Investigating the Immigrant Health Advantage in Smoking Initiation: Evaluating Differences by Sex and Hispanic Ethnicity

This dissertation is an effort to contribute to the body of literature concerned with understanding the interplay between nativity status, sex, and Hispanic ethnicity on smoking initiation within the U.S. population. I use explanations of the immigrant health advantage to evaluate variations in smoking initiation among U.S. immigrants and nonimmigrants who have over a decade of residency in the United States. The three major aims of this dissertation bring attention to the intersection of migration and population health by exploring the risk of initiating smoking and smoking behavior between immigrants and nonimmigrants by sex and Hispanic ethnicity. Aim 1: investigates and compares the relative risk of smoking initiation between immigrants and nonimmigrants from adolescence to adulthood. Aim 2: investigates and compares sex differences in the relative risk of smoking initiation between immigrants and nonimmigrants from adolescence to adulthood. Aim 3: investigates and compares ethnic differences in the relative risk of smoking initiation between Hispanic and non-Hispanic immigrants, and their nonimmigrant counterparts from adolescence to adulthood. I use the National Longitudinal Survey of Youth 1997 cohort data (1997-2011, 14 waves, ages range from 12-31), discrete-time hazard regressions, and hazard ratios to estimate the risk of smoking initiation. Results suggest that immigrants have a lower relative risk of initiating smoking than nonimmigrants. Male immigrants have a lower relative risk of initiating smoking than nonimmigrant males. Hispanic and non-Hispanic immigrants have a lower relative risk of initiating smoking than their nonimmigrant counterparts. Findings provide evidence about the existence of an immigrant health advantage in smoking initiation in the United States, and that the immigrant health advantage is greater among males and Hispanics.