parents optimally come to realize that the unilateral exercise of authority, which satisfied the demands of childhood, must be transformed into greater equality, reciprocity and mutuality." (Hofer, 2004). However, despite the general tendency towards a more unrestricted family environment, parenting styles in practice still vary across cultures and social classes. In a Chinese-Canadian immigrant family, parent-child relationships tend to be a lot more complicated than in regular families of either cultural group. The frequent difficulties facing the new second generation arise from their struggles to balance the demands of western culture with those of tradition-minded parents. Portes & Rumbaut (1996) conceptualize the acculturation gaps between immigrant parents and their children in a typology of "generational consonance versus dissonance." Generational consonance occurs when parents and children both remain unacculturated, or both acculturate at the same rate, or coincide on selective acculturation. Generational dissonance occurs when children's levels of acculturation do not correspond to those of their parents and they do not conform to parental guidance, leading to role reversal and intensified parent-child conflicts. Accord ing to Portes & Rumbaut, these acculturation patterns interact with contextual factors, such as racial discrimination, urban subcultures, and labor market 21 prospects, to affect adaptational outcomes of children. When contextual factors are unfavorable, as is the case confronting the majority of second generation immigrant youth, consonant acculturation enables immigrant children to lean on material or moral resources available in the family and the immigrant community; it thus increases the probability of upward assimilation. On the contrary, dissonant acculturation breaks ties between children and their adult social world, deprives children of family or community resources, and in this situation, immigrant children are l ikely to rebel against parental expectations. A m o n g the population of Chinese immigrants in particular, parenting appears to be a bi-directional factor in terms of the impact it causes on adolescent smoking. A previous study found that rigorous parenting derived from traditional Chinese culture shows a positive association with lower adolescent smoking rate (Wu, 2004). However, it also found out that application of Chinese-style family values and roles in a non-Chinese society tends to create conflicts at home, thus Chinese immigrant youth w i l l have to cope with two levels of acculturative stress both at home and outside of home, which, sometimes might lead to problematic behavior. Fami ly relationships is one of the primary conditions I investigated in my thesis research in order to find out how certain types of parenting practices prevent or facilitate Chinese youth smoking in the context of acculturation. 2.4 EXISTING RESEARCH GAPS The earliest research I could find with a specific focus on the relationship between acculturation and smoking among As ian immigrants was conducted by Chen in California in 1999 (Chen, 1999). Her research drew on two surveys, the California Tobacco Survey 22 in 1990 and the California Youth Tobacco Survey in 1996, that assessed smoking-related attitudes and behaviors among California youth in grades 7-12. Acculturation status was evaluated in the survey with items that measured Engl ish usage, language spoken at home, and age at immigration to the United States. The results showed that Asian-American youth have relatively lower smoking rates and a later age of smoking onset than non-Asian youth in California. In addition, As i an American youth with low levels of acculturation exhibited lower rates of cigarette smoking, and smoking risk increased dramatically as they became more acculturated. A subsequent study of Asian-American acculturation into smoking by M a (2004) was part of a community-based, comprehensive cross-sectional study tailored to assess a broad array of knowledge, attitudes and behavior on tobacco use in a multi-ethnic and multi-lingual Asian-American community, Delaware Val ley . Compared to the previous study, this research used a more comprehensive and multidimensional measurement of acculturation including language use, preparation and consumption of native foods, age when a person immigrated to (and length of residency in) the U S , parents' birthplace, ethnicity of friends, and involvement in cultural groups and activities. The findings showed that acculturation had a variable effect on smoking behavior: more acculturated youth and less acculturated male adults had higher smoking rates, and more acculturated adult females had a higher smoking rate than the less acculturated. Since a positive correlation of acculturation and tobacco use among Asian-Amer ican adolescents and females was demonstrated in both of the survey-based studies, it is important to investigate these same conditions in Canada and to examine the ways that acculturation 23 affects Asian-Canadian youth to see i f these same patterns hold true in a different national context. A t the same time, the primary research questions for my study are somewhat different from those of the previous investigations, and are intended to help f i l l gaps in the previous research. Firstly, the previous survey research d id not provide contextual information about smoking behavior. For instance, M a and Chen's research both explain the relationship of acculturation and smoking but do not specifically account for how acculturation influences smoking uptake and continuance in immigrant youth. Through ethnographic research built on observation and interviews with selected informants, my research explores the meaningful relationships between acculturation and smoking behavior, which so far have only been understood in correlational terms in survey research. M y study also incorporates the concepts of peer pressure, family relationships and youth smoking cultures to supplement understandings of acculturation theorized based on surveys. Acculturation alone is inadequate to inform research that aims to study adolescent smoking. A more comprehensive approach is needed which engages the multiple perspectives, positionalities and strategies embraced by youth as it is restricted to a cross-cultural perspective. A large theoretical gap in acculturation research remains to be f i l led by the literatures on youth cultures, and particularly on youth smoking cultures. 24 3 RESEARCH METHODS 3.1 THE QUALITATIVE APPROACH AND RETROSPECTIVE RESEARCH DESIGN Methodologically, my study mainly drew on a qualitative approach that is informed by ethnography. Prus (1996) explained ethnography by saying: "In contrast to physical scientists who study inanimate phenomena, those in the social sciences require a methodology that is "sensitive to the human capacity for symbolic interaction". Ethnography helped to inform my study as it emphasizes social context, and the ways that people construct and live their lives, deliberately and meaningfully. M y study focused on assessing how acculturation impacts the lives of Chinese-Canadian girls, particularly with respect to smoking uptake. It also examined the specific culture(s) of and the cultural meanings surrounding female smoking. Therefore, a qualitative research approach particularly fit the study. M y research plan involved two steps: 1) an evaluation of the participants' level of acculturation and 2) interviews that focused on their cultural values as wel l as peer and family relations. The study used a retrospective research design to identify the early smoking-related life experiences of university and college students who were making the transition from adolescence to early adulthood. Retrospective research is in some respects inferior to prospective research because retrospective design requires the participants to recall events that happened in the past, and this may affect the accuracy of the data. However, there are times when retrospective research may produce more valid data. "Retrospective designs generally are employed when an event or phenomenon in the 25 present is l inked to a prior event." (King , 2001). Smoking is a phenomenon that starts at a certain age and continues over a period of years in a smoker's life. A s the participants in this study were university and college aged, their recall of starting smoking would still be quite good since the modal age for smoking startup is 12-16 years. A l s o , university-aged participants are cognitively more developed and mentally more mature than adolescents, and tend to have better understandings of their social context and the cultural and identity issues examined in this study. 3.2 DATA C O L L E C T I O N 3.2.1 Semi-structured Interviews Semi-structured interviews were used as the means of data collection. Hostein (1997) noted that "Interviews impose particular ways of understanding reality upon the participants." A s one of the most important methods in qualitative research, interviews help researchers to gain natural, spontaneous and non-verbal responses from the informants. In an interview scenario, areas that might be difficult to frame in specific survey questions can be explored, and probing questions can be used to give responses greater depth. A s Morgan (1996) emphasized, compared to survey and other methods, interviews provide an occasion where researchers can discuss specific topics through directed interaction. This study mainly drew on semi-structured interviews which, compare to structured ones where specific items are entirely predetermined, al low for considerable latitude in the length and detail of the instrument. They are a valuable practice for ethnographic research because they can help researchers to determine feelings, thoughts, intentions, and past behaviors of research participants in a flexible context. In 26 semi-structured interviews, interviewers have room to explore in their own way matters pertaining to the research questions being studied. They also al low for the introduction of unanticipated answers from interviewees. This less r igid form of interviewing can help the researcher to i l l ic i t more valuable information. In this study, 20 interviews were carried out individually with 20 participants including 10 smokers and 10 non-smokers during February and March , 2007. They were conducted at the U B C School of Human Kinetics Audi tor ium Annex Office at a convenient time chosen by the participants. Each of the interviews lasted about 1-1.5 hours. T w o sets of interview guidelines with sequenced questions were prepared for smokers and non-smokers, respectively. Questions were broken down into six areas pertaining to adolescent life, female smoking, acculturation and cultural values, ethnic identity, peer pressure, and parenting style. In each area, a funneling technique was used which progressed from broad, general questions to more narrow, specific and sensitive ones. Some questions were close-ended and were designed to elicit a specific piece of information from the respondents like their time of smoking initiation. O n the other hand, the open-ended questions were designed to identify feelings, beliefs and opinions in relation to smoking, culture and identity. Probing questions were also prepared in order to stimulate the participants to think and to recall. A s Patton (1990) noted: "This (probing question) allows for more flexibili ty and the periodic use of unscheduled probes and questions, and for the interview to unfold in a conversational style." Sampling Design T w o study samples were developed based on smoking status (smoker versus non-smokers) with a l l other conditions remaining the same. The rationale for using two groups lies in the ability to compare and contrast their life experiences and their distinct understandings of and relationships with smoking. More than half of the participants in the smoker group were identified and approached at "smoking pits" located outside classrooms and cafeterias, or while walking on campus and smoking. Snow ball sampling strategy was employed to help collect the rest of the qualified informants. Non-smoker participants were approached in different venues on campus, such as classrooms, cafes and stores. Each group consisted of 10 Chinese-Canadian females who were registered in university or college, had been born and raised in China and had l ived in Canada for at least last 5 years. Dunn's (2001) definitions were used to determine smoking status. A nonsmoker was defined as a person "who had never smoked or who had experimented with less than 20 cigarettes (one package) in her lifetime and had not smoked in the past 30 days". A smoker was defined as an individual who had smoked more than 20 cigarettes in her lifetime and had smoked in the past 30 days. The requirements of Chinese-born status and 5-year's minimum residency in Canada were intended to insure that the research participants have been exposed to both cultures and had undergone an acculturation process. For the purposes of this research, I used a broad definition of Chinese origin as representing people who are ethnically Chinese, and who were born in mainland China, Hong K o n g or Taiwan. The rationale behind this categorization is that people from these three regions generally share similar cultural values even though they 28 are perceived as distinct communities due to polit ical differences. Participants were mainly selected from The University of Bri t ish Columbia except for two who were recruited through snowballing and were respectively from Langara College and E m i l y Carr Institute of Art . The inclusion of n o n - U B C students was seen as an opportunity to engage a population that was potentially less skewed towards upper income and wel l educated middle class families. Out of 20 interviews, 17 were conducted in Engl ish, 3 were conducted in Chinese, which eventually were translated to Engl ish during data analyses. Questions To examine potential relationships between acculturation and immigrant youth smoking, exploratory, open-ended questions along with scheduled or unscheduled probes were administered on the fol lowing topics: 1) Attitudes toward and experience with female smoking 2) Personal experiences of cultural adaptation 3) Preferences and understanding of cultural values and identity 4) Friends and peer pressure 5) Parents and parenting style The interview guideline is found in Appendix 2. 3.2.2 The Vancouver Index of Acculturation The Vancouver Index of Acculturation ( V I A ) (See Appendix 1) was used to assess the participants' level of acculturation. This bi-dimensional scale was chosen for its brevity and because it constitutes a broader and more val id framework for understanding 29 acculturation as compared to uni-dimensional scales, such as the Suinn-Lew As i an Self Identity Acculturation Scale ( S L - A S I A ) and the Chinese Canadian Self Identity Acculturation Scale ( C C S I A ) (Ryder et al. 2000). Unl ike the C C S I A , the V I A is standardized, thus enhancing its reliability. Moreover, the V I A was specifically designed to measure the level of acculturation of the Chinese population in Vancouver, which is ideal for this Vancouver-based study. Whi le the instrument is relatively new, it has been used by at least 15 acculturation researchers (Ryder, 2000), and the bi-dimensional approach has been researched extensively for at least 20 years, most notably by John Berry (Ryder, 2000). In my research, the Vancouver Index of Acculturation was utilized as a means to measure the level and direction of acculturation. M y goal was to combine the data from the index with the information gathered from interviews to better understand the role of acculturation in the lives of Chinese immigrant youth and particularly regarding their smoking behavior. This standard scale-based evaluation tool offered an opportunity to collect normative data regarding the acculturation status of each research participant. Each question in this instrument was designed to capture a particular aspect of the lives of Chinese-Canadians, such as food choices, cultural preferences and social networks, and the overall study stood to benefit from information directly collected in those questions. 3.3 DATA ANALYSIS The majority of the data analysis took place between March 2007 and M a y 2007, after al l interview tapes were transcribed. This began by calculating the acculturation level of each participant, reading over al l transcripts and identifying important themes. 30 Fol lowing the initial survey, each transcript was systematically search of for al l possible themes, which were recorded. Coding categories were developed around these ideas and applied to al l data. It is noted that the coding scheme was refined as the process unfolded; overlapping themes were collapsed, and categories added, expanded and redefined. Data were then sorted into the coding categories and quantified using frequency tables for each question. Data init ially left out of analysis were reviewed to determine whether they would fit into existing categories or could form new categories. Mos t data collected were analyzed. However, as some of the data collected from the interviews were irrelevant, the researcher did not attempt to force remaining data into the coding scheme i f they did not fit. Secondary sources were later examined to support, contest, and enhance the interview findings. 3.4 ETHICAL ISSUES Hammersley (1995) pointed out that the negative effects of doing ethnography without ethical sensitivity and compliance could be enormous. H e quoted the fol lowing Barnes' (1979) statement: "a l l social research entails the possibility of destroying the privacy and autonomy of the individual, of providing more ammunition to those already in power, of laying the groundwork for an invincibly oppressive state." He also emphasized that participants own any data pertaining to them, no matter i f the data is collected by interview or participant observation (Harmmersley, 1995). In this study, ethical research procedures were strictly followed. The research proposal was reviewed and approved by the U B C Behavioral Research Ethics Board in January, 2007. (See Appendix 4). Ab id ing by the U B C Research Ethics Policies, ful l consent has been 31 obtained by the research from each of the participants prior to interviews and any other forms of data collection. Strict confidentiality has been and w i l l be maintained for all the information collected in the study. 32 4 RESULTS This chapter presents the results of the 20 personal interviews that were conducted with 10 smokers and 10 non-smokers in spring 2007. It begins with an overview of the research participants. This section includes findings from the Vancouver Index of Acculturation ( V I A ) and provides a profile of their levels of acculturation. The next sections outline the key findings from the interviews, and are organized under four main headings: social environment, smoking patterns, functional values of smoking, and culture and identity hybridity. The chapter closes by presenting themes that emerged from participants' insights into female smoking and their transcultural status. 4.1 PARTICIPANT CHARACTERISTICS 20 ethnic Chinese females participated in this study, 10 smokers and 10 non- smokers. The majority of the participants were U B C undergraduate students at the time, except one smoker who was attending Grad school at U B C and two smoker participants who were recruited from outside U B C . Their ages ranged from 19 to 25 years, with the mean age being 21.5 years. The mean age of the smoker group was 21.8 and 21.3 for the non-smokers. A l l the participants were born in Main land China, Hong K o n g or Taiwan and immigrated to Canada with their parents. The average age at immigration was 9.4 years for the smokers group and 8.7 for the non-smokers group. For al l the smokers, the mean age of smoking onset was 16 years. The participants that scaled in the H W L C (High Western L o w Chinese) group on the V I A demonstrated an earlier starting time of 15 years as compared to the H W H C (High Western H i g h Chinese) group which demonstrated a starting time of 16.5 years. (Refer to Table 4.1-1 and Table 4.1-2). 33 Table 4.1-1: Age (Smokers) T O T A L H W L C H W H C L W L C L W H C Smokers 10 3 6 1 Age(Mean year) 21.8 23.5 21.9 20 Age at Immigration 9.4 6.7 11.5 10 Age at Smoking Onset 16 15 16.6 15.5 Table 4.1-2: Age (Non-Smokers) T O T A L H W L C H W H C L W L C L W H C Non-smokers 10 4 1 5 Age 21.3 20.5 23 20.4 Age at Immigration 8.7 7.5 9 9.6 Out of 10 smokers, three were born in Main land China, four were born in Hong K o n g and three were born in Taiwan. The same combination applies to the 10 non-smokers. (Refer to Table 4.1-3 and Table 4.1-4). Table 4.1-3: Place of Birth (Smokers) T O T A L H W L C H W H C L W L C L W H C Main land 3 0 3 0 Hong K o n g 4 1 3 0 Taiwan 3 1 0 2 Table 4.1-4: Place of Birth (Non-smokers) T O T A L H W L C H W H C L W L C L W H C Main land 3 1 0 2 Hong K o n g 4 2 0 2 Taiwan 3 1 1 1 The data show that none of the participants communicate with their parents in English. They either speak Mandarin or Cantonese at home depending on where they are originally from. It is noted that the non-smokers' parents were reported as having higher Engl i sh ability than smokers' parents. Eight smokers responded that neither their father nor their mother could speak English, whereas in the non-smoker group, only three smokers reported inability to speak Engl ish on the part of their parents. (Refer to Table 4.1-5 and Table 4.1-6) Table 4.1-5: Language Spoken at Home and Parent's English Abil i ty (Smokers) T O T A L H W L C H W H C L W L C L W H C Engl ish 1 1 Mandarin 5 1 3 1 Cantonese 4 1 3 Parents can speak Engl ish 2 1 1 0 Table 4.1-6: Language Spoken at Home and Parent's English Abil i ty (Non-smokers) T O T A L H W L C H W H C L W L C L W H C Engl ish 0 Mandar in 6 2 1 3 Cantonese 4 2 2 Parents can speak Engl ish 7 3 1 3 The smoking status of family members was investigated. N o maternal smoking was reported by the two groups. Paternal smoking was reported by 3 smokers and 4 non-smokers. Sibl ing (brother) smoking was reported by 2 smokers and 1 non-smokers. (Refer to Table 4.1-7 and Table 4.1-8) Table 4.1-7: Family Members Smoking (Smokers) T O T A L H W L C H W H C L W L C L W H C Father Smokes 3 1 2 Mother Smokes 0 Sibl ing Smokes 2 1 1 Table 4.1-8: Family Members Smoking (Non-smokers) T O T A L H W L C H W H C L W L C L W H C Father Smokes 4 2 1 1 Mother Smokes 0 Sibl ing Smokes 1 1 Mos t importantly, prolonged absence of a parent or parents due to long distance commuting and time away for work (the so-called "astronaut family" syndrome) was found to be a more frequent condition for the smokers. Seven smokers reported their 35 father's frequent absence during high school, and of these seven, two smokers reported a long term absence of both parents. (Refer to Table 4.1-9 and Table 4.1-10) Table 4.1-9: Astronaut Family (Smokers) T O T A L H W L C H W H C L W L C L W H C Father Away 5 1 3 1 Mother Away 2 2 Both Away 2 2 Table 4.1-10: Astronaut Family (Non-smokers) T O T A L H W L C H W H C L W L C L W H C Father Away 2 1 1 Mother Away 0 Both Away 0 4.2 V A N C O U V E R I N D E X O F A C C U L T U R A T I O N (VIA) R E S U L T S Figure 4.2 summarizes the findings from the Vancouver Index of Acculturation. Each participant was required to f i l l out the V I A questionnaire at the end of the personal interview. Based on the forms, each participant obtained two scores in Western values and Chinese values, respectively, according to her responses to 10 questions focusing on Chinese values and another 10 questions focusing on Western values. The scores of al l 20 participants were plotted on a graph with the X axis representing Chinese values, and the Y axis Western values, and a triangle signifying a smoker and a circle a non-smoker. The scores ranged from 40 to 90, with 65 as the median for both scales. The coordinates have been divided in figure 4.2 into four sections which are named H W L C (High Western L o w Chinese), H W H C (High Western H i g h Chinese), L W L C (Low Western L o w Chinese) and L W H C (Low Western H i g h Chinese), according to the relative values of the scores in each section. 36 Chart 4.2-1: The VIA Evaluation 90 85 80 75 70 65 60 5 5 50 45 40 A A HWLC HWHC A • • • * • A • A X • T W7T • LWH^ • A • . * — , A Smoker • Non-smoker 4 0 4 5 5 0 5 5 6 0 6 5 70 75 8 0 8 5 9 0 It becomes fairly noticeable that 8 out of 10 smokers are positioned in the H W (High Western) area, quite the opposite, 9 out of 10 smokers are positioned in the H C (High Chinese) area. In the H W L C (High Western L o w Chinese) section, there are no non-smokers, whereas no smokers are found in the L W H C (Low Western H i g h Chinese) section. Due to the small sample size, no conclusion can be drawn from this distribution statistically, however, it helps to describe the relationship between acculturation and smoking status for the participants. 4.3 ROLE OF SOCIAL ENVIRONMENT The social environment emerged as an important factor for the Chinese-Canadian smokers. The environment or the smoker's interpretation of the environment was referred to by participants in the context of discussing reasons for their smoking initiation and the 37 unique smoking patterns they followed. Social environment is discussed in four subsections. 4.3.1 Physical and Demographic Environment With a female smoking rate of approximately 20% in British Columbia (CTUMS, 2005), female smoking is relatively more common than in many places in Asia. The interview participants, both smokers and non-smokers, viewed female smoking as a very visible and normal occurrence in their daily lives. When asked about their smoking initiation, a number of smokers spontaneously listed the free environment and female smoking popularity in Vancouver as a motivation. Here is a quote from a smoker: "Vancouver is a free place, and a lot of people smoke, and a lot of girls smoke too, you know, that's kind of the environment elements most of girls, they smoke when they are at gatherings, or hanging out something like that " (HWHC) The same smoker also commented on the club scene: "For example, you go to a night club in downtown, I can say that every single female there smokes " (HWHC) Another smoker stressed the normality and acceptance of female smoking in Canada by giving an example: "Let's say I make a trip to China, and I come back, the first thing I wanna do is to have a smoke, because I feel, I'm in Canada, that's the difference. Because I can smoke out in the open." (HWHC) 4.3.2 Different Cultural Environments The Chinese-Canadian girl smokers are influenced simultaneously by two starkly different cultural environments surrounding female smoking. The researcher found the 38 participants were to different extents aware of the stigma attached to female smoking in Chinese culture, at the same time, they were aware of the acceptance in Canada. The H W H C sub-group demonstrated a higher level of sensitivity about the negative images of female smoking than the H W L C and L W L C sub-groups. A smoker told the researcher: "My mom said, in Asian culture, for a girl to smoke, first, the parents are horrible, you know, you look like some gangster woman, you look dirty, you look filthy, and obviously smoking has a lot of dirty effects on your body." (HWHC) Although she became a smoker 2 years ago, she seemed to be strongly influenced by her parents and those aspects of Chinese culture that are extremely against female smoking. She oscillates back and forth within the two cultures by constantly adjusting her behavior. She admits: "When I go back to China, I completely do not smoke, because if you smoke in the street, people will look at you, like, oh, where is this person from, right? She must not be from here, or whose child is she?" (HWHC) The other smokers were all conscious of the cultural differences between the West and the East in the case of female smoking. A more westernized smoker from the H W L C sub-group recalled her recent trip back to China few years ago: "Last time when I went back to Taiwan, I didn't see a lot of female smoking. I think female smokers are a little bit categorized."(HWLC) Despite the extremely negative attitude towards female smoking they already knew about in Chinese culture, the Chinese-Canadian girls have easily developed a less critical view of it as a result of residing in Canadian culture. It was very clear to them that the western culture showed much higher tolerance for female smoking. 39 "When I'm here, it's more like there is no culture restriction, so I will smoke." (HWHC) "Definitely there are more Caucasian girls who smoke here. I guess they are less strict about these things, their view on tobacco is a little different, they don't have that cultural thing to it." (HWHC) A smoker mentioned how according to her experiences, media advertisements for cigarettes operate differently in the two cultures. The fo l lowing quote captures her spontaneous reaction when asked why female smoking is glamorized in Canada but despised in her mother culture. "I guess media has a bit effects too. I mean in China, I don't think I have seen a TV commercial, or even there is TV commercial, they don't put a woman up smoking cigarette looking sexy or something. But here, all the commercials where there are cigarettes have a woman in there, a very good-looking, very sophisticated woman. But in China, that kind of ad would never work." (HWHC) 4.3.3 Family Environment Fami ly context is the most direct way that most Chinese-Canadian youth learn about and become connected to Chinese culture. Parents and in some cases even the extended family in China exert significant influences on the next generation who quickly pick up i Canadian lifestyles and adapt to Canadian cultures. In the case of the smokers in this study, these girls received strong advice against smoking, continuous monitoring of their daily lives and both prevention and cessation from their families. "I was brought up in a very strict environment, I have a tight extended family, even my grand parents, they kind of know of the fact that I smoke, then there is kind of joint effort to teach me how bad it is for a girl." (HWHC) Smoking can stir up significant tension in the family of a Chinese gir l . A s it was 40 shown in an earlier quote, a girl's smoking behavior can be a major discredit to her family. When asked about the reaction of their parents to their smoking when they first found out, the participants reported the utter shock of their parents and in many cases, the disappointment was more about" being a girl" than the act of "smoking" itself. "Very very mad, my dad was like, what did I do wrong to make you smoke?" (HWHC) "My dad was mad, he was like, well, you are a girl, what are you thinking?" (HWHC) "Oh no, you are a girl!" (HWLC) Worth mentioning is that the "Astronaut family structure" was reported as contributing to smoking initiation and continuation among the smoker group. The heaviest and most bold smoker in this group pointed to her parents' absence beginning from the time she was first accompanied by them to Vancouver at the age of 9. Afterwards her parents went back to Taiwan and she only lived with her older sister and younger brother in Vancouver. As she said: "My parents don't live with me. They lived in Taiwan when I started smoking and they still live in Taiwan now." (LWLC) Another two smokers reported the same sort of situation where their parents kept flying back and forth between China and Canada. They emphasized the amount of time when their parents were away, and how that basically allowed them extreme freedom to do whatever they wanted during the away period. "My dad went back to HK after he accompanied my mom and me to Vancouver since he doesn't like [it]. My mom almost moved back to HK after I entered UBC, hardly comes back, so they left the place for me to live. Most of time I'm here by myself." (HWHC) 41 "My dad comes to visit me once a year because he has some business in the US, my mom probably comes once every 2 years. They just leave the house and the car to me." (HWHC) These 3 girls were found more relaxed about the subject of tobacco use. They all started out smoking during their parents' absence. It is also possible that they received less pressure from their parents not to smoke as well. 4.3.4 Secondary School Environment The participants who have been attending secondary school in both China and Canada reported very different school policies and environments in regard to smoking. In China, smoking inside school grounds is absolutely prohibited. This strict policy also made students aware of the bad consequences of being caught smoking, which included probation or expulsion. Whereas in Canada, designated smoking spots on campus literally encouraged smoking by providing an opportunity for doing it in a correct way. A smoker expressed this opinion: "When I was attending high school in HK, two girls were caught smoking in the washroom and they were expelled. You know, nobody dare to do so after seeing this, but here, just relax, smoking is really not something that horrible, they even tell you that you should smoke in a smoking pit..." (HWHC) 4.4 SMOKING PATTERNS Similar smoking patterns were reported by the smokers which may or may not be characteristic of other ethnic groups. Within the group, smokers affiliated with a variety of acculturation sub-groups and demonstrated a range of smoking styles. The following subsections describe 3 major smoking patterns of the group. 42 4.4.1 Self-identified as Social Smokers It is noted that ninety percent of smokers, except the heaviest who smoked half a pack a day, identified themselves as social smokers. They typically smoked from 4 to 8 cigarettes per day. Three reasons were given for identifying themselves as social smokers. Firstly, they believed they started out as social smokers. Secondly, they stressed they only smoked on certain occasions. Thirdly, they considered smoking more of a mental thing for them, rather than a physical addiction. During the interviews, participants were asked to recall their smoking initiation scenarios and they reported that their motivation was largely socially driven. "I started out smoking by hanging out with a group of people who smoke, so when you are outside having a break, everybody takes out their cigarettes to smoke." (HWHC) "So the people who are close to you, if they smoke, you are under the secondhand smoke condition, then I guess that was a trigger." (HWLC) "I know many westernized Chinese girls who smoke as social smokers, they started smoking because they hang out with people who smoke." (HWHC) The smoking initiation of one participant from the L C L W subgroup (the only smoker whose VIA scores were situated in this sub-group) was different from the rest in that it lacked an immediate peer context. "I was the first one who started in my high school friends circle, I started at home, and I'm not quite a social smoker."(LCLW) "I took my first puff because I got bored When I smoke, I don't like to talk. I don't usually smoke in front of people, I like to smoke when I'm at home." (LCLW) Apparently, where and on what occasion a person smokes become the main condition 43 to measure against social smoking. Most of the participants who identify themselves as social smokers reported they only smoke with others. "Light a cigarette while socializing with other people, that's how I started, and I'm still a social smoker now, I don't smoke just by myself." (HWHC) "I usually smoke when I hang out with my friends." (HWHC) Eighty percent of the smokers believed that they were not addicted to tobacco, which constituted another reason they self-identified as social smokers. Below are the quotes from 2 self-defined "social smokers" who reported currently smoking everyday and consuming approximately 2 packs of cigarettes a week: "I'm not really addicted to nicotine, if you take away tobacco from me, I'm not gonna run out of the way go crazy, smoking for me is more of a mentality thing than a physical thing."(HWHC) "When you are walking from a place to another, you have nothing to do, so it just falls naturally, it's like a habit. That's why I say it's a mental thing, because I can smoke or not, doesn't really make the physical difference." (HWHC) However, a previous US-based research defined a social smoker as "A 'non-daily' smoker who only smokes when others are smoking." (Gilpin, 2005). Obviously, many of the smokers in my study have showed higher frequency and intensity of tobacco use than a "non-daily" smoker. The discrepancy between standard understanding of social smokers and the smokers' own interpretation indicates that social smoking needs to be better understood by the youth so that they will not use it as a justification for tobacco use. 44 4.4.2 "Close t S m o k i n g " The term "closet smoking" can be used to describe a shared smoking pattern of all the participants who reported making continuous efforts to hide smoking from their parents for years after they started. The smokers would do anything in their power to keep smoking a secret from their parents. If they got caught once, they would make it up right away to their parents to convince them they had quit. Al l in all, lying about and hiding their smoking from their parents were strategies of daily life for these Chinese -Canadian girls. "Well, I'm very careful when I am at home, I make sure I walk around the blocks so that the smoke is gone from my clothes and then I will walk back home." (HWLC) "The first time my mom smelled the smoke from my room, I blamed it on my brother...coz you know, I'm a girl, they are gonna freak out if they know me smoking and it's a lot better if that's just my brother doing it." (HWHC) It is quite surprising how much they would try to adjust their behavior just for the purpose of concealing it from their parents and even the surrounding area of their parents. As a smoker disclosed, "But still, even here in Vancouver, let's say if I'm near an area I know my parents' friends live, I won't smoke, I will not smoke even 5 kilos within [kilometers from] my house. It's just because it's not respectful." (HWHC) It also was apparent that this strategy was not just characteristic of the participants themselves. They reported that the majority of their Chinese friends who smoked did the same thing. "Of course, most of Chinese friends I know smoke, they are all hiding from their parents." (HWHC) 45 "The funny thing is that some of my parents' friends' kids smoke too, but it's more like hidden from the parents as well, but I know they smoke and they know I smoke." (HWHC) From the perspective of the smokers themselves, "hiding" was considered a very typical Chinese thing as far as smoking was concerned. After discovering the popularity of "hiding" among this group, the researcher improvised the fol lowing sub-question: "Would you hide your smoking i f you were from a Caucasian fami ly?" The response were consistently negative, indicating that they did not think they would need to hide their smoking: "I guess not, my Caucasian friends don't seem to do this." (HWHC) "If that is the case, I will probably not hide smoking from my parents. Because I know Chinese parents are gonna be very very mad at this, I'm pretty sure." (HWHC) "Probably not, their family are not gonna be as mad as ours on his matter, plus their family is more liberal, you get your chance to make mistake, to disappoint, and then you still have your right to negotiate, I don't see any of these in my family..." (HWLC) 4.4.3 S m o k i n g among G r o u p s of Chinese Y o u t h Social smoking occurs in groups. Interestingly, the interviews show that Chinese-Canadian smokers are more l ikely to smoke in Chinese ethnic groups. Eighty percent of smokers reported that the majority of their smoker friends were Chinese. 9 out of 10 current smokers mentioned that their first puffs were taken together with their Chinese friends and most of the time they tend to hang out smoking with other Chinese. "My friend, who is also Chinese, I guess she learned how to smoke from one of her other friends. One day she says: "Do you wanna try?" I was like: "Hmmm, ok, just one." Yeah, so that was my first one, we were walking around, I tried my first cigarette." (HWLC) "Most of my smoker friends are Chinese, I seldom hang out with Whites 46 to smoke." (HWHC) 4.5 FUNCTIONAL VALUES OF SMOKING This part of the chapter presents the four most important functional values of smoking identified by the smokers as follows: acculturation coping strategy, empowerment, a way to de-stress, and rebellion. Each of them also serves as a reason for smoking initiation and continuation among this particular group. 4.5.1 Acculturation Coping Strategy Participants emphasized the cultural differences and pressures to cope that they experienced during their first few years of relocating to Canada with their parents. They felt different stresses, and different people responded to the same stress in different ways. Three participants reported that the temporary pressures and disorientations associated with cultural differences contributed to their decision to try smoking. A smoker talked in her interview about the most shocking cultural difference she encountered: "You know when I was in HK, I was the goodie goodie student, wore the uniform to go to school everyday, and then you go home, you don't go out after, right? And then, here, all the girls wear trendy clothes at school, it's just like a big popularity contest system, I never experienced that in my life, I was totally shocked." (HWHC) This contrast led to major stresses on the adolescents who were caught in the incompatibility of the host culture and their original culture. The tension resulted from the conflict of the two cultures that are respectively represented by their Chinese-style parents at home and their western peers at school. "Chinese parents would think studying and getting to the university are 47 the only things you need to think about. Whereas here in the western culture, they started value socialization at much younger age. It was too big adjustment for me." (HWHC) As she continued the disclosure of her acculturative experiences, she emphasized her frustration: "I really wanted to buy clothes once in a while and to be the popular one, but then it was also frustrating that my parents didn't see the need, for quite a while I felt helpless, seemed no one could truly understand me." (HWHC) She tried very hard to be as adapted as possible to certain western values and in contrast, to stay as far away as possible from her mother's culture because, according to her experiences: "The only way to survive is to follow it, otherwise you would be stereotyped as a little geeky Asian girl, you also get bullied pretty badly by the popular ones." (HWHC) In the end, she confessed that her smoking uptake was to a large extent related to all the stress, anxiety and insecurity she had gone through in that period of time. "The experience of being bullied made me feel important to fit into a certain group and to join the popular ones. I think that's probably why I took up smoking later. But now I think it was dumb doing so, I should have kept myself." (HWHC) Smoking was unfortunately utilized by these girls as a tool to cope with their adaptive stress for three reasons. Firstly, smoking was a way to fit in. Female smoking as a social taboo for Asian girls served the purpose of detaching themselves from the original cultures and shortening the distance with the local culture in a superficial sense. Secondly, on a more practical level, smoking as a social activity also helped these new comers to make friends efficiently. Thirdly, smoking provided them with a chance to "stay tough" 48 and "become popular", which is related to how their peer interpreted female smoking. The "tough" and "popular" image of girl smokers in practice prevented them from being bullied or stereotyped. These three reasons will be further discussed in the following paragraphs. Why is smoking a way to fit in? Why does the task of making friends become relatively natural and easy when you have a cigarette in your hand? According to a smoker: "Because you always smoke in a group, when you are outside of classroom or dormitory, you always smoke in a group of smokers. And by doing this, you can form a group of friends by just smoking." (HWLC) Another smoker gave examples of her girlfriends who simply take smoking as a tool to socialize with people. "I know many of my girl friends smoking because they try to fit in. like I just had a cigarette few minutes ago, and now you wanna go for a smoke, and I will say ok, I will go again, even I don't really wanna go. You know what I mean? They just try to fit in to chat, gossip or whatever. A lot of girls do that, especially the really fashion kind of girls." (LWLC) Smoking is a behavior that can easily draw the boundary between the smokers and the non-smokers. "Because my ex hangs around with that type of girls, and I was really fond at him, and I just wanna fit in with his friends stuff like that. Now I think it was really dumb." (HWHC) Aside from the practical function of making friends, smoking in some cases also helps adolescents achieve cultural adaptation. The participants believed that by taking up smoking, you look and feel more westernized and, alternatively, better adapted. A few of 49 the quotes from the smokers that follow indicated that they positively associated female smoking with being western. It is inappropriate to make the assumption that smoking is motivated by westernization, however, the more westernized Chinese-Canadian female youth tended to be smokers in this case, and the smokers all considered themselves relatively more western. "When I see an Asian girl smoking, I would always think she most probably has stronger western values." (HWHC) "Yeah, I kind of think they are related. For myself, I consider myself pretty western, a bit more than some of my friends I know who move here at the same age." (HWLC) "I think an Asian girl who smokes is definitely more western" (LWLC) However, it is worthy of note that non-smokers provided very different point of view on this matter. They completely disagreed with the hypothesis that girl smoking had something to do with being more western. They gave examples about their friends who smoke, "Not really. I know girls who are smokers, they are pretty Chinese, they are like, only watch Hongkong drama, they don't watch any western TV." (HWHC) "The girl I know who smoked in my class, she was only popular in Chinese group. She was no way considered western." (HWHC) All in all, smoking sometimes can be a way to fit in. For newly arrived immigrant youth who are temporarily challenged by physical relocation, cultural transition and emotional disconnection, smoking can be a way for them to make friends, to socialize with people, to gain a sense of belonging and to feel more adapted to the local cultures in a short period of time. Ironically, smoking turned out to be a useful coping strategy to 50 deal with these pressures and to satisfy those short-term needs. Pressures varied from being isolated to being stereotyped and bullied. In order to deal with those pressures, it was important for the youth to belong to certain groups, including the tough and popular ones. As demonstrated earlier, smoking to some degree helped youth get connected to groups, but how exactly did it function to give them with a "tough" and "popular" image? This has to do with the girls' own perceptions of female smoking, and the kinds of images that are attached to female smoking by peers in their social context. The smoker who reported her experiences of being bullied expressed the general impressions she had about female smokers in her high school by saying, "They always dressed up pretty stylish, they knew all kinds of the hip things, yeah, those kind of girls, they tend to smoke. They are the ones really popular and people get to look at them more." (HWHC) She pictured them in more detail saying, "They usually wear jeans, little trendy hair, dyed, maybe brown, surrounded by guys." (HWHC) Reponses from other smokers are similar: "I think she will probably have a lot of friends, and probably her hanging out place is a certain kind of environment." (HWHC) "It was true that the more of the stylish, dressed up, cooler girls were the smokers, I learned smoking from kind of the cooler, less study crowd." (HWLC) Non-smokers were asked to picture a female smoker they know in person and it turned out the way they respond was quite different from the smokers. "Her love life is very complicated. We also knew that she and her boyfriend were on and off, they cheated each other stuff like that." (HWHC) 51 "She doesn't like study very hard, she is most probably in a relationship.. .yeah, just doesn't value school that much." (HWHC) 4.5.2 Empowerment Empowerment is hypothesized as another potential functional value of smoking for Chinese-Canadian female youth smokers. In this part of the interview, participants responded to the question: " D o you think in any way smoking might have empowered you?" The notion of "individuali ty" appeared many times in the smokers' responses. "There are some people who are more Asian than western, (by smoking), so they are not considered a "fresh off the boat" kind of person. Because that was almost a sign of individuality." (HWHC) "There are maybe some of that, you know. Probably more of individuality, 'I will do what I want to do anyways' kind of thing." (HWLC) "Yeah, a little bit. I actually found all the girls who went to my high school ended up smoking, they are the ones who are more rebellious, more independent. So yeah, I do have this sort of impression about girl smoking." (HWHC) Gender equality was also identified as an issue because it was seen as enabling girls to socialize more with boys and engage in activities reserved for boys in China. A smoker gave her insights about the different levels of acceptability of female smoking in western and eastern cultures, "The boys in China have much more of the social club kind of things going, you know, they are like the ones who make the deals, the ones that sit around, we gonna drink without women. But here, the women and men are much more intermingled. I think smoking, it's a social activity, let's say we go to a coffee shop to study, and during the study break, we are going out for smoking. You know, then the boys and girls go together, like the girls get joined in the social activities that may not be able to in China." (HWLC) "Women here are more included into the social circle. In China, women 52 are either excluded, or they tend to keep to themselves and talk about the women things, you know, women and men are not as much intermingled." (HWLC) These comments proved that some of the girls have knowingly or unknowingly gained access to smoking by exerting their newfound gender rights to mingle with boys. 4.5.3 A Way to De-stress The study data show that some university students use smoking to 'de-stress'. This was rated by the smokers as the major reason for their smoking continuation and increased tobacco use in their college life. A smoker explicitly mentioned her plan to postpone quitting until her graduate from university. "I have actually reached an agreement with my family, say once I graduate from the university, no more smoking. Because smoking for me now is a way to de-stress." (HWHC) The stresses of school life with a heavy course load and homework was given as a reason for increased tobacco use. Two smokers emphasized this point: "Since starting law school, I have got into much heavier." (HWLC) "When I got older, also a lot more stress in school, then I feel more involved in smoking." (HWHC) One of them gave a more detailed explanation of the relationship between stress, school work and smoking. "During study, when there is a natural break, I usually go out for cigarettes. I can go up to a pack a day, but that is only when something stressful happens, generally about 8 a day." (HWLC) Employment stress faced by senior university students was also offered as an important reason for them to increase their smoking, one participant shared her 53 experience: "Well, it was an employment shock, so it was my first job working for a white employer and I was working outside of my city too, so I didn't have my social support group here in Vancouver. I remember I had a lot of trouble adjusting when I was working there, like I said, I had troubles talking to my co-workers, talking to my employer in on a casual basis. So I picked up smoking, I went outside and did my thing." (HWLC) 4.5.4 R e b e l l i o n In some cases, smoking reflected an act of rebellion by the participants against cultural restrictions, stereotypes and strict parenting applied to them at a younger age. Smoking helped satisfy their need to overcome the labels that fol lowed them as As ian girls, as a smoker confessed: "Yeah, a little bit I guess, there is a sense of... what's called... like you are doing something a little bad, rebelling against being the proper Asian gir l . . . things like that. You know..." (HWLC) The concept of rebellion appeared to be so firmly implanted in the minds of some girls that they attributed rebellion as having played a significant role in their starting smoking. For example, a participant who had been l iv ing on her own in Vancouver for years, without the supervision of her parents was asked whether she would still have started smoking i f her parents had been around. Her response was sufficient evidence of her resistance to authority and control. She believed that l iv ing with her parents would have raised a stronger emotion of resistance from inside her with could have encouraged her to smoke more. "If my parents lived with me along the way, I could see I wil l (smoke), because of rebellions, I would do it more." (LWLC) 54 4.6 CULTURAL HYBRIDITY AND IDENTITY CONFUSION "Hybridity"1 was an important topic that was discussed by the participants in the interviews. Al l 10 smokers tended to describe themselves as 'hybrid', whereas the non-smoker group showed less interest in this term 4.6.1 Swinging between Two Cultural Domains The smokers demonstrated strong cultural hybridity in adopting strategies that accommodated values from both their home and host communities. Compared to the non-smoker group, the indication of cultural hybridity was more obvious with the smokers. Although smokers and non-smokers provided a similar presentation of Chinese values which gives their views on certain issues, the smokers showed higher levels of adaptation to western values than the non-smokers. These interview findings were consistent with the results of the Vancouver Index of Acculturation, where the 10 smokers scored higher in western values than the non-smokers. Rigid Chinese Family VS. Liberal Western Society In this part, questions regarding family and the external social environment of the participants were brought up once again in order to understand how these two divergent conditions were pulling them in different directions and possibly stimulating so called "cultural hybridity". Al l the smokers considered their parents to have a very typical Chinese parenting style of being rigid and controlling. They expected their children to be outstanding academically. 1 "Hybridity" was not originally included in the interview guidelines, however, during the first interview, the interviewee introduced this topic by using the work 'hybridity' to describe herself and gave very interesting insights about it. Afterwards, I intentionally added "hybridity" for discussion in the interviews that followed. 55 "Asian parents, you know, they are always like, ok, this is 99%, where is the (HWHC) "My mom is strict, you should get A, you go spend more time on it, I don't care if you enjoy or not, this is study, is not fun." (HWHC) "Oh yeah, why there are only 5 As, why can't you make it 6." (HWHC) In their own social circle, the parents demand their children to honor them by acting in a very proper way. "My parents are very strict in a sense, let's say if I'm proper, whether I'm respectful, the lifestyle whatever. They are very strict on the lifestyle things, it's like the way you present yourself. Say if I go back to China, am I a good representative of who they are." (HWHC) When it comes to planning for the future of their children, Chinese parents will always involve themselves in any decision making and leave their strong influences. "My parents wanted me to go to UBC, I don't want, because I don't know what I wanna get out of a UBC degree. I have so many friends going to UBC, they are smart, but when you ask that why you take Engineering, they go like, I don't know." (LWLC) "They put like... they try to, you know, make me walk through certain direction that they wanna me to. Ever since I was young, they told me, oh, you gonna go to this learning class, then in high school, they would say, you should go to UBC. Now I'm finally here, and they started to think about getting me back to take care of their business. Their influences were always there." (HWHC) The relationship between the children and their parents was typically challenged during the early phase of immigration. The girls spent their whole day being immersed in a western social environment at school and then had difficulty communicating with their Chinese parents when they came home. "For years, we didn't even talk to each other, we just suddenly became so different, so distanced. They think that I'm not the child I used to be...well, according to them, I'm self-centered, impolite, or ...but you 56 know, we are not in China anymore, I'm supposed to change. And if they can't change, they shouldn't stop me changing." (HWLC) Family was the major source of traditional Chinese culture for most participants. The comment from a smoker who lived separately from her parents reaffirmed this condition: "I think their absence during that time gave me a chance to be more western, I mean if they were in Vancouver, they would probably brainwash me with Chinese culture." (LWLC) O n the other side, the peers they interacted with beyond their family constituted a good representation of the host culture. Relative to the non-smokers, the smokers made a greater effort and demonstrated stronger inclinations to make friends with Caucasians. A s a smoker mentioned: "I seriously considered joining a Sorority, so that I would be able to meet more white girls. For a long time, I thought I had problem speaking to Caucasian female, especially at my age, so I thought Sorority will be a good place to..." (HWLC) A l l 10 non-smokers indicated that their close friends are fully ethnic Chinese with strong Chinese values remained. Yet half of the smokers reported having close friends with other ethnic backgrounds. When asked about making friends with Caucasians, two non-smokers replied: "I used to try to make friends with Caucasians, especially in the first few years, but later I just started to notice it's hard to achieve good closeness level with them." (HWHC) "People with similar backgrounds gathered, otherwise it's harder to share." (HWHC) Based on these interviews, the smokers were found to be more immersed in western culture by having Caucasian friends or friends from a wider variety of cultural backgrounds. Their level of cultural hybridity was relatively higher than the non-smokers 57 and they also encountered a harsher adjustment while constantly swinging back and forth between the two cultures, which subsequently led to their identity confusion. Participants' Own Interpretation of Chinese Values and Western Values In this section, participants' personal understanding of Chinese and Western values are discussed. The data show that smokers tend to interpret Western values in a positive way, whereas Chinese values are viewed more critically. The reverse occurred in the non-smoker group. A smoker expressed her insight explaining differences between the two cultures: "It (Chinese culture) is a culture built on what looks good, you know, whereas here, this culture (Canadian culture) is built on what feels good." (HWHC) This is the same girl who mentioned that her parents were very demanding about her lifestyle. When asked to comment on different characteristics of Chinese and western people, the smokers and the non-smokers had different responses. For example, one of the interview questions asked " D o you think people in western cultures are generally more independent?" Two smokers answered: "I think Canadian in general, not just white, they tend to be more independent and strong for some reason." (HWHC) "Oh definitely, Chinese kids are always so dependent on their parents in so many things." (LWLC) A non-smoker made different comments: "They (Western people) may not be independent, because they could be dependent on a lot of things if their families are not as important to them as to Chinese, they might be dependent on their boyfriend, or any other people around them, their relationships in their lives." (HWHC) 58 4.6.2 Identity Confusion Identity confusion was generally found to be a companion condition of hybrid cultural status in the study. More noticeably for the smokers, the participants' shifting cultural strategies sometimes gave them uncertainty about who they were. "I don't know where I stand, I'm too westernized to be fully Chinese, and then I'm not westernized enough to be fully Canadian. You know, it's pretty tough in the middle ground, you don't know what you are." (HWHC) A girl who moved here at a very young age and who had for a long time considered herself C B C (Canadian Born Chinese) still expressed uncertainty about her identity after she realized the gap of being a real Canadian and a Canadian born Chinese, "I didn't really have identity confusion until I realized I wasn't as Canadian as I thought I was. Because until I saw more mainstream culture during my undergrad period, I noticed that, wow, there is a difference between the CBC and the mainstream culture." (HWLC) The majority of the smokers identified themselves as Canadian rather than Chinese, whereas eighty percent of the non-smokers claimed their Chinese identity as primary. Below are several quotes from the smokers: "I identify myself Canadian first, but I always know I'm Chinese by race, this is the fact." (LWLC) "Even with that crisis now, I always consider myself more Canadian than Chinese. I would say I'm Canadian Chinese too sometimes." (HWLC) "I would say my primary identity is Canadian and then secondary identity is Chinese." (HWHC) In order to ascertain the possible relationship between smoking and identity, all the smokers were asked to respond to the question: "Do you think smoking somehow 59 enhances the Canadian identity inside you?" Two responses are given as examples: "Hmm...maybe I won't say enhance, because I don't smoke only because I wanna tell myself I'm Canadian, but in the end, it did make me feel I'm not a typical Chinese and I'm more Canadian." (HWLC) "I guess a little bit, because a typical Chinese girl won't smoke. It (smoking) pulled me away from being a standard Asian girl, so my Canadian identity is getting stronger." (LWLC) 4.7 M O D E R A T E D A C C U L T U R A T I O N IN C A N A D A Although the Chinese- Canadian girls disclosed considerable pressures they have come across during the acculturation process, from their own perspectives, the participants all accepted as true that Canada has a much more accommodating and tolerant stance on the influx of different cultures than other western mainstream societies such as the United States. Canada's multiculturalism strategy was considered effective at easing off the adapting pressures for immigrants. Coincidentally, a participant in the study was able to provide different perspectives about acculturation based on her three years experience in America prior to moving to Canada with her family. Living in both the United States and Canada helped her to develop comparative views about the different socio-cultural environments that determine the dissimilar features of the acculturation processes. Her unpleasant experiences in an area in America where there were no Asians were marked with horrendous racism from an insensitive teacher who had a deeply-rooted racist mentality and didn't even know she was making racist comments. "Once in a geography class, our teacher pointed to my face to demonstrate to the whole class how an Asian looks like." (HWHC) 60 She said that she has been putting tremendous efforts into making friends with Caucasians, even letting them step over her i f it turned out necessary: "I was desperately trying to be one of them. And the only way to be accepted, or the only way for the people to think of you as a normal person in stead of looking at you like that, is to actually try to be one of them. I was ready to sacrifice a lot to achieve that, just to be one of them." (HWHC) Three years later when she moved from the U S to Canada with her parents, she found the whole acculturation process here to be much less stressful. "Vancouver is quite different, I never tried to get close to them, I never made an effort in making white friends here. Because coming from that environment which is a lot harsher than Vancouver, I think here everything is so easy, because you have gone through that, now everything is easygoing, equal or whatever, you see a lot less pressure going."(HWHC) N o w after she had experienced the two adapting processes, she was positive about the unequal cultural confrontation in the U S which deprived her of the right to develop her own cultural identity. She said very certainly: "I know if I stayed there, the adapting will never end, because there the cultures is just like you have to force yourself to be one of them. I even think if I have stayed, I would probably have had started smoking earlier. Yeah, I'm pretty sure."(HWHC) Acculturation takes on different forms depending on to what extent a society is wi l l i ng to accommodate different cultures and give them enough space to freely grow. 61 5 DISCUSSION AND IMPLICATIONS This chapter discusses the results in the context of the theoretical explanations, respectively in acculturation, hybridity and family structure. It connects to the literature review and responds to the gap left from the previous research by further analyzing the study findings. Drawing upon the findings in Chapter 4, this chapter addresses why the Chinese-Canadian immigrant girls with higher acculturation levels are more l ikely to take up smoking. Previous quantitative research based in the U . S . suggested that acculturation has a direct effect on smoking initiation and continuation among As i an immigrant female youth. Section 4.2 of this report also found a direct correlation between the two, but findings outlined in the subsequent sections supported additional factors playing a role. The fundamental differences between the U . S . and Canadian societies add another layer of complexity. Besides acculturation itself, the other 2 factors related to acculturation were also significant. Thus, the roles of cultural hybridity and immigrant life are discussed at length in order to better fulfi l l the research objectives. After discussing these three major conditions that play a role in Chinese-Canadian female youth smoking, the chapter outlines strategies that may contribute to reducing immigrant youth smoking in Canadian society, which w i l l hopefully be useful to anti-smoking policy makers and other community workers focusing on immigrants. 5.1 ROLE OF ACCULTURATION The findings have vividly depicted the role acculturation played in triggering smoking uptake among the Chinese-Canadian girls. The testimonies of the participants 62 document how rough and sometimes unbearable the acculturation process can be. In the worst case, it f i l led the individuals with feelings of insecurity, marginalization and humiliation. A n easy way to cope with marginalized and isolated circumstances was to locate a group that the individual could quickly belong to; and the effective way to walk away from being humiliated and to gain a sense of security was to take on a tough image. Coincidently, these two needs happen to be fulfilled by taking up smoking. The case recounted by one of the girls (4.5.1) indicates how acculturation process can confront an individual. The effects of acculturation on immigrant youth smoking, however, can be more extensive than one story can tell. In the fol lowing sections, the power of acculturation w i l l be discussed in greater detail. 5.1.1 Identity Negotiation A s a major adjustment conducted at the emotional level (Phinney, 2003), identity negotiation is a part of the acculturation process which generates direct and immediate outcomes on an individual 's behavior. Being constantly faced with identity confusion, immigrant youth tend to take actions that can accentuate their preferred identity for the purpose of solving conflicts. This study identified a positive correlation between smoking and Canadian identity preference as wel l as stronger identity confusion among smokers. The findings showed that the identity negotiation that occurred with smokers were more profound than with non-smokers. For example, smokers were found to be relatively more anxious and uncomfortable about their middle ground identity status, whereas the non-smokers were more l ike ly to consider their dual identity as an advantage and to be more accommodating of different cultural situations. Another finding indicated that the 63 smokers showed a stronger inclination to a Canadian identity than to a Chinese identity. The reverse was found in the non-smoker group. The study also found that the relationship between smoking and Canadian identity preference is complex. A Chinese-Canadian girl 's willingness to be identified as Canadian may provoke her to choose smoking because smoking could make her feel more westernized. Equally, smoking behavior may give a Chinese-Canadian girl a Canadian identity because her Chinese identity w i l l be thwarted by the female smoking behavior. These both reflect the acculturation process in theory, because behavior change is always interwoven with identity negotiation. 5.1.2 Cultural Value Changes A s foreseen by Berry (1993), Cultural value changes occurred gradually in the acculturation process and in a relatively gentle way but with far-reaching impacts on the individuals. Different from identity formation at the emotional level, the cognitive transformation in values lent rational support to behavior change, hence the influences was more stable and deep-rooted. M y study was intended to uncover the association between smoking and certain cultural value orientations among Chinese-Canadian girls. The results indicate that the smokers were more l ikely to interpret western values in a positive way and more easily express cri t icism of certain Chinese values. The non-smokers tended to highlight the positive side of Chinese values and conveyed crit icism to certain Canadian values. For example, when both were asked to give views on "independence", many smokers spoke highly of it as a typical western value and believed it is extensively missing in Chinese 64 culture. The non-smokers, however, interpreted it from a completely different angle in defense of Chinese culture. The differences hinted at a connection between smoking and a western cultural value orientation. 5.2 R O L E O F H Y B R I D I T Y Different from acculturation that usually results from confrontation of two unequal cultures and mainly reflects a one-way cultural assimilation, "hybridity" refers to a relatively dynamic and multi-dimensional status of cultural mixture. After facing and coping with enormous pressures during acculturation, a hybrid individual displays a combination of personal values extracted from both cultures. Grounded on the participants' own interpretations of "hybridity", the research has found that the smokers are more l ikely to self-portray as hybrids. They constantly employed the term "hybridity" to illustrate their internal cultural shape. O n the other hand, most of the non-smokers expressed uncertainty about associating themselves with the term "hybrid". The potential reasons for this are probably similar to the reasons that explain why the smokers scored higher on Western values than the non-smokers on the V I A questionnaire. A s Chinese girls, the smokers first must break away from the traditional Chinese culture that is against female smoking; they have to give up certain Chinese values and leave room for the western values that could give female smoking a justification. In this sense, the smokers show weaker dependence on their original culture and a stronger inclination for the host culture. Therefore, when coming from a pure Chinese background, those who are more active in resisting the home traditions and assimilating to the host traditions are more l ikely to accept female smoking as their own 65 practice than those who are conservative and cautious about changing values. The former w i l l reach the status of hybridity faster, as being hybrid is compatible with the goal of acquiring Western values, which at the same time dealing with one's own origins. That is why the smokers were found to be more comfortable with defining themselves in terms of "bybridity" In the end, what roles does cultural hybridity play on Chinese-Canadian female youth smoking? 1) Cultural hybridity resulted in a cognitive adjustment to accept female tobacco use by the Chinese-Canadian girls; 2) It also caused them to play lengthy hiding games about their smoking from their family, as wel l as neighbors and extended family. 5.2.1 Acceptance of Female S m o k i n g The smokers who considered themselves hybrid al l accepted female smoking as their own daily or occasional practice from a social cultural perspective. The smokers' opinions on relevant health issues were not discussed in the study on account of its focus on a socio- cultural context. The main point of being hybrid is to allow the individual to move around between two cultures and to develop their own cultural position by picking pieces of values from the two different value systems. Therefore, a hybrid cultural status could help the Chinese-Canadian smokers to justify female smoking instead of judging it by the traditional Chinese values. A s was found in the interviews, the less hybrid non-smokers who demonstrated tighter bonds with Chinese culture continued to express the stereotypic ways that people in China judge a girl smoker: " not a study type", "maybe from a divorced family, lack of care and love" "have controlling and messy love l i fe" "a problem gi r l " , etc. Admittedly, many non-smokers listed heath concerns as the most significant 66 reason preventing them from smoking, but their social concern based on the impropriety of female smoking was not any less evident. Under these circumstances, cultural hybridity increased the probability of female smoking among Chinese-Canadian girls by overturning the o ld Chinese taboo and establishing a whole set of new behavior codes for them. 5.2.2 H i d i n g Games When the participants started selectively cutting off from their Chinese values and f i l l ing up the empty spaces with Western standards, there were always certain deeply rooted principles that were not rejected. This is what cultural hybridity offers as wel l , an assortment of values that the individual embraces. For instance, the study found that smokers and non-smokers demonstrated equally strong family values. A good indicator of this is the fact that a l l of the smokers have continued to hide their smoking from their families. It is not far-fetched to l ink this phenomenon with family values. Someone may argue that i f a ch i ld possesses truly strong family obligations, she would never have taken up smoking. However, the amount of effort the smokers put into concealing smoking from their parents and their parents' social relations reflected positively on how much they were concerned about the good image of their family and how much they wanted to always be part of it. The hiding games indicated the presence of many other Chinese values as wel l . Particularly, it shows that the smokers still tended to abide by Chinese traditions and to stay in touch with Chinese culture. They developed two sets of principles to guide their 67 behaviors under the two different circumstances. Cultural hybridity gives a useful explanation to the unique smoking characteristic of the Chinese-Canadian female youth smokers. 5.3 EFFECTS OF GROWING UP IN IMMIGRANT FAMILY Growing up in an immigrant family can be a harsh experience for immigrant youth. The floating status of a whole family in a brand new environment generates uncertainty, insecurity, and isolation for every member of the family. It is common in this atmosphere for the parents to fail to fulfi l l the social, cultural and emotional needs of their children, although the family is supposed to be the place for the youth to seek resources of this kind. The incapacity of the family in this regard leads to various problems during the process of growing up for the youth. Particularly for those transmitting from adolescence to adulthood, this special relocation experience w i l l add more complexity to their already intricate development process. Smoking, as one of the problems along the way, is directly related to the family situation of immigration, and family circumstance may eventually be categorized as an adaptive issue under acculturation. Considering the significant role a family plays in any acculturation process, a major discussion is given to this particular topic. This part of the chapter emphasizes relevant literature in this area and analyzes the data from the perspective of immigrant families. 5.3.1 "Astronaut Family" "Astronaut Fami ly" syndrome emerged in the interviews and turned out to be a critical factor leading to adolescent smoking. In order to better understand this 68 phenomenon particularly existing in immigrant families, I reviewed a few articles based on the research respectively by Lidgard (1998) and Zhou (1995). The astronaut arrangement by some immigrant families occurrs when adult immigrants are sometimes either unable to work, unable to work in their desired profession in the host country, or they face difficulties in establishing and maintaining their businesses because of the different business practices in their home and host countries (Lidgard et al., 1988). A s a result, they choose to travel back and forth between the home country and the host country. A n astronaut family may include only one person being the "astronaut", or it can be a family where both parents are "astronauts". The "Astronaut family" structure causes harm to adolescents who are in great need of appropriate supervision and emotional support from the parents. Firstly, to avoid "downward assimilation" (Zhou, 1997), parents' wise intervention is important. Accord ing to Zhou, assimilation has continued to serve as a norm for immigrant adaptation, but its outcomes have become segmented. The paths to assimilation may lead upward as wel l as downward. The question is what makes some immigrant youth susceptible to the downward path or to the permanent trap, and what allows others to avoid it? A s indicated from my study, stronger parental supervision, marked as a more frequent presence, is important in preventing Chinese-Canadian girls from taking up smoking in a pattern of downward assimilation. Secondly, parents' failure to attend to their child 's daily life would enhance the children's feelings of isolation and hopelessness in the context of challenging conditions. Fami ly serves as the first point of contact when they come home looking for help after encountering considerable acculturation pressures 69 in their larger social environment. When an immigrant family fails to offer this function, the ch i ld may undergo an emotional crisis, in which situation, downward assimilation is most l ikely to take place. Therefore, it was understandable that there were more astronaut families being reported from the smoker group. 5.3.2 Intergenerational Communication In a western society, immigrant adolescents often become westernized so quickly that their parents cannot keep up with them. There is a fear in the older generation that their children w i l l leave them, become like other Canadian youth, and forget about their roots. This fear, however, has originated not from the process of acculturation but from the immigration process itself. Immigration disrupts normal parent-child relationships in a number of observable ways. First, many immigrant families suffer lengthy separation from the father or mother because of the reasons already illustrated in the previous section under the heading 5.3.1. A l s o , face-to-face interaction between parents and children decreases as both parents are usually out working for long hours. Third, because parents lack proficiency in Engl ish, children often act as interpreters and translators for their parents. The study has found low levels of Engl ish proficiency among parents but especially in the smokers' parents. Such role reversal usually leads to greater dependence of parents on children and a loss of parental authority. Meanwhile members of the younger generation are anxious that they might never become "Canadian" because of these intrinsic family ties. Immigrant children and their parents tend to perceive their host society and their relationships with it from different angles. The younger generation tends to focus on current adjustment, paying attention to the external traits of what they have 70 come to define as being "Canadian." They struggle to fit in based on a frame of reference that they have acquired from their Canadian peers and from the mass media. They often find themselves confused by such questions as: H o w do I fit into Canadian culture and my own ethnic culture at the same time? W h i c h side should I stay loyal to, Canadian or my own ethnic culture? Can I ever become Canadian without leaving home? A t times, they feel embarrassed and frustrated by their parents' " o l d " ways. The study presented a story told by a smoker about how her parents never understood her needs to buy clothes because she always wore a uniform in Hong Kong . Parents, on the other hand, are primarily concerned both with making the best of a new environment and with retaining traditional family life. These parental concerns tend to lead them to focus on the future and to emphasize discipline and scholastic achievement. When children respond to these emphases in an unexpected way, parents puzzle: W h y are my children so disrespectful? H o w can I make my children understand that everything I am doing is for their own good? Can ' t they understand that I wouldn't have chosen a life here i f it hadn't been for them? What should I do to keep my children from losing their cultural roots and from assimilating too much? The findings of my study identify more disrupted communication between parents and the youth in the smoker group, which might be related to a higher percentage of "astronaut" parents and a lower Engl ish ability. The results also prove that "Dissonant acculturation" (Portes & Rumbaut, 1996) marked by disconnection and conflicts between the worlds of parents and children w i l l cause stronger rebellion against parents' supervision and a higher tendency for downward assimilation by the chi ld. 71 5.3.3 Rigid Parenting Style and Rebellion It was found in my study that rebellion played an important role in the smoking behavior of the girls who experienced rigid supervision at home. Chinese parenting is wel l-known for its rigidness and harshness. The style sometimes works wel l on chi ld development because it provides a whole set of guiding principles for the behavior of children. But in some cases, authoritarian parents, who have r ig id rules and who paid less attention to the real needs of their children tended to raise children who rebelled against them. Particularly as a Chinese immigrant family l iv ing in a western society, the adaptation of the youth and the parents does not occur simultaneously. Parents often fail to identify the cultural and psychological needs of children who are going through fast adjustments at all levels. The parent's insensitiveness towards the internal alteration and newly developed expectations of the children, coupled with unmodified Chinese parenting styles, tend to cause tensions between the two worlds. Consequently, smoking becomes perceived and used by the youth as a way of rebelling against their parents. 5.4 IMPLICATIONS FOR YOUTH HEALTH PROMOTION Factors that lead to immigrant youth smoking are primarily social. Youth health promoters working on immigrant populations should particularly look into the social context in which immigrant "tobacco use occurs. They should take an active role in designing and offering programs that help immigrant youth to cope with acculturative pressures and improve their mental well-being. It is important to have knowledge about the various stresses during the acculturation process. In addition, speaking about female 72 smoking in particular, it is useful to fully understand the cultural differences surrounding the topic of female smoking across the world. Whi l e highlighting the health risks of smoking, the health promoter should be cautious about immigrant girls making a connection between gender equality and smoking which could lead them to perceive smoking as an empowering tool. It could be also helpful to educate the immigrant parents about parenting strategies: to be more open-minded about positive assimilation, more active in taking part in social activities and building social relations in the host country, and to provide necessary supervision and emotional support to the adolescents undergoing acculturative pressures. Since tobacco was used by some of the immigrant youth as an acculturation coping strategy and a way to de-stress in their daily lives, it is important for health promoters to develop and support alternative ways of dealing with pressures and stresses. For instance, in stead of smoking, participating in sports or other healthy social activities could potentially be used by immigrant adolescents to gain friends and social supports. School and parent should also consider joint initiations to convince current youth smokers and potential smokers that smoking is not the only way to overcome difficulties in the process of growing up. 5.5 IMPLICATIONS FOR CANADIAN GOVERNMENT HELATH DEPARTMENT This study found that there is a lack of available information about the smoking patterns of ethnic groups i n Canada. Future studies focusing on Canadian immigrant smoking would greatly benefit from having access to more comprehensive quantitative 73 data on ethnic patterns of smoking. Health Canada could address this issue by enhancing the Canadian Tobacco Use Monitoring Survey to gather data on immigrant population smoking status. 5.6 IMPLICATIONS FOR THE IMMIGRATION POLICY MAKERS Immigration is a significant social issue concerning both the receiving society and the people who are relocating. The smooth and successful settlement of an individual or a family is an important objective for immigrants, and should lead to a positive outcome for the society. A critical step to improve the overall well-being of immigrants is to allow space and time for them to adapt at a comfortable pace. As the study shows, Canada's multicultural strategy has been given credits compared to the American melting pot. With the Canadian government continuing to support open immigration policies, current policy makers should put more effort into providing a more supportive acculturation environment. 74 6 CONCLUSIONS 6.1 AN ETHNOGRAPHIC VIEW OF IMMIGRANT YOUTH SMOKING This study presented an ethnographic view of immigrant female youth smoking, which has not been wel l reported in previous studies in Canada. The thesis discussed Chinese-Canadian female youth smoking from several major theoretical perspectives. A s noted above, the findings demonstrate both direct and indirect support for the theories and prior research reviewed in the thesis. Firstly, the harsh acculturation process is believed to serve as a dynamic force in forming an impulse for smoking. Secondly, cultural hybridity, a post-acculturation phase helps explain the specific shared smoking patterns of the population. Thirdly, immigrant family life plays a significant role in smoking initiation and continuation among Chinese adolescent immigrant girls in Canada. 6.2 LIMITATIONS The researcher has been unable to find data on female smoking rates in the Chinese population in Canada. The Canadian Tobacco Use Moni tor ing Survey, conducted annually by Health Canada, does not provide smoking prevalence rates by ethnicity. Census Canada did not release ready-made tables with the two variables (smoking status, ethnicity). The researcher also could not f ind any Canada-based quantitative studies about the association between youth smoking and acculturation. Without sufficient statistical information on this topic in Canada, the study drew on related research in the United States. For example, the research conducted by Chen (1999) and M A (2004) which focused on Chinese-Americans. It remains to be seen whether their conclusions about a positive correlation between acculturation and female smoking can apply to the 75 Chinese-Canadian population in Canada. Canada and Amer ica are pursuing different immigration policies which have resulted in different socio-cultural environments supporting different acculturation processes. The lack of prior research in Canada constitutes a limitation for this study. Secondly, due to ethical and practical reasons, the study focused on university and college students. 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Use the following key to help guide your answers: Strongly Disagree Disagree Neutral/Depends Agree Strongly Agree 1 3 5 7 9 I. 1 often participate in Chinese traditions 1 2 3 4 5 6 7 8 9 2.1 often participate in mainstream North American cultural traditions 1 2 3 4 5 6 7 8 9 3.1 would be willing to marry a Chinese person 1 2 3 4 5 6 7 8 9 4.1 would be willing to marry a North American person 1 2 3 4 5 6 7 8 9 5.1 enjoy social activities with Chinese people 1 2 3 4 5 6 7 8 9 6.1 enjoy social activities with typical North American people 1 2 3 4 5 6 7 8 9 7.1 am comfortable working with Chinese people 1 2 3 4 5 6 7 8 9 8.1 am comfortable working with typical North American people 1 2 3 4 5 6 7 8 9 9.1 enjoy Chinese entertainment (e.g. movies, music) 1 2 3 4 5 6 7 8 9 10.1 enjoy North American entertainment (e.g. music, movies) 1 2 3 4 5 6 7 8 9 II. 1 often behave in ways that are 'typically Chinese' 1 2 3 4 5 6 7 8 9 12.1 often behave in ways that are 'typically North American' 1 2 3 4 5 6 7 8 9 13. It is important for me to maintain or develop Chinese cultural practices 1 2 3 4 5 6 7 8 9 14. It is important for me to maintain or develop North American cultural practices 1 2 3 4 5 6 7 8 9 15.1 believe in Chinese values 1 2 3 4 5 6 7 8 9 16.1 believe in mainstream North American values 1 2 3 4 5 6 7 8 9 17.1 enjoy the typical Chinese jokes and humor 1 2 3 4 5 6 7 8 9 18.1 enjoy typical North American jokes and humor 1 2 3 4 5 6 7 8 9 19.1 am interested in having Chinese friends 1 2 3 4 5 6 7 8 9 20.1 am interested in having North American friends 1 2 3 4 5 6 7 8 9 8 1 APPENDIX 2 Interview(smoker) #: gateT •'<& 7 /07 ; Language: EnglishD MandarinD Attitudes towards and experiences about femaW^^MM OA. When and how did you start smoking, were there any particular reasons? Could you please recall that part of your past and share with me? Q2. From a gender perspective, how do you understand (interpret) female smoking? Probes: • Do you think it's a feminist issue? • How do you feel about yourself when you light a cigarette, smoking just like a man. • Do you think smoking is particularly cool for girls, more than the extent that is to boys Why? • Please spend a few minutes imagining a girl who smokes in your class, how would you like to picture her? Q3. From a cross-cultural perspective, how would you understand (interpret) a Chinese girl's smoking behavior? Probes: • Do you think she is more westernized than other Chinese because Chinese girls who follow their original cultures normally don't smoke? Or do you think it's very common that a Chinese girl smokes here. • In your high school, do you always see more Caucasian girls than Chinese girls smoking? • Do you know there are more females smoking in Canada than in China? When and how did you know this? What do you think the reasons are for such a difference on female smoking prevalence between the two countries? Would you take up smoking if you never came to Canada? • Please spend a few minutes imagining a Chinese girl who smokes at your school, how would you like to picture her? CljfflS^^ about cultural diffelencM Q4. When you first arrived in Canada, did you feel strong cultural differences? How long did it take for you to basically adapt into this new cultural environment? How did you feel about that particular adaptive phase? Was it challenging? Q5. What mechanism did you use to deal with those challenges? Q6. Have you ever particularly tried to do something that a typical white is likely to do and a typical Chinese is not likely to do so that you feel yourself part of the Canadian culture, for example? Probes: • Did you try to eat more western food and less Chinese food? • Did you particularly try to make friends with white Canadian? 82 • When did you start dating? Was it earlier than the time Chinese girls normally start dating? • Did you participate in many extracurricular activities even against your parents' will? • Would you consider taking up cigarette smoking one of them? Q7. What are the different characteristics as you can observe between a typical Chinese and a typical white Canadian? Probes: Generally speaking, in my class, • A White Canadian tend to be more: Individualistic/independent/brave/self ish/aggressive/straightforward/rebelliousn • A Chinese student tend to be more: Shy/submissive/dependent/collective/hard-working/unsocial Q8. How do you feel about yourself? Are you more Chinese? Or are you more Canadian? Probes: • Tell me how you understand the following pairs of western and eastern values? • Individualistic / Collectivistic • Independent / Family oriented • Feminist /Gender differentiated • Liberal / Self- restraint • Based on the above value items, which are always more important for you in your life up to now? Why? Q9. Have you have ever had identity crisis between being a Chinese and being a Canadian? If so, when and how did this confusion come along? Q10. Does smoking make you feel you are more Canadian? Why? Q11. Are/were the majority of yours friends Chinese or Caucasian? Are/were your best friends Chinese or Caucasian? Did/Do they smoke? Q12. Can you describe your best friends? (clothing style, hobby, way of acting) Q13. How often do/did you hang out with your friends, what kind of social activities do/did you usually attend? Q14. How much would you care about your friends' opinions when you kind of make a decision? Q15. What are/were your friends' opinions about your smoking? I^^^s^and parenting styles Q16. How long have your parents lived in Canada? Can they speak English? What language do you use to communicate with your parents, English or Chinese? Do they smoke? Q17. Are/were they very strict with you? Probes: Friends and peer pressures 83 • Do they always force you to learn things you don't enjoy, (eg, playing piano, drawing)? • Do they always push you to study hard and never get satisfied with your grades? • Do they always try to control your life, such as deciding whom you should or should not make friend with? • Do they always put lots of expectation on you to become a successful person in the future? Q 3 . How is/was your relationship with your parents? Do/did you communicate very often? Are/were the communications smooth and pleasant most of time? Q 4 . How did your parent react to your smoking behavior when the first time they found it? Or what do you expect they reactions will be once they get to know it? Q 5 . Do you think your parents are of very typical Chinese type? And what do you like and dislike about their parenting style? 84 APPENDIX 3 . .. , v _ „ . . „ , . . . , . „ . L _ Interview (Non-smoker) #; . Date l^r/" "/071 Language: English• MandarinD Attitudes towards female snWiJM Q1. From a gender perspective, how do you understand (interpret) female smoking? Probes: • Please spend a few minutes imagining a girl who smokes in your class, how would you like to picture her? • How do you feel about female smoking? Do you think smoking resulted in a negative image for a girl, but not so much for a boy. Or do you think smoking is particularly cool for girls, more than the extent that is to boys? Why? • Do you think it's a feminist issue? Q2. From a cross-cultural perspective, how would you understand (interpret) a Chinese girl's smoking behavior? Probes: • Do you think she is more westernized than other Chinese because Chinese girls who follow their original cultures normally don't smoke? Or do you think it's very common that a Chinese girl smokes here. • In your high school, do you always see more Caucasian girls than Chinese girls smoking? • Do you know there are more females smoking in Canada than in China? When and how did you know this? What do you think the reasons are for such a difference on female smoking prevalence between the two countries? • Please spend a few minutes imagining a Chinese girl who smokes at your school, how would you like to picture her? Cultijres.and your experiences about cultural differences Q3. When you first arrived in Canada, did you feel strong cultural differences? How long did it take for you to basically adapt into this new cultural environment? How did you feel about that particular adaptive phase? Was it challenging? Q4. What mechanism did you use to deal with those challenges? Q5. Have you ever particularly tried to do something that a typical white is likely to do and a typical Chinese is not likely to do so that you feel yourself part of the Canadian culture, for example? Probes: • Did you try to eat more western food and less Chinese food? • Did you particularly try to make friends with Caucasian Canadian? • When did you start dating? Was it earlier than the time Chinese girls normally start dating? 8 5 • Did you participate in many extracurricular activities even against your parents' will? Q7. What are the different characteristics as you can observe between a typical Chinese and a typical Caucasian Canadian? Probes: Generally speaking, in my class, • A White Canadian tend to be more: Individualistic/independent/brave/selfish/aggressive/straightforward/rebelliousD • A Chinese student tend to be more: Shy/submissive/dependent/collective/hard-working/unsocial Q8. How do you feel about yourself? Are you more Chinese? Or are you more Canadian? Probes: • Tell me how you understand the following pairs of western and eastern values? • Individualistic / Collectivistic • Independent / Family oriented • Feminist /Gender differentiated • Liberal / Conservative • Based on the above value items, which are always more important for you in your life up to now? Why? Ethnic identity Q9. Have you ever experienced identity crisis between being a Chinese and being a Canadian? If so, when and how did this confusion come along? Q10. How would you like to identify yourself? Friends and peer pressures Q11. Are/were the majority of yours friends Chinese or Caucasian? Are/were your best friends Chinese or Caucasian? Did/Do they smoke? Q12. Can you describe your best friends? (clothing style, hobby, way of acting) Q13. How often do/did you hang out with your friends, what kind of social activities do/did you usually attend? Q14. How much would you care about your friends' opinions when you kind of make a decision? Q16. How long have your parents lived in Canada? Can they speak English? What language do you use to communicate with your parents, English or Chinese? Do they smoke? Q17. Are/were they very strict with you? Probes: • Do they always force you to learn things you don't enjoy, (eg, playing piano, drawing)? • Do they always push you to study hard and never get satisfied with your grades? • Do they always try to control your life, such as deciding whom you should or should 86 not make friend with? • Do they always put lots of expectation on you to become a successful person in the future? Q3. How is/was your relationship with your parents? Do/did you communicate very often? Are/were the communications smooth and pleasant most of time? Q5. Do you think your parents are of very typical Chinese type? And what do you like and dislike about their parenting style? 87 The University of British Columbia Office of Research Services Behavioural Research Ethics Board Suite 102, 6190 Agronomy Road, Vancouver, B.C. V6T 1Z3 CERTIFICATE OF APPROVAL - MINIMAL RISK PRINCIPAL INVESTIGATOR: INSTITUTION / DEPARTMENT: UBC BREB NUMBER: Robert E.C. Sparks UBC/Education H06-03559 INSTITUTION(S) WHERE RESEARCH WILL BE CARRIED OUT: Institution Site UBC Point Grey Site Other locations where the research will be conducted: N/A CO-INVESTIGATOR(S): Li Shun SPONSORING AGENCIES: N/A PROJECT TITLE: Understanding the Effects of Acculturation on Chinese-Canadian Female Youth Smoking: An Ethnographic Study using a Retrospective Approach CERTIFICATE EXPIRY DATE: January 15, 2008 DOCUMENTS INCLUDED IN THIS APPROVAL: DATE APPROVED: January 15,2007 Document Name Version Date Protocol: Thesis Proposal N/A January 1, 2006 Consent Forms: Subject Consent Form N/A January 6, 2007 Advertisements: Recruitment Poster N/A January 6, 2007 Questionnaire, Questionnaire Cover Letter, Tests: Interview Guide (Non-smokers) N/A January 6, 2007 Questionnaire N/A January 6, 2007 Interview Guide(Smokers) N/A January 6, 2007 The application for ethical review and the document(s) listed above have been reviewed and the procedures were found to be acceptable on ethical grounds for research involving human subjects. APPENDIX 4 UBC 88 Approval is issued on behalf of the Behavioural Research Ethics Board and signed electronically by one of the following: Dr. Peter Suedfeld, Chair Dr. Jim Rupert, Associate Chair Dr. Arminee Kazanjian, Associate Chair Dr. M. Judith Lynam, Associate Chair 89


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