DOCUXENT RESUME

ED 318 824 UD 027 399

AUTHOR Austin, Gregory A.; And OthersTITLE Substance Abuse among Asian American Youth.

Prevention Research Update. Number Five/Winter1989.

INSTITUTION Far West Lab. for Educational Research andDevelopment, San Francisco, Calif.; NorthwestRegional Educational Lab., Portland, Oreg.; SouthwestRegional Laboratory for Educational Research andDevelopment, Los Alamitos, Calif.; Western Center forDrug-Free Schools and Communities.

SPONS AGENCY Department of Education, Washington, DC.PUB DATE 89

CONTRACT SI88A80003NOTE 29p.; For a related document, see UD 027 400.PUB TYPE Reports - General (140) -- Information Analyses (070)

EDRS PRICE NFO1 /PCO2 Plus Postage.DESCRIPTORS Adults; *Alcohol Abuse; Annotated Bibliographies;

*Asian Americans; Cultural Differences; Drinking;*Drug Abuse; Ethnic Groups; *Incidence; Prevention;Social Influences; *Sociocultural Patterns; SubstanceAbuse; Whites; *Youth Problems

IDENTIFIERS California; Hawaii

ABSTRACTThis report discusses the substance use patterns and

problems of Asian Americans adults and youth relative to other ethnicgroups (primarily Whites). In addition, it summarizes the mainexplanations that have been offered for ethnic differences in use,and offers possible conclusions that may be drawn concerningprevention for Asian-American young people. The following sectionsare included: (1) "Nature and Extent of Use"; (2) "Substance-RelatedProblems"; (3) "Correlates of Use"; (4) "Prevention": and (5)"Summary and Conclusions." Within each section, adults, youth, anduse of various drugs are considered separately. The followingfindings, derived mostly from research in California and Hawaii, arepresented: (1) Asian Americans drink less than Whites and have lowerlevels of druc, use; (2) they have a relatively large percentage ofabstainers; (3) most drinking is done by males but at moderatelevels; (4) considerable variations in drinking patterns and drug useexist among different Asian groups; (5) Asian Americans suffer lessfrom substance-related problems than do other ethnic groups; and (6)the evidence regarding the relative influence of socioculturalfactors and physiological factors in keeping alcohol use low amongAsians is inconclusive. Abstracts of 19 documents about substanceabuse among Asians are included. A list of 94 references is included.(JS)

Reproductions supplied by EDRS are the best that can be madefrom the original document.

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SUBSTANCE ABUSE AMONGASIAN AMERICAN YOUTH

Prevention Research Update

Number Five / Winter 1989

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Prevention ReseIrch Update is a quarterly current awareness service, prepared by the WesternCenter for Drug-Free Schools and Commtmities, which summarizes recent research on adolescentdrug abuse and its prevention. Each issue abstracts and reviews the prevention implications ofnew research dealing with a major topic of concern in the field, placing the new information inthe context of past findings. The goal is to help bridge the communications gap between dmresearcher, the practitioner, and the general pcpulation, by disseminating research findings in anaccessible manner and providing an introductory review of their Again.' cance. Abstracts arearranged alphabetically by first author's last name. Preceding the abstracts is an orerviewdiscussion in which references to abstracted studies are identified by an asterisk (*). Referencesto all documents cited are located following the abstracts. Copies of the Updates are availablefrom all the Western Center sites, listed on the last page of this issue.

SUBSTANCE ABUSE AMONG ASIAN AMERICAN YOUTH

Gregory A. Austin, Ph.D.Michael L. Prendergast, Ph.D.Western Center for Drug-Free Schools and CommunitiesSouthwest Regional Laboratory

Harvey LeeWestern Center for Drug-Free Schools and CommunitiesCenter for the Advancement of Pacific Educaton / Northwest Regional Educational Laboratory

Overview / 1

Introduction / 1

Nature and Extent of Use / 2Substance-Related Problems / 6

Correlates of Use / 8Prevention / 11

Summary and Conclusion / 12Abstracts 15

References / 23Author and Information Source Addresses / 27

Western Center Sites / 28

OVERVIEW

Introduction

Asian Americans make up about 2% of thepopulation of the United States and are one of thefastest growing immigrant groups. In 1980, theynumbered 3.7 million; in 1985, an estimated 5million. This is a diverse population: within thebroad designation "Asian/Pacific Islander" are at least32 different national and ethnic groups (Trimble,Mille, and Bell 1987:6). According to the 1980census, Chinese are the largest Asian minority in theU.S. (812,000), followed by Filipinos (781,000),Japanese (716,000), and Koreans (357,000). It is

expected, however, that the 1990 census will showthat Filipinos now predominate. Nearly half of theAsian Americans in the United States are foreign-born. Southeast Asians are the newest and fastestgrowing Asian population on the West Coast.

Almost two-thirds of all Asian/Pacific Islanderslive in three wt.= California (35%), Hawaii (16%).and New York (9%). The majority also live in urbanareas. In Hawaii, Asian/Pacific Islanders Make up61% of the population. In California, their numbersgrew so fast during the 1980s that they are now thestate's third largest ethnic group, behind Caucasiansand Latinos, comprising 9% of the population (Chi,

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evidence that alcohol use among Asian Americans isincreasing.

California. Researchers at the University ofCalifornia, Los Angeles, have surveyed drinkingamong Chinese, Japanese, Korean, and Filipinos in LosAngeles. Abstinence among these groups was high:among men, 17% of Japanese, 19% of Filipinos, 21%of Chinese, and 45% of Koreans. Among women,abstinence was reported by 27% of Japanese, 51% ofChinese, 55% of Filipinos, and 75% of Koreans.Heavy drinking among men ranged from a low of 14%among Chinese to 29% among Filipinos; Koreans(26%) and Japanese (29%) were close behindFilipinos. Three percent or less of the women wereheavy drinkers, except Japanese women, with 12%.

The researchers concluded that while the resultsconfirmed the traditional view of Asian women asabstainers or light drinkers, they also revealed aconsiderable amount of heavy drinking among men,particularly Japanese and Koreans, possibly as high asin the general U.S. population.

These Asian-American groups also differedsignificantly in their drinking behavior. Among allfour groups, similarities were found among thosewho drank heavily: they were most likely to be menunder age 45, of relatively high social status andeducational background, in professional or whitecollar occupations, with permissive personal attitudestowards use, and with friends tolerant of drinking.But even those who were heavy drinkers exhibitedlittle evidence of alcohol-related problems (e.g.,arrest for drinking, loss of personal impairment,drastic changes in lifestyle) (Chi, Lubben, and Kitano1989 *; Kitano and Chi 1989; Lubben, Chi, and Kitano1988*; Lubben, Chi, and Kitano 1989*).

These samples only included Asian Americans, sodirect comparison with White drinking levels is notpossible. A rough comparison, however, is providedin the National Household Survey of 1985, in which12% of adults age 26 and older were abstainers(NIDA 1988:21).

A survey in Santa Clara County focused on thedrinking patterns of Japanese Americans and Whites,as pan of a larger joint US-Japanese study of Japanesedrinking in Japan, Hawaii, and California (Clark andHesselbrock 1988; Kitano, Chi et al. 1988*). Whitesin Santa Clara were more likely to drink and to drinkheavily than Japanese. The difference between thepercentages of male drinkers was not great (87% forWhites vs. 82% for Japanese), but the percentage ofheavy drinkers among Whites was twice that amongJapanese (26% vs, 13%). Among females, nearlythree times as many Whites as Japanese were heavydrinkers (11% vs. 4%).

Hawaii. Pour surveys of alcohol use among themajor ethnic groups in Hawaii have been conductedsince 1975 (Schwilters, Johnson et al. 1982*; LeMarchand, Kolonel, and Yoshizawa 1989*; Hawaii1979, cited in Ahern 1989; Murakami 1989.): a fifthsurveyed alcohol Use among Japanese-Americans onOahu (Kitano, Chi et al. 1988*). The reportedpercentages from each survey are not always

3

Substance Abuse Among Asian American Youth

comparable because of differences in the definition ofdrinking. The rankings of the different groupsincluded in each survey are comparable, however.

A survey of drinking monk" ethnic groups inHawaii conducted in 1975 found that the proportionof anent drinkers was highest among Whites (81%),followed closely by Hapa-Haoles (80%). (Haps-Haole is a Hawaiian term referring to a person withone parent of Caucasian ancestry and the other ofAsian ancestry.) Hawaiians/Part Hawaiians (69%),Chinese (69%), and Japanese (67%) reported similarproportions of drinkers. Trailing the other groups bya considerable amount was Filipinos, among whom49% were current drinkers (Schwiuers, Johnson et al.1982*; for other reports on this sample, seeSchwiners, Johnson et al. 1982a; Wilson andMcClearn 1978).

From 1975 to 1980. the Epidemiology Programof the Cancer Research Center of Hawaii includedquestions about drinking practites in its yearly healthsurvey (Le Marchand, Kolonel, and Yoshizawa1989*). As in the previous survey, Whites andNaive Hawaiians had the highest percentages ofdrinkers, and drinking was more common amongJapanese than among Filipinos. In this survey,however, Chinese males ranked last, while Chinesefemales ranked third. A somewhat different patternemerges when the average amount of alcoholconsumed per day is examined. Native Hawaiiansreported the highest level of alcohol intake, followedby Whites. Although Japanese were more lady thanFilipinos to drink at least weekly, Filipinos drankmore per day than Japanese. The discrepancy in rankbetween Chinese males and females in frequency ofuse disappeared when quantity was considered: bothwere least likely of all groups to drink large amountsat a time.

A survey by Hawaii's Department of Health in1979 confirmed the results of the earlier surveys:Native Hawaiians had the highest prevalence rate,Filipinos the lowest, with Japanese and Chinese in themiddle 1979, cited in Ahern 1989). Asecond Deparmient of Health survey in 1984 alsofound that larger percentages of Native Hawaiiansdrank and drank heavily than did Filipinos andJapanese, but contrary to other surveys, this onefound higher levels of drinking and heavy drinkingamong Filipinos than among Japanese (Murakami1989*).

Drinking among Asian Americans may differsignificantly by location. A survey of JapaneseAmericans residing on Oahu in 1984 found a fairlyhigh level of abstinence among males (21%) comparedwith samples of Japanese Americans in Sr.nta Clara(19%) and Los Angeles (14%). The level of heavydrinking in Oahu (29%) was somewhat less than thatin Los Angeles (36%), but was more than double thatin Santa Clara (13%). For females, the rankingsamong the three sites for abstinence and for heavywere the same as for males (Kitano, Chi et al.1988*).

Prevention Research Update S

Youth

Surveys that report on alcohol use among Asian-American young people have sampled three types ofpopulations: secondary school students, collegestudents, and young people not in sdtool. With fewexceptions, those that did survey general populationsof youth only included a single category of "Asian" or"Oriental." Also, the small number of AsianAmericans included in some of the samples cast doubton whether the results can be generalized to the totalpopulation of Asian youth. The results from mucollege surveys should be viewed with caution sinceAsian college students tend to be an elite group,whose alcohol use patterns may not represent those ofother young adults of similar age.

Secondary School Surveys. A national surveyof junior and senior high school students conducted in1974 found that Asian-American youth repeated highlevels of abstinence relative to other ethnic grasps.But significant gender differences also existed amongthose who drank. Asians ranked second in thepercentage of abstainers, after Blacks (35% vs. 41%).Asian girls had the lowest level of heavy drinking(5%). Among males, however, those who did drinktied with Native- American boys as the heaviestdrinkers (25%). Heavy drinking was five timesgreater among Asian boys than among Asian girls.which was the largest male:female ratio of all theethnic groups (Rachel, Williams et al. 1975, cited inWeibel-Orlando 1986 :167).

State and local surveys have found similarresults. Barnes and Wedte (1986) surveyed over27,000 seventh-to-twelfth grade students in NewYork State in 1983, 2% of whom were AsianAmericans (most of these were probably ChineseAmericans). Asians had the lowest level of drinkingout of six ethnic groups: only 45% of Asian studentsreported drinking at least once in the past year, whichwas substantially below the 61% of the next highestgroup (West Indians). Asians did not, however, ranklowest in the proportion of heavy drinkers (6%),being slightly higher than Blacks (5%) and WestIndians (4%). (Heavy drinking was defined asdrinking at least once a week and drinking largeamounts at a typical session.) Despite the low levelof drinking among Asians, they drank more per daythan any other ethnic group (1.46 ounces per day vs.0.76 ounces for Whites). This finding needs to befurther studied to determine whether it is true ofAsian students generally and, if so, why it should beso. Again, significant gender differences amongAsian-American students were found. All of theheavy drinkers among Asians were males, whereas theother ethnic groups had at least some females whowere heavy drinkers.

In California, a biennial survey of alcohol sadother drug use among 7th-, 9th-, and 1 1 th-gradestudents in California provides data on how use haschanged over time among different ethnic groups(Skagen, Frith, and Maddahian 1989). In the mostrecent survey, conducted in the winter of 1987-1988,

4

7,022 students throughout the state completedanonymous questionnaires about their drug use. Atall three grade levels, Asian-American students hadsignificaney lower rates of alcohol use than the otherethnic groups included within the study; furthermore,their use of alcohol did not change significantly fromthe 1985-1986 survey.

In a longitudinal survey of drug use amongstudents in Los Angeles at three points in time (1976.1979, 1980), the rankings remained the same in allthree years: Whites had the highest rates of use,followed by Hispanics, then Asians, then Blacks(Maddahian, Newcomb. and Bender 1986).

The only school-based survey that reportedresults for specific groups of Asian/Pacific Islanderswas carried out in schools throughout Hawaii in1987. The sample included six ethnic groups:Filipino, Japanese, Hawaiian/Part Hawaiian, White.Mixed, and Other. Among 12th graders, Whites andHawaiian/Part Hawaiians reported the highestprevalence of use (both 91%), while Filipinos andOther reported the lowest (both 81%); Japanese andMixed fell between (86%). Heavy use was highestamong Hawaiian/Part Hawaiian students and lowestamong Filipino and Japanese students. The latter twogroups also had larger percentages of low-level usersthan the other groups (Anderson and Deck 1987 «:23 -24).

College Surveys. Sue, Zane, and Ito (1979*)studied drinking patterns among Asian and Whitestudents at the University of Washington.Consistent with other studies, Asian studentsreported lower levels of drinking than Whitestudents. Abstinence or light drinking was reportedby 15% of Asians and 9% of Whites; heavy and veryheavy drinking was half the level among Asians asamong Whites (34% vs. 66%).

In a survey at the University of California, LosAngeles, Asian students were seven times more likelyto be abstainers than Whites (20% vs. 3%).Infrequent or light drinking was more common thanmoderate or heavy drinking among Asian students,whereas it was the reverse for White students(Akutsu, Sue at al. 1989*).

A survey of alcohol use among college studentsin Hawaii broke down the results by ethnicity andgender. Among males, Whites and Hawaiians/PartHawaiians had the highest proportion of alcohol usersand Chinese and Filipinos had the lowest, withJapanese in the middle. Among females, the orderwas the same, except that Hawaiians/Part-Hawaiiansrather than Whites held first place (Danko, Johnsonet al. 1988*).

Community Surveys. A survey of San Diego JobCorps members conducted in 1981 found thatIndochinese young people had the lowest level ofdrinking (use in the past six months), compared withWhites, Blacks, and Hispanics. As in other surveys,gender differences among the Indochinese youthexceeded those of the other groups. Two-thirds(66%) of Indochinese males and 43% of femalesdrank, compared with an average of 87% for males

and 88% for females for the other groups.Indochinese youth began drinking later than othergroups: age 18 for both males and females, comparedwith 11 years for males and 14 years for femalesamong Whites. This was the only study found thatreported age of initiation for drug use (Morgan,Wingard, and Felice 1984). (Although not stated inthe article, it is likely that most of the Indochinese inthe sample were Vietnamese).

The first (and apparently the only) community-based survey of substance use among Asian-Americanyouth was conducted in San Francisco's Chinatown in1985. The 123 subjects, who ranged in age from 13 to19 years old, were selected by a chain referral methodrather than randomly, so it is not clear whether thesample was representative of the population ofChinese-American youth in Chinatown or SanFrancisco generally. The percentage of the sampleindicating ever use of each alcoholic beverage was asfollows: beer 77%; wine 54%; and hard liquor 49%(Wong ri.d.*).

Other Drugs

Very few surveys have been conducted of drug useamong Asian Americans. A study from the 1960s ofopiate addiction among Chinese is of more historicalthan contemporary interest (Ball and Lau 1966).Only one recent survey of drug use among Asian-American adults has been foiled. In Hawaii, threeAsian-American groups (Chinese, Japanese, andFilipino) had significantly lower levels of use ofvarious licit and illicit drugs than Native Hawaiiansand Whites, with Filipinos reporting the lowestlevels of use (McLaughlin, Raymond et al. 1987*).Unlike the case with alcohol, there is moreinformation on drug use among Asian-Americanyoung people than adults.

Secondary School Surveys. Within the NewYork State sample of junior and senior high schoolstudents, lifetime use of any drug (other thanalcohol) by ethnicity was a follow= American Indian54%; White 27%; Asian 26%; Hispanic 26%; Black19%; and West Indian 16% (Welte and Barnes1987:331). Asians ranked higher for drugs than foralcohol, which was largely accounted for by theirrelative high rates of over-the-counter andpsychotherapeutic drugs. The percentage of ever useof particular drugs by Asian-American students wasas follows, with the rank order of Asians and thepercentages for Whites indicated in parentheses:marijuana 23% (6th; 45%); over-the-counter drugs31% (4th; 34%); pills 20% (4th; 33%); and harddrugs 12% (5th; 17%) (Welt* and Barnes 1985:491).

The report of the California statewide studentsurvey reported ethnic comparisons for specific drugsonly if differences between use levels were significantfor at least two ethnic groups. Generally, Asiansreported less drug use than other groups, but therewas some variation by grade level. In all grades,Asians had the lowest level of marijuana use; among11th graders, they had the lowest level of cocaine use.

S

Snitstaireo Alms Among Asian American ronth

Only for inhalants did Asians have slightly higher(but nonsignificant) levels of use: higher than Blacksin 9th grade and higher than Blacks and Hispanics in11th grade. Between the 1985-1986 and the 1987-1989 surveys, the use of the most commonly usedillicit drugs declined among all students. Thoseethnic groups with the highest levels of use generallyshowed significant declines in the greatest number ofspecific drugs. For Asians, the only significantdecline in use was for cocaine (Skager, Frith, andMaddahian 1989).

Among four ethnic groups in the survey of LosAngeles students, Asians had the lowest level ofcannabis use and the next to the lowest levAs of theuse of non-prescription drugs and hard drugs (afterBlacks) Ovladdshian, Newcomb, and Bender 1986).

In the Hawaii student survey, results for 12thgraders indicated that the highest levels of lifetimeuse of illicit drugs was found among Hawaiians/PartHawaiians (66%), followed by Whites (59%), Mixed(58%), Other (46%), Filipinos (41%), and Japanese(39%) (Anderson and Deck 1987*:24).

Other than Native Hawaiians, little is knownabout drug use among Pacific Islanders. A surveyconducted on Guam in 1974 found use rates (at leastonce in the previous year) ranged from 40% formarijuana to 4% for methaquakme. Drug use washighest among stateside students and lowest amongFilipino students, with Micronesian and Chamorrostudents falling between (Chung (1975]).

Community Surveys. Indochinese young peoplein the San Diego Job Corps sample (drinkers only)had very low levels of drug use; none had usedcocaine; 3% had used marijuana; 3% speed; 5% gine;3% paint; and 3% angel dust. By way of comparison,although Whites reported use of glue or paint, theiruse of other drugs ranged from a low of 7% forcocaine to 53% for marijuana (Morgan, Wingard, andFelice 1984).

By contrast, relatively high rates of drug usewere found among young people in San Francisco'sChinatown. The percentages indicating ever use ofvarious drugs were as follows (with the results foralcohol repeated from above for comparison): beer77%; cigarettes 75%; marijuana 59%; wine 54%; hardliquor 49%; quaaludes 42%; cocaine 40%; hashish22%; Valium 16%; and LSD 15%. Limited use wasreported for amphetamines (5%), amyl nitrates (2%).opium (2%), PCP (1%), and glue (1%). Males andfemales had roughly comparable levels of use formost drugs, but females more often reported use ofValium, Codeine, and quaaludes. No one reported useof heni.n. By comparison with previous communitysurveys of drug use among other ethnic groups in SanFrancisco, quaalude use was twice as high amongChinese-American youth as among White and Latinoyouth and five times greater than among Black youth.On the other hand, Chinese Americans had lower useof heroin, PCP, amphetamines, and Valium than didother groups (Wong n.d.*).

Nonsurvey Data. The survey data reviewed sofar show low levels of drug use among Asian

Prevention Research Update S

Americans compared with other ethnic groups. Otherevidence, however, present a less favorable picture.Many within the Asian community are concerned thatdrug use is greater than what surveys show and that itis rising. A NIDA repot: on drug abuse amongminorities (Trimble, Padilla, and Bell 1987)summarized the results from surveys carried out inthe 1970s that indicated low levels of drug use, butthe report also cited other evidence of serious drugproblems among Asian youth. It quoted from areport on drug use among Asian - American youth inthe Seattle area, which stated that 'drug use withinthe Asian youth community is much more seriousrhea what is recorded by law enforcement agencies orindicated by the policies of drag treatmentprograms....Asian youth appear to use drugs at a levelequal to if not higher than the nationalaverage...known users tend to begin use of drugsearlier and continue in a manner and extent far abovethe national average. Heroin was used by at least40% of this group and appeared to be continuing' (p.7, quoting Washington State Commission 1983).

At state legislative hearings held in San Diego inthe Fall of 1989, witnesses testified that while druguse within Asian communities was not widespread,the problem was growing and would get worse unlessaction was taken to contain it. Witnesses mentionedthat recently fanned Asian youth gangs in San Diegowould likely result in increased drug use andtrafficking among Asian youth (California Senate1989).

A very recent phenomenon, which has receivedconsiderable press coverage, is the apparent increase ofuse of smokeable methampheiamine known as "ice;which is sometimes combined with crack. The drug iswidely used in Japan, and newspaper and televisionreports have indicated that a major source of "ice" isKorean and Filipino gangs in Hawaii. But the littleevidence that does exist on this new form of drug usesuggests that it is no greater problem among Asian-American youth than among other ethnic groups (LosAngeles Times 10/8/89, 10/14/89).

Summary

The surveys of alcohol use among adults andyoung people suggest rather consistent patternsamong the various ethnic groups. Drinking is morecommon among Whites than among any Asian/PacificIslander group for which data are available. Asianshave lower prevalence rates that Native Americansand Latinos. Only Blacks have similar or lower rates.As is found with other ethnic groups, Asian males aremore likely to drink and to drink heavily thanfemales; unlike other groups, the differences in thedrinking behavior between Asian males and femalestends to be more polarized. Among Asian subgroups,only Native Hawaiians drink at levels that are moresimilar to Whites than to other Asian groups.Japanese generally rank after Whites and, in Hawaii.after Native Hawaiians. Drinking is lowest amongFilipinos and Chinese. Only one survey has included

6

Korean- (Lubber, Chi, and Kitano 1989), and itexamined only adults. The results indicated that bothmen and women had a lower level of drinking thandid Chinese, Filipinos, and Japanese. but Korean menhad levels of heavy drinking that approached those ofJapanese and Filipino men, suggesting even largergender differences than exist among other Asiansubgroups. The single survey that includedIndochinese youth found that their level of alcoholuse was considerably below the average for the othernon-Asian groups surveyed.

Very few studieson adults or rtithprovidedata on the prevalence of drug use amongAsian/Pacific Islanders. Furthermore, studies tend togroup all Asian Americans in the sample together.What there is suggests, as with alcohol, that theyhave low levels of use compared with other ethnicgroups an exception is Native Hawaiians, whose druguse appears to be more similar to Whites than toother groups. Some indirect and anecdotal evidencesuggests that the prevalence of drug use in someAsian-American communities is higher than thatreported in more formal surveys.

Substance-Related Problems

Alcohol

Data on levels of use indicate that those Asianmales who drink often have high rates of heavydrinkers, although still not as high as among Whites.Thus, one might expect that substance-relatedproblems would be heavier in this group, whileremaining low in the Asian population in general, asupposition that is born out by what limitedinformation is available on use problems.

Adults

Studies indicate that Chinese and JapaneseAmericans have low inane% admission rates foralcoholism (Sue, Zane, and Ito 19790:41). Asdiscussed further below, admission runes probably donot reflect of the actual number of people who needtreatment, but other data do support thegeneralization that Asian Americans have low levelsof alcohol problems. For the period 1978-1980, theage-adjusted death rate for chronic live disease andalcoholic cirrhosis among Chinese Americans was 1.2per 100,000 population, compared with 4.7 forWhites and 10.5 for Blacks (Yu and Liu 1987:16). Ina recent survey of Asian Americans in Los Angeles,reports of alcohol-related problems were few; forinstance. among the Japanese, none of the respondentsreplied that they experienced problems with alcohol,although several did mention problems amongrelatives or friends. The existence of AlcoholicAnonymous groups for Japanese in Los Angeles does.however, Engest that some portion of the Japanesecommunity suffers from drinking problems (Kin noand Chi 1987:46; Kitano, Lubben, and Chi 1988°:419,427).

Youth

In the survey of New York State students,Asians who had more than 10 misconduct incidentsduring the school year drank more than Whites with asimilar level of misconduct (1.64 ounces per day vs.1.40). Asian students who drank also repotted moreproblems than other groups: they ranked second inthe mean number of times drunk per month and in themean number of alcohol-related problems per month,after American Indians. (Alcohol problems includedtrouble with teachers, friends, or police because ofdrinking, drinking-driving, use of alcohol at school,attending class while high.) Even though Asianstudents drank the greatest amount of alcohol perday, they had d. .1 lowest mean number of alcohol-related problems per month for each ounce of alcoholconsumed per day. What is uniting in the drinkingb. havior of Asian students in this survey is thatdifferences between males and females on the variousmeasures were greater than those for the other ethnicgroups; in other words, males accounted almosttotally for drinking problems among Asian students(Barnes and Welte 1986; Write and Barnes 1987).

In agreement with results from other surveys,Morgan, Winprd, and Felice (1984) found thatIndochinese youth in San Diego had substantiallyfewer problems (vocational, legal. medical)associated with drinking than other ethnic groups.

By contrast, an exploratory study of alcohol useamong university students in Oklahoma found thatChinese respondents had relatively high levels ofalcohol problems compared with other ethnic groups(Hughes 1981).

Drugs

Data from NIDA's CODAP (Client OrientedData Acquisition Process) system for 1983 indicatedthat less than 1% of the clients in treatment wereAsians (Malone 1985:138). In a survey conducted inHouston of Indochinese refugees, 14% reported thatthey sometimes felt they had troubles with drugsother than alcohol (Yee and Tbu 1987*). Youth inSan Francisco's Chinatown reported a variety of acutephysical and psychological problems associated withsubstance use, including (1) having been sick fromdrinking alcohol (48%), (2) had a smoker's cough(42%), (3) bad a bad hangover from alcohol (40%),(4) had shortness of breath from smoking, and (5)suffered memory loss from alcohol or drugs (24%).Forty percent used marijuana at school, nearly 11% ona regular basis. The main problems associated withusing marijuana at school had to do with being able tofunction mentally (Wong n.d.*).

Although the data from surveys and treatmentfacilities show that Asian-Americans ha,e fewerproblems with alcohol and drugs than other ethnicgroups, members of the various Asian/Pacific Islandercommunities are concerned that substance abuseofficials and community agencies underestimate theextent of the problem, largely because of the "model

7

Susan* Abisv Among Asian American Youth

minority" stereotype. As a result, alcohol and drugproblems among Asian Americans receive insufficientattention, either in terms of research efforts andtreatment and prevention resources. Treatmentservices for Asian Americans may be inadequate oreven nonexistent. Also, since young people in Asianfamilies are taught that their behavior reflects on theentire family for generations, personal problems tendto be hidden or solved within the family. Thus,people who do have alcohol or other drug problemsare reluctant to seek professional treatment. Thosewho do seek treatment tend to enter a privatehospital, often outside the local community, ratherthan use services that participate in 1311-gatheringprograms. An additional factor, it has c...st alleged.is that the legal system often treats Asian juvenilesmore leniently than other minority groups, whichmeans that Asian young people with substance abuseproblems are less likely than other youth to be forcedinto treatment, which further hides the problem. Butonce they do enter the public health service system,either because they have exhausted private resources orbecause of legal difficulties, their substance-useproblems may have reached an advanced stage (Sue andMorishima 1982; Munro 1982:424; Kitano, Hatanakaet al. 1985; Kotani 1982 Sue 1987).

Even here, however. one must be aware ofdifferences among the various Asian/Pacific Islandergroups and within generations. Recent immigrants andrefugees are more likely to handle problems withinthe community, while those who have become moreassimilated into American society are probably morecomfortable using available public services.Therefore, a finding that treatment rates for arecently arrived group, such as the Vietnamese, werelower than those for a more established group, suchas the Japanese, would not necessarily mean thatVietnamese had fewer problems than Japanese. Thus,researchers need to consider differences in ethnicbackground, in generational status, and in degree ofassimilation when examining substance-relatedproblems among Asian/Pacific Islanders (Chang1981:7; Shon and Ja 1982:221). The issue ofassimilation is discussed below.

Summary

The limited information available indicates that,consistent with their low levels of use, AsianAmericans suffer less from substance-relatedproblems than do other ethnic groups. Whatproblems do occur are mainly accounted for by males.It would be a mistake, however, to say that AsianAmericans do not have problems associated with theuse of alcohol and other drugs. Indirect evidencesuggests that the magaitude of alcohol and other drugproblems may be greater than what is commonlyassociated with the "model minority" stereotype orwhat is reported in surveys and official recordsbecause of the tendency of Asian Americans to handleproblems within the family or the community ratherthan seek out public treatment services. This latter

9

Pr:wisdom award' Uptake

fact may contribute to Asians' having relatively highrates of more severe substance-use problems once theycome to public attention.

Correlates of Use

Most of the research-based information on thecorrelates of substance use come from surveys ofalcohol' use. A major focus of research on alcohol hasbeen the role of physiological or genetic factors asaccounting for differences in drinking patternsbetween Asians and Whites. There has been nosuggestion that differences in drug use arc alsoexplained by physiological factors, but it is likelythat the sociocultural influences that have beenidentified for alcohol use also operate in regard todrug use.

Physiological Factors

Studies have shown that most Asians exhibit a"flushing reaction" following alcohol consumption,which apparently results from the fact that Asiansmetabolize alcohol more quickly than Whites, causingflushing, tachycardia, dysphoria, and other feelings ofdiscomfort (for recent reviews, see Chan 1986; Stoil1987/1988; Clark 1988). Some researchers believethat the flushing response and the unpleasantsubjective symptoms discourage alcohol consumptionamong Asirns, particularly at high levels (Akutsu,Sue et aL 1989*:261-262). The physiological basis ofthe flushing response has been traced to the lack of aliver enzyme (called ALDH-I) involved in themetabolism of alcohol. According to Stoil(1987/1988:135), "In effect, the absence of ALDH-Iacts as a natural equivalent to administration of thedrug disulfiram (Antabuse) by creating a physicalreaction to alcohol that is so unpleasant that itdiscourages many Asians from drinking excessively.'

The degree to which Asians are "immunized"against excessive alcohol use by flushing is not clear,however. Nagoshi, Dixon et al. (1988) concludedfrom a survey of families in Hawaii, Korea, andTaiwan that to the extent that flushing influencesalcohol consumption, the covariance is almostentirely genetic. In a study of variables that mightaccount for differences between Asian and Whitealcohol consumption, Akutso, Sue et al. (1989*)found that while both attitudes toward drinking andphysiological reactivity were significant predictors ofethnic differences in drinking, physiological reactivitywas more important than attitudes. By contrast, intheir survey of alcohol use among different ethnicgroups in Hawaii, Johnson and his colleagues(Johnson, Nagoshi et al. 1987*) found strong,although indirect, evidence that cultural norms had astronger influence on drinking behavior than didgenetic differences in alcohol metabolism.

The importance of flushing should not beexaggerated. Not all Asians experience flushing, andthe prevalence of flushing differs from one Asiangroup to another. Other groups that also flush, such

8

as Native Americans, still have high rates of drinkingand alcohol problems (Sue 1987:61-62).Furthermore, there are two types of flushing: "fastflushing," which occurs after one drink or less, and"slow flushing," which occurs after two or moredrinks. Fast flashers tend to report less alcohol usethan slow flusher& although fast flushing is lesscommon than slow flushing (Johnson 1989:388).Finally, not all Asians who flush stop drinking onceflushing occurs (Sue, Zane. and Ito 1979*; Chu,Fertig et al. 1978).

According to Chan (1986:94), *Therefore,flushing does not automatically 'immunize' anindividual against alcohol use....Presumably, theprevalence of the highly visible flushing responsewill deter Mongoloid groups from drinkingexcessively as long as their social structure is intactand there are social sanctions against intoxication."Similarly, Johnson (1989188) concluded from studiesof flushing in Hawaii, Japan, Taiwan, and Korea that"flushing is associated with reduced consumption onlyfor fast flushers in relatively intact cultures with ahigh normative rate of alcohol consumption."

The evidence from research to date would seem toindicate that within- and between-group differences inAsians and Asian Americans in flashing response areso large as to cast doubt on the physiological modelas the main explanation of Asian drinking behavior,since the model would predict similar rates ofdrinking regardless of generational status or culturalvalues (Sue 1987).

An additional physiological factor that mayinfluence drinking among Asians/Pacific Islanders wasfound in a survey of drinking in Hawaii Amongabstainers and former drinkers, those of Asian/PacificIslander ancestry (Chinese, Japanese, Filipino,Hawaiian/Part Hawaiian, and Hapa-Haole) weresignificantly more likely than Whites to state thatthey did not drink or had stopped drinking becausethey disliked the taste of alcohol (Johnson,Schwiums et al. 1985.).

Sociocultural Factors.

Since genetic or physiological factors areapparently not sufficient alone to account for ethnicdifferences in drinking behavior, many researchershave sought an explanation in the values. customs,and undid -s of the various Asian groups. Severalwriters have noted that Americans valueassertiveness, individual achievement, individualism,and spontaneity, while the Chinese and Japanese valueresponsibility to others, interdependence, restraint,moderation, and group achievement. Alcohol use isthus presumed to be more congruent with Americanthan with Chinese or Japanese cultural traditions (Sue1987:62).

In accordance with Asian cultural values, Asiandrinking is social rather than solitary, occurs inprescribed situations, is usually accompanied by food,is used to enhance social interaction, and occurswithin a context of moderate drinking norms.

0

Women are expected to drink little or no alcohol. InChinese and Japanese cultures, aggressive, disorderly,and noisy behavior when intoxicated are particularlycondemned. Thus, even when they do becomeintoxicated, Chinese and Japanese drinkers are seldomarrested for public drunkenness or other disorderlybehaviors in public. Although cultural traditionstend to keep drinking levels low. as noted above, theymay also hide problems that do exist (Chu 1972;Kitano, Hatanaka at al. 1985; Chi, FertiS at aL 1978;Singer 1972; Wang 1968; Chi. Lubben. and Kitano1989*:15-16; Sue 1987:63).

Drinking in Asian society is thus governed bysocial norms that indicate what behavior is prescribed("drink this way") and what behavior is proscribed("don't drink this way"). Furthermore, drinkingoccasions appear to be an integral part of social life.As Frankel and Whitehead (1981:17) note, "clear andconsistent proscriptive and prescriptive norms,tort/ter with drinking practices that are wellintegrated into the cultural life of the group, areassociated with low rates of damage."

Writing of the Chinese, Kua (1987:224-225) hasobserved:

Drinking is permitted in the Chinesefamily but drunkenness is frowned upon andis considered an embarrassment to theindividual and his family. Adults areencouraged to drink, especially duringfestivals or banquets but excessiveconsumption or disorderly behaviorconlavene the social mores which have beeninfluenced since ancient time by the teachingsof Confucianism and Taoism. Both of thesephilosophies emphasize moderation, order andharmony in the society, and invariablyinfluence Chinese attitude towards alcoholconsumption.

While alcohol is an essential part of Chinesereligious ceremonies and festive occasions, excessiveuse is condemned as one of the four vices that menshould seek to avoid (the others being womanizing,gambling, and opiate use) (Yu and Liu 1987:14).Wang (1968) believed that the importance ofintellectual control within Chinese culture madealcohol an unlikely drug of choice.

Descriptions of cultural background and drinkingstyles in other Asian groups would differ in detail,but it is clear that the drinking attitudes and customsof the various Asian cultures are similar in theirencouragement of moderation.

If cultural values account for the differences inthe drinking behavior of Asians and Whites, then onewould expect that Asian Americans would hold morenegative attitudes toward drinking that Whites andthat they would perceive their parents as also holdingnegative attitudes. This hypothesis was supported bySue, Zane, and Ito (1979*) in their study ofUniversity of Washington students; they found thatthe Asian students had, and reported their parents as

Substance Abase Among Asian American Youth

having, more negative attitudes toward drinking thanWhites and that the differences in attitudes weresignificantly related to reported drinking levels.

Further support for a sociocultural theory ofethnic drinking differences is a survey by Danko,Johnson at aL (1588*) of Hawaiian college students'judgments of what they perceived as "normal"drinking behavior in relation to their actual alcoholuse. They found that ethnic groups differed in whatthey regarded as "normal" alcohol consumption andthat these beliefs ware closely associated withdrinking levels. The higher the level of drinking thatstudents considered normal, the higher their level ofconsumption. An interesting finding was that,whether grouped by gender, ethnicity, or drinkingSWIM (abstainer, former drinker, current drinker),the respondents believed that other people were moreliberal than themselves in what they regarded asnormal drinking.

Acculturation.

As has been found for Native Americans andLatinos, the level of alcohol use among AsianAmericans is influenced by the degree of acculturation(Austin 1989; Austin and Gilbert 1989). Accordingto acculturation theory, those Asians who are recentImmigrants should drink in a manner similar todrinking in their home country; as Asians becomemore assimilated into American culture, their alcoholconsumption should become more like that of Whites

Lubben, and Kitano 19890:15). A variation ofthis view is that alcohol becomes one means by whichAsian immigrants cope with the stress thataccompanies changes in social norms, familyrelationships, and upward mobility (Yu and Liu1987:60). The evidence for the influence ofacculturation on Asian drinking is mixed, however.

Several studies have found generational effects.In their survey of college students, Sue, Zane, and Ito(1979*) found some support for the hypothesis thatmore highly assimilated Asian students drank morethan did less assimilated students. Similar restiltswere reported by Kitano, Hatanaka at al. (1985) forJapanese-American adults. Yuen and Johnson (1986,cited in Danko, Johnson et al. 1988*:760) found thatdaughters of Chinese and Japanese ancestry in Hawaiidrank significantly more than their mothers did.

Several studies have cast doubt on theacculturation theory. A recent survey of collegestudents concluded that acculturation was not asignificant predictor of increased drinking amongAsians (Akutsu, Sue at al. 1989*). In the survey ofnlipinos in Los Angeles, women retained Asiandrinking patterns while men drank in ways that weremore similar to western patterns, which wouldsuggest that other factors besides acculturation wereoperating (Lubben, Chi, and Kitano 1988*1. Kitano,Chi at al. (1988*) analyzed drinking behavior in foursamples of Japanese residing in Japan, Oahu, SantaClara County, and Los Angeles to test the hypothesisthat drinking patterns of Japanese Americans would

9

11

Promotion Research Update 5

be less like those in Japan and more lice those ofWhites as one moved successively from Oahu, to LosAngeles, to Santa Clara. The findings indicated that,contrary to the hypothesis. there was no clearprogression in alcohol consumption by location. Forinstance, the acculturation theory would predict thatin Santa Clara County, where the Japanese communityis small, scattered, and relatively well integratedinto the dominant culture, Japanese drinking patternswould be similar to those of Whites. In fact,compared with Whites in Santa Clara, there was muchmore abstinence and infrequent drinking and much lessmoderate and heavy drinking among Japanese. Theauthors concluded that the influence of the dominantculture on ethnic drinking patterns was mediated bylocal conditions--"community and family cohesion,reception by the dominant community, length of stay,and life experiences' (p. 130).

Reasons for Use

Several studies have asked respondents why theyuse (or do not use) alcohol or other drugs. Amongthe Job Corps members in San Diego, the two mostcommon responses given by Indochinese youth were toforget (59%) and friends drink (55%) (Morgan,Wingard, and Felice 1984). Yee and Thu (1987)found that 40% of the Indochinese refugees (nearlyall Vietnamese) interviewed in Houston sometimesused alcohol to deal with their problems; 6% saidthey often did so. Percentages for the use of otherdrugs to diminish sorrows or problems were 12%(sometimes) and 0.5% (often). Those who reporteduse of alcohol and other drugs as a coping mechanismwere more likely to report having problems withdrugs. An issue related to reasons for use is thepositive experiences that people associate with druguse. In the survey of Chinese-American youth in SanFrancisco, the top four positive associations withdrug use were feeling relaxed, feeling happy andcarefree, feeling less anxious and tense, and experiencemusic as more enjoyable; all of these fell between50% and 60%. The next step down were thosepositive associations mentioned by between 30% and40% of the sample: find it easier to rap withgirls/boys. experience relief of pain, have moreenergy, able to escape, increased self-confidence, andfeel closer to other people (Wong n.d.*). As theauthor comments. 'for Chinese American youth whohave to cope with not only the normal problems andconcerns of growth but also the added pressures offamily, parents and the larger communities as a resultof [their] bicultural and bilingual statuses, positiveassociations [from drugs] to lessen pressures, anxietyand tensions and to promote relationships, self-confidence and energy are viewed as attractive andhelpful to the user" (pp. 12-13).

Risk Factors

Asian youth experience many personal and socialproblems by virtue of their ethnic and generational

10

status that may !cad to substance use. UCLAresearchers have investigated ethnic differences in riskfactors for substance in two student populations. Arisk factor index was constructed from 12 separatefactors that had been found to be antecedent to druguse initiation or increased drug involvement (e.g.,early alcohol intoxication, perceived adult drug use,absenteeism, emotional distress). Among students inthe Ventura County (California) school district,Asians had the lowest risk index for substance abusegenerally and for cocaine and cannabis specificallycompared with other ethnic groups (differencesbetween groups far alcohol and hard drugs were notsignificant) (Newcomb, Maddahien et aL 1987:431).

In a similar surrey of students in Los Angeles,Asians bad the second lowest overall risk factor scar(after Blacks). For Asian students, the main high-risk factors were low religiosity, poor self-esteem,poor relationships with family, and sensation seeking.As the number of risk factors among Asian increased,there was a corresponding likelihood of heavy use ofcannabis and hard drugs, as also occurred among theother ethnic groups (Maddnhian, Newcomb, andBender 1988).

Other specific risk factors have been discussed byCheryl Scikya (1989), Prevention Director at theAsian American Drug Abuse Program in Los Angell./

Fear of Failure. Because of the modelminority" stereotype and the high expectationsfor achievement, Asian-American youth are undergreat pressure to succeed, which they may try torelieve through alcohol or drug use.

Lack of Social Skills. Particularly forrecently arrived Asian/Pacific Islander youth,who have limited language skills and who arelack social skills needed in American culture,drug use may be a way to find acceptance anddevelop friendships.

Identity Conflicts. Asian/Pacific Islanderyouth face not only the problems of adolescence,but also those of coming to terms with thedemands of the dominant culture to be more"American" and those of parents to be more"Asian" and those related to physical appearance--all of which may be alleviated (or avoided)through drug use.

Acculturation. Although we have seen thatthe effects of acculturation are complex, it istrue that young people generally learn and adoptthe values, behaviors, and attitudes of thedominant culture faster than their parents,leading to conflicts between parent and child.

Role Reversal. In families where theparents are non-English speaking, children whodo speak English may be force to accept adultresponsibilities to help the family function oreven survive. Youth may turn to alcohol anddrug use not only way to relieve the stressassociated with added, unfamiliar responsibilities,but also to take on the behaviors of their adultrole.

1 )

Family Life. For recently arrived families,parents may be too overwhelmed with theproblems of survival and adjustment to provideadequate emotional support, attention, anddiscipline to their children.

Avoidance and Denial. Parents either maynot be adequately informed about substanceproblems and 0, early warning signs or maydeny that the pwl, ion exists.

These psychological and emotional problemscan place Asian youth at risk for substance abuse. Butit is also important to realize that the problems thatyoung people face differ depending on whether theperson is a new arrival or is from the second or thirdgeneration. In the former case, the person is facingthe difficulties of learning a new language, adjustingto a new life, and possibly just surviving. For thoseof the second or third generation, the problem is notusazily language or survival, but attempting to cometo terms with the conflict between their own cultureand the dominant American culture, often includingracial prejudice and discrimination. In either case, theresult is stress and emotional problems. As Chang(1981:4) notes, 'Asian Americans often findthemselves alienated from the mainstream ofAmerican society. They experience identity crises andtend to have feelings of loneliness. helplessness andpowerlessness....Psychological isolation andalienation, in turn, lead to the development of lowself-esteem."

Summary

The evidence regarding the relative influence ofsociocultural factors and physiological factors inkeeping alcohol use low among Asians isinconclusive, although it seems reasonable to assumethat both operate and interact in ways not yet fullyunderstood. Most investigators have focused eitheron physiological factors or sociocultural values, butthe evidence suggests that both should be consideredin explaining Asian drinking patterns. Sue andNakamura (1984) have proposed what they call areciprocity model in which alcohol consumption, thephysiological dimension, and the social/psychologicaldimension interact with one another. Within thesocial/psychological dimension, a person's drinkingbehavior is presumed to be influenced by the cultureof the person's parents and by the mainstreamAmerican culture. They also suggest that researchersattempting to disentangle the various influences ondrinking among AsianAmerican groups wouldbenefit by considering the successive generations ofthree groups: Asian Americans, recently arrivedAsian Americans, and Caucasian Americans.

To the extent that the heightened physiologicalsensitivity of Asians to alcohol protects them againsthigh levels of alcohol use and alcohol problems,Asian drinking levels will probably always remainbelow those of other ethnic groups. On the otherhand, some studies have shown that drinking tends to

11

Substance Abase Among Asian American Youth

be greater among Asians Americans who are moreassimilated into American culture, which indicatesthat physiological factors do not automaticallyprotect against higher levels of use. It also suggeststhat as Asian young people gradually loosen theiradherence to traditional values and behaviors andadopt mainstream values, their use of alcohol aimother drugs will increase, e.;. will their risk ofproblems.

Prevention

Substance use levels, patterns, and norms amongthe various Asian nationalities, though similar whencompared with those among Whites, are not identical;this should be taken into account in developingprevention programs for the different groups of Asianyoung people. An additional fact to consider indeveloping prevention programs is that the socialnorms for what is acceptable drinking behavior andwhat is not within Asian cultures are fairly clear andconsistent, although the specific norms may varysomewhat from one Asian group to another.Prevention programs should draw attention &I thesenorms and stress their utility in fostering moderatealcohol use,

Prevention is especially important in the Asiancommunity since research indicates that many Asian-American substance abusers are shielded by theirfamilies and may not enter treatment until the latestages of the problem. An important part of acommunity prevention program for Asian Americanswould be to provide education on alcoholism and drugabuse and to lessen the stigma that is attached toseeking professional help. Because of the importanceof the family in Asian communities, prevention andintervention programs need to involve parents asindividuals and as groups in their efforts; here, as inprevention work generally among Asian/PacificIslanders, prevention staff need to be bicultural andbilingual (Kitano, Hatanaka et al. 1985; MSAPP1988).

What we know about substance use among AsianAmericans points to the need for prevention programsto address more than just alcohol and other drug use.Substance abuse prevention programs may need to bedeveloped and implemented along with a broaderrange of programs that address the social and mentalhealth problems that face new arrivals in thiscountry. For example, recent immigrants,experiencing the stress that accompanies adjusting tothe new culture, often without adequate social andinstitutional support, may turn to alcohol and otherdrags to help them cope their problems. Providingalternative ways to deal with these problems wouldseem called for.

The studies of risk factors for substance use showthat ethnic groups differ in the constellation offactors that place them at risk for starting andcontinuing drug use. For Asian students, factors thatwere found to be of little importance relative toother groups were poor academic achievement, early

13

Prevention Restarts Update S

alcohol use, social deviance, peer drug use, and adultdrug use. Those risk factors on which Asian scoredhigh were low religiosity, poor self-esteem,depression, poor relationship with parents, andsensation seeking. Although more work needs to bedone on risk factors, this approach does suggest whichfactors should be stressed in programs designed forspecific ethnic groups and which should be left out orat least given less attention. Since peer drug use wasa :isk factors for only 11% of Asian students,teaching this group refusal skills would probablyhave little influence on preventing or reducing use.By contract, 38% of Asian students were at risk ofdrug use because of low self-esteem and 28% becauseof depression. Thus, prevention programs directed atAsians might be more effective if they were toinclude materials and activities to improve self-esteem and cope with depression and other distressingfeelings.

Two reports discuss specific principles andstrategies for developing prevention programs forAsian-American youth. Chang (1981) presentsprevention activities under four categories:

- Information: identification of resources andorganizations within the Asian community,development of indigenous self-help networks,and publication of drug-information literatureand service directories in Asian languages.

Education: programs to educate young peoplein ethnic heritage and customs in order topromote cultural identification, self-esteem, andimproved family communication; providingeducation for parents in English, American life,and drug abuse issues; and training bilingual andbicultural persons to carry out preventionservices in Asian communities.

Alternatives: recreational and sportsactivities, cultural heritage programs anddiscussion groups, community service activities.and clubs--all of which promote personalgrowth, self-esteem, cultural identity, and asense of accomplishment.

Early Intervention: family counseling andsupport, peer counseling, and communityprograms.

Other guidelines for prevention programsdesigned for Asian/Pacific Islander are provided in areport of the Ad Hoc Task Force of the MinoritySubstance Abuse Prevention Project, funded by theOffice for Substance Abuse Prevention (MSAPP1988). The task force expressed particular concernover the needs of the Amerasian children fromVietnam, who are more likely than other groups tobecome involved in drug trafficking and violentactivities. The report also noted that "Just Say No"programs have little meaning for Asian/PacificIslander youth a more effective approach would be toprovide information on the effects of substance abuseon the body. The development and implementation ofprevention programs in Asian/Pacific Islander

communities requires that key organizations andleaders be identified and involved in the programs.According to the task force report, "Every subgrouphas power brokers that need to be identified toimplement effective programs. With theirparticipation, eventual penetration and successfulimplementation of programs in the groups mayactually be osier."

Evaluations of substance abuse preventionprograms that analyze results by ethnicity are few.Project SMART (Self-Management and ResistanceTraining), developed at the University of SouthernCalifornia, provides students with social skills toresist drug offers and with affect managementtechniques to deal with decision making, valuesclarification, and stress. An evaluation of theprogram presented to seventh graders found that itwas most effective for Asian students and leasteffective for Whites (Graham, Johnson at al. inpress)

Another study evaluated the effectiveness of atobacco and alcohol prevention program taught byminimally trained instructors. The components ofthe program included peer pressure resistance training,correction of normative expectations, inoculationagainst mass media messages, information aboutparental influences and consequences of use, makingpublic commitments not to drink or smoke, and peeropinion leaders. The program had no effect on theonset of alcohol use among any ethnic group, nor didit prevent smoking among Asians or other minoritystudents, although it was moderately successfulamong White students (Hansen, Malone, andField:" 1988).

Sunzary and Conclusions

The various studies that we have reviewed showthat Asian/Pacific Islanders have high rates ofabstinence and low rates of heavy use of alcohol andalcoholism compared with other ethnic groups,although variations within the various groups ofAsian/Pacific Islanders must be recognized. InHawaii, Native Hawaiians have the highest proportionof drinkers, followed by Japanese. Elsewhere,Japanese Americans drink more than other Asiangroups. Chinese, Filipinos, and Koreans have lowlevels of use, although their relative rankings varyfrom study to study. No study has yet compareddrinking among Indochinese in America with that ofother Asian groups. Differences in drinking patternsbetween Asian males and females tend to be morepronounced than for other ethnic groups. As withalcohol, AsinneMacific Islanders have lower levels ofdrug use than Whites, especially of marijuana,cocaine, and other hard drags. The one exception isNative Hawaiians who, in a recent survey of studentuse, had overall use rates higher than all other Asiangroups and Whites. There is some evidence to indicatethat both alcohol and drug use among AsianAmericans is increasing.

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The low levels of alcohol consumption amongAsian Americans are believed to be the result ofdifferences in physiological factors and socioculturalvalues which interact in ways that are not yet clearlyunderstood. Drug use among Asians is apparently notmoderated by physiological factors, but the samesociocultural values that influence alcoholconsumption probably also influence drug use.

While Asian-American youth are at lower riskfor substance use compared with other ethnic groups,they are nonetheless at some risk, and that riskappears to be increasing. This may be a result ofadopting the values and attitudes of American cultureor of turning to alcohol and other drugs in order tocope with the stresses of learning to live in a newculture. There is also a belief among Asian-Americansubstance abuse specialists that population andschool-based surveys underestimate the extent ofproblems caused by alcohol and other drugs amongAsian-American youth.

It should also be remembered that most of whatwe know about substance use among Americans ofAsian ancestry derives from surveys of groups thathave been in the United States for a generation ormore, particularly Chinese and Japanese. Thediversity of Asian Americans in national origin,generational status, degree of acculturation, economicstatus, and other traits means that care should betaken in making statements about drug use or drugproblems of Asian Americans as a whole.Furthermore, these differences need to be recognizedwhen developing prevention programs tailored tospecific groups.

Despite the increased attention given to substanceuse and abuse among Asians/Pacific Islanders in recentyears, much remains unknown. Topics and issues thatwarrant particular attention include within-group andbetween-group differences; generational effects; theinfluence of acculturation on specific groups; the riskfactors that are most salient for Asian-Americanyouth; and the extent of substance problems in Asian-American communities.

Even though research indicates that Asian-American youth have fewer risk factors than othergroups, it is important to develop preventionprograms for this population now since the number ofrisk factors to which Asian-American youth areexposed will likely to increase with increasingacculturation and since Asian Americans have atendency to avoid treatment. From the limitedinformation available on prevention programs forAsian Americans and from the literature on otherethnic groups reviewed in earlier Updates, it isevident that prevention programs need to take intoaccount the values, customs, language, and specificdrug use patterns and problems of Asian-Americanyouth. They also need to identify existing communityresources and organizations that can be enlisted insubstance abuse prevention. Including the familyrather than just the adolescent in program activities isalso important. While such programs need to bedeveloped and implemented now, their effectiveness

Se Once Abuse Among Asian American Youth

would be improved if we knew more about the use ofalcohol and other drugs among this groupits extent,its patterns, its problems, its correlates.

The state of California has funded two projects toestimate the prevalence of alcohol and other drug usewithin the Asian-American population, and the U.S.Office of Substance Abuse Prevention has fundedseveral demonstration and prevention projects toaddress the needs of Asian communities. Theseprojects should considerably expand our knowledgeabout use and prevention among Asian-Americanyouth. Asian-American community organizationsworking on this problem include the Asian AmericanDrug Abuse Program in Los Angeles. the AsianAmerican Recovery Services in San Francisco, and theNational Asian Pacific American Families AgainstSubstance Abuse. Their addresses are provided insection 4 below?

lln the Overview, all percentage figures have beenrounded to whole numbers. The decimal valuesappear in the abstracts.2Ms Flora Yen of the Western Center for Drug FreeSchools and Communities / Northwest RegionalEducational Laboratory also provided invaluableassistance in the preparation of this issue.

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ABSTRACTS

AKUTSU, PHILLIP D.; SUE, STANLEY;ZANE, NOLAN W.S.; AND NAKAMURA,CHARLES Y. 1989. Ethnic differences In alcoholconsumption among Asians and Caucasians in theUnited States: An investigation of cultural andphysiological factors. Journal of Studies on AlcoholS0(3) :261- 267.18 refs.

The present study examined Asian and Caucasiandifferences in alcohol consumption and the interactionof consumption with sociocultural values andphysiological reactivity to akohoL The subjects were83 Asian (38 male, 45 female) and 96 Caucasian (48male, 48 female) college students in Los Angeleswho completed questionnaires on demographicinformation, general attitudes and values, level ofalcohol consumption, attitudes toward drinking, andphysiological reactivity.

Use LOWS. The results indicated that Asianshad lower levels of alcohol consumption than didCaucasians. Abstinence was reported by 20% ofAsians, but by only 3% of Caucasians. Amongdrinkers, Asians were likely to be infrequent or lightdrinkers (51%), whereas Caucasians were more likelyto be moderate or heavy drinkers (54%).

Correlates of Use. Multiple regression analysisindicated that physiological reactivity to alcohol andattitudes toward drinking were stronger determinantsof ethnic differences in alcohol consumption thanwere general cultural values. Among Asians, thedegree of acculturation was not a significant predictorof drinking, but physiological reactivity and attitudestoward drinking were significant in explainingconsumption.

Conclusions. The results provide evidence thatdifferences in the drinking behavior of Asians andCaucasians are primarily explained by physiologicalfactors, in particular the increased sensitivity ofAsians to alcohol. The study also suggests theimportance of simultaneously evaluatingphysiological reactivity and sociocultural factors inalcohol consumption rather than examining themseparately.

ANDERSON, PATRICIA S., AND DECK,DENNIS. 1987. Student Substance Use and Abusein Hawaii: Analytic Report. Portland, Ore.:Northwest Regional Educational Laboratory. 8refs.

In order to determine the extent of substance useamong children and adolescents in Hawaii, twoversions of the Hawaii Student Use Survey wereadministered to 39,341 private and public schoolstudents in grades six, eight, ten, and twelve. Sixth-grade students completed an elementary version of thesurvey containing 44 questions, and students in gradeseight, ten, and twelve completed a standard version ofthe survey containing 60 questions. One of the manyvariables measured was ethnic differences in substanceuse, particularly for twelfth graders, from groups

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Substance Abuse Among Asian American Youth

categorized as Filipino, Japanese, Hawaiian/PartHawaiian, White, Mixed, and All Other.

Alcohol. Rates of alcohol use were highestamong White and Hawaiian ethnic groups (91.4% and91.1%, respectively). Filipino (81.3%) and All Other(80.9%) reported the lowest rates of alcohol use,with Japanese (86.4%) and Mixed (86.4%) racialgroups reporting the same percentage of alcohol use.The Hawaiian/Part-Hawaiian and Mixed groups hadgreater percentages of heavy use.

Drugs. Even greater differences were reportedamong ethnic groups for drug use, with Hawaiianshaving the greatest percentage of drug use amongtwelfth-grade students. The percentage of drug usereported by students of Hawaiian, White, and Mixedethnic groups was 66.2%, 58.9%, and 58.4%,respectively. Students of All Other, Filipino, andJapanese ethnic groups reported lower percentages ofdrug use (46%, 40.8%, and 39%, respectively).

Conclusions. It appears there are ethnicdifferences in alcohol and drug use, with Hawaiianstudents reporting among the greatest percentages ofboth alcohol and drug use, while Filipino, Japanese,and All Other ethnic groups reported the lowest ratesof both alcohol and drug use.

CM, IRIS; KITANO, HARRY ILL.; ANDLUBBEN, JAMES E. 1988. Male Chinesedrinking behavior in Los Angeles. Journal ofStudies on Alcohol 49(1):21 -25.16 refs.

The study was intended to identify thecharacteristics that distinguish male Chinese drinkersfrom abstainers and light drinkers from heavydrinkers. A random sample of 218 adult Chinese menfrom Los Angeles was interviewed as to theirdrinking behavior. Their mean age was 40.8 years;nearly 90% bad been born in China, Hong Kong, orTaiwan.

Use Levels. Low levels of use were found; 22%of the sample were abstainers, and only 14% wereheavy drinkers. The largest category was lightdrinkers (36.7%).

Correlates of Use. A logistic regressionanalysis of significant characteristics indicated thatparental drinking and going to or giving panics werethe most important variables differentiatingabstainers from drinkers. Higher education was alsorelated to drinking. A second logistic regressionmodel was used to determine characteristics thatpredicted levels of drinking. Chinese men who wentto bars and who had friends who drank were the mostlikely to be heavy drinkers.

Prevention Research Update $

CHI, IRIS; LUBBEN, JAMES E.; ANDKITANO, HARRY H.L. 1989. Differences indrinking behavior among three Asian- Americangroups. Journal of Studies on Alcohol SOW:IS-23.24 refa.

It is commonly believed that there me few if anyheavy drinkers among Asian-Americans. This studywas designed to test the hypothesis that differentpatterns of alcohol consumption would be observedamong different groups of Asians. A survey ofalcohol consumption patterns compared 298 Chinese(218 males, 80 females), 295 Japanese (235 males, 60females), and 280 Koreans (155 males, 125 females)who were randomly selected from the Los Angelesarea telephone book. The survey was administered toeach participant in their home by interviewers ofChinese, Japanese, and Korean ancestry.

Use Levels. Japanese males (28.9%) had thehighest percentage of heavy drinkers, followed byKorean males (25.8%) and Chinese males (14.2%).The majority of Korean males (44.5%) wereabstainers, and Chinese males (17.9%) represented thehighest percentage of moderate drinkers. Drinkingpatterns of females by ethnic group showed that11.7% of the Japanese women were heavy drinkers.and 0.8% of the Korean women were heavy drinkers.There were no heavy drinkers among Chinese women.The highest percentage of female drinkers was foundamong the Japanese (73.3%), followed by the Chinese(48.7%). Females in the Korean group (75.2%)represented the highest percentage of abstainers.

Cerrelates of Use. Having friends who drankwas significantly predictive of heavy drinking amongboth Chinese and Japanese males, while having patentswho drank was significantly predictive of heavydrinking among Korean males. Since few Asianwomen drank heavy amounts, it was not possible toanalyze these data; however, variables that predicteddrinking behavior were analyzed. For Japanesewomen, there was a positive relationship betweenhaving a high education and drinking behavior, while apositive relationship between weekly worship andabstaining from drinking was found among Chinesewomen. Education and parents' drinking behaviorwere only marginally related to the drinking behaviorof Chinese women. Korean female drinking waspositively associated with parents' drinking behavior,and abstinence was positively associated with weeklyworship.

Conclusions. This study showed that AsianAmericans differ in their drinking behavior.However, having friends who drink was the commonpredictor of heavy drinking for Japanese, Chinese, andKorean males. Further, the data suggest that heavyalcohol consumption among Asian males, particularlyJapanese and Koreans, is as prevalent as it is amongmen in the general U.S. population.

DANKO, GEORGE P.; JOHNSON, RONALD C.;NAJOSHI, CRAIG T.; YUEN, SYLVIA H.L.;GIDLEY, JANE E.; AND AHN, MELINDA.1988. Judgments of "normal" and "problem"alcohol we as related to reported alcoholconsumption. Alcoholism; Clhdcsl endExperimental Research 12(6):760.768.23 res.

This study tested the hypothesis that alcoholconsumption within an ethnic group is directlyrelated to the group norms for drinking within thegroup. Adults (n-928) from Hawaii's five majorracial/ethnic groups provided data on their ownjudgment of what constituted normal and problemuse of alcohol, of what constituted the general socialnorm of normal and problem drinking, and of thedegree to which various alcohol-related behaviorsindicated problem use data on alcohol use were alsoobtained. The ethnic groups were Caucasian, Chinese,Japanese, Filipino, and Hawaiian/Part Hawaiian.

Um Levels. Differences among the ethnic groupsin consumption (measured in a combined quantity-frequency scare) were significant; the groups tankedas follows (from highest to lowest): Hawaiian/PartHawaiian, Filipino, Caucasian, Japanese, and Chinese.Although Filipinos had a high level of consumption,they also had a high level of abstinence (along withChinese). Also, the consumption score of Japerespondents was twice as high as that of Chinese,despite their common Asian ancestry and theirsimilarity in flushing response.

Norms. Alcohol use norms varied across sexesand ethnic groups and were predictors of consumptionboth within and across groups. Also, small butsignificant differences among ethnic groups werefound in the number of specific behaviors judged to beindicative of a drinking problem. Those groupsreporting the highest levels of consumption(Hawaiian/Part Hawaiian and Caucasians) listed morebehaviors as being problematic, particularlypathological as opposed to celebratory behaviors.Within all ethnic groups, subjects believed that otherpeople were more liberal than themselves with regardto what level of drinking constituted both normaland problem use.

Conclusions. The results from this studyindicate the drinking norms vary across ethnic groupsand are directly related to alcohol consumption. Thehigher the level of drinking considered normal. thehigher the level of consumption. One element of analcohol prevention program might be to provideinformation of what other people regard as normaldrinking behavior, especially since people tend tobelieve that others are more accepting of alcohol usethen they are.

JOHNSON, RONALD C.; NAGOSHI, CRAIG T.;AHERN, FRANK M,; WILSON, JAMES R.;AND YUEN, SYLVIA H.L. 19g7. Cultural factorsas explanations for ethnic group differences inalcohol use in Hawaii. Journal of PsychoactiveDrags 19(1):67 - 75.23 refs.

As a group, Asians have been found to manifest amore rapid ethanol metabolism but a less rapidacetaldehyde metabolism than Caucasians. Theconsequent aversive effects of alcohol (includingfacial flushing, increases in heart rate, and nausea) forAsians has been thought to be a factor in reducingalcohol consumption. Alternatively, ethnic groupdifferences in alcohol use in Hawaii may be due todifferences in cultural norms as to what constitutesnormal and problem drinking. A survey questionnairewas distributed to 3,714 adult residents of the islandof Oahu, including people of Chinese, Japanese,Filipino, Caucasian, Ilawaiia. n/Part-Hawaiian, andHapa -Haole ancestry. au latter term refers to aperson with one Caucasian and one Asian parent.)Questionnaire items examined demographiccharacteristics, quantity and frequeacy of alcohol use,familial alcohol use, personal attitudes towardalcohol, reasons for drinking or not drinking,physiological symptoms following alcohol use, socialproblems with alcohol, and some personalitymeasures.

Cultural Influences. Subjects of mixedCaucasian - Japanese ancestry drank at levels that weresimilar to those of nonmixed Caucasian ancestry andthat were ccnsiderably higher than those of nonmixedJapanese ancestry. The incidence of facial flushing inthe Caucasian-Japanese group was comparable to thatfound in the :swathed Japanese group and was higherthan that found in the =mixed Caucasian group,which supports previous research indicating thatflushing has little influence on alcohol use amongethnic groups in Hawaii. Chinese, Filipinos, andJapanese subjects who were born in Hawaii were morelikely to drink than those born in their ancestralhomelands. Among Caucasians, those born in Hawaiihad a lower prevalence of drinking than those born inthe mainland U.S. The prevalence of alcohol useamong Hapa-Haoles was similar to that reported byCaucasians: also, Ilspa-Haoles who were born inHawaii tended to have a lower level of alcohol usethan those who were born in the mainland U.S.

Conclusions. The results provide strong,although indirect, support for the idea that culturalnorms are important determinants of the level ofalcohol use and probably of the risk for alcoholism.They argue against genetic differences between ethnicgroups in alcohol metabolism as a reason for ethnicgroup differences in levels of alcohol use andalcoholism. The results also suggest that in amultiethnic society in which there is frequentinteraction and intermarriage the different groupsinfluence each other in their attitudes toward alcoholuse.

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Substance Abuse Among &km Americo' Youth

JOHNSON, RONALD C.; SCHWITTERS,SYLVIA ILL.; WILSON, JAMES R.;NAGOSHI, CRAIG T.; AND MCCLEARN,GERALD F. 1985. A cry -dictate comparison ofreasons given for using alcohol, not using alcohol,or ceasing to use alcohol. !want of Studlss onAlcohol 46M:233-21M 14 Feb.

This study sought to determine whetherdifferences between ethnic groups in alcoholconsumption could be accounted for by differences inreasons given for drinking, never drinking, or ceasingto drink. Questionnaires were completed by 3,712adult residents of Hawaii, representing six ethnicgroups: Chinese, Japanese, Filipino, Caucasian,Hawaiian or part-Hawaiian, and Hapa-Haole (mixedOriental and Caucasian ancestry).

Reasons for Drinking. Across all ethnic groups,subjects endorsed celebratory reasons for drinking(e.g., for fun, in a good mood, to be sociable) muchmore often than pathological reasons (e.g., whentense, when sad, wish were different person).Significant differences were found among the ethnicgroups in the mean number of reasons given fordrinking, with those groups that reported higheralcohol consumption (e.g.,Caucasians) giving morereasons for drinking than those reporting lowerconsumption (e.g., Chinese). The main exception wasFilipinos, who had a relatively large number ofabstainers or former drinkers; but those who diddrink were more likely to check pathological reasonsthan the other groups. Across all ethnic groups, thehigher the level of use, the more often was eachreason for drinking endorsed and the more reasonswere checked. Subjects who checked morepathological than celebratory reasons for drinkingwere also likely to indicate that they had problemswith drinking.

Rerisons for Not Drinking. Reasons for notdrinking by abstainers and former drinking alsodiffered across ethnic groups. Caucasians andHawaiians endorsed religion as a reason for notdrinking more often than did the other groups.Disliking the taste of alcohol was endorsed less oftenby Caucasians than by the other groups.

Conclusions. The findings seem to indicate thatdifferences between ethnic groups in drinking levelsare more likely the result of different norms forwhat is acceptable drinking behavior rather than ofgenetic or environmental differences. One area thatdeserves further study is the possibility thatdifferences in taste sensitivity may influences alcoholuse.

Prevention Research Update 5

KITANO, HARRY H.L.; CHI, IRIS; LAW,C.K.; LUBBEN, JAMES; AND RHEE,1988. Alcohol consumption of Japanese in Japan,Hawaii, and California. In: Towle, L.11., andHarford, T.C., eras. Caftans: Influences andDrinking Patterns: A Focus on Hispanic andJapanese Populations. Washington, D.C.: GPO. pp.99-133. 20 rets.

This paper reported on alcohol consumptionpatterns among Japanese living in Oahu, Hawaii; SantaClara County and Los Angeles, California; and fourcities in Japan. A comparison sample of Caucasianfrom Santa Clara was also included. The hypothesiswas that the drinking patterns of Japanese-Americansliving in Hawaii would be closer to those living inJapan than to those living in California. Also,because the Japanese population in Santa Clara wassmaller and more Integrated than that in Los Angeles,it was expected that the drinking patterns of theJapanese in Santa Clara would more closely resemblethose of the mainstream culture than elsewhere. TheSanta Clara sample consisted of 516 JapaneseAmericans and 526 Cate any; in Oahu, 415 Japanesewere interviewed; in Los Angeles, 295; and in Japan,1,225.

Use Levels. There were statistically significantdifferences in drinking levels between locations forboth males and females. Among males, the rankorder for abstainers was Hawaii (20.8%), Santa Clara(18.5%), Los Angeles (13.5%), Caucasians (12.7%),and Japan (9.4%). The highest level of heavy drinkingwas reported by Japanese-Americans living in LosAngeles (35.8%), followed by Japan (32.4%), Hawaii(29.0%), Caucasians (26.4%), and Santa Clara(12.9%). Among females, abstinence was mostcommon in Japan (45.1%) and lowest amongCaucasians (16.9%), with Hawaii (33.7%), LosAngeles (26.7%), and Santa Clara (26.2%) falling inbetween. The rank order for heavy drinking amongfemales was Los Angeles (13.3%), Caucasians(11.4%), Hawaii (9.1%), Santa Clara (4.2%), andJapan (3.8%).

Characteristics of Drinkers. Significantdifferences were found for various socioeconomiccharacteristics at one or more of the locations.Generally, there were higher proportions of drinkersamong younger age groups, among those with moreeducation, among those with higher income, amongthose with lower church attendance, and among thosefrom families in which both parents drank. Amongthe three Japanese-American groups,drinking differedsignificantly by generation (uteri for Japanesewomen in Los Angeles). Among males, the highestproportion of drinkers was found among the Sansei(third generation) in Hawaii and Santa Clara andamong the Nisei (second generation) in Los Angeles.Among females, drinking was highest among theSansei and lowest among the Nisei.

Further analysis of the results using logisticregression models to evaluate the significantcharacteristizs differentiating drinkers from abstainers

and heavy drinking males from non-heavy drinkingmales found no clear pattern among the sites.

Conclusions. It would appear that drinkingstyles in Japan exert little influence on JapaneseAmericans in different locations in the United States.Drinking patterns in a specific location seem to bemore influenced by the experiences of JapaneseAmericans in their respective areas of residence. Theassimilationist model from which the mainhypothesis of this study was drawn makes twoassumptions that may not be wansnted: (1) Drinkingpatterns remain constant in Japan and change onlyafter emigration to the United States: (2) drinkingpatterns throughout Japan are homogeneous. Theresults of this study emphasize the danger ofgeneralizing from the drinking patterns of JapaneseAmericans in a single location to Japanese Americansas a whole and the importance of taking location andlocal conditions into account in studying JapaneseAmerican drinking patterns.

KITANO, HARRY Hi.; LUBBEN, JAMES E.;AND CHI, IRIS. 1988. Predicting JapaneseAmerican drinking behavior. International Journalof the Addictions 23(4):417.428.7 refs.

The purposes of this study was to assess drinkingpatterns among Japanese Americans in Los Angelesfrom interviews with a random sample of heads ofhouseholds with Japanese surnames (tur295). Thespecific aims of the study were to determine thecharacteristics that differentiate drinkers fromabstainers and heavy drinkers from light drinkers, andto develop models that would predict Japanese-American drinking behavior.

Um Levels. Japanese Americans born in theUnited States had lower drinking levels than thoseborn in Japan. Significant gender differences werefound in Japanese-American drinking behavior:abstinence was reported by 16.6% of males and 26.7%of females, whereas heavy drinking was over twice ashigh among males (28.9%) as among females (11.7%).Those respondents who did drink tended to be eitherlight drinkers or heavy drinkers, rather than moderatedrinker&

Correlates of Use. Demographic and socialdeterminants of drinking were examined throughlogistic regression. The most important variablesdifferentiating abstainers front thinkers were going tobars or nightclubs and attending religious services.Japanese Americans who had more education, bad beenborn in Japan, had a mother who drank, and had closefriends who drank were more likely to be drinkersthan abstainers. Respondents were more likely to beheavy drinkers if they reported that they frequentlydrank alcohol with neighbors or with close friends.Othet, less significant, variables associated withhear 'kinking were age, going to bars or nightclubs,and income.

Problem. None of the respondents reported thatalcohol was a problem for them, but there was

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occasional mention of friends or relatives withalcohol-related problems.

LE MARCHAND, LOIC.; KOLONEL,LAURENCE N.; AND YOSHIZAWA, CARL N.1989. Alcohol consumption patterns among fivemajor ethnic groups in Hawaii: Correlations withincidence of esophageal and oropharyngealcancer. In: National Institute on Alcohol Abuseand Alcoholism. Alcohol Use among U.S. EthnicMinorities. Rodiville, Md.: National Institute onAlcohol Abase and Alcohoikan. pp. 355-37L 24refs.

Ethnic differences in drinking habits wereexamined among the five major ethnic groups inHawaii (Caucasians, Japanese, Chinese. Filipinos, andNative Hawaiians) using interview data collectedbetween 1975 and 1980 from a representative smeltof approximately 50,000 Hawaiian residents.

Use Levels. Native Hawaiians had the highestconsumption of beer, and Caucasians had the highestconsumption of wine and spirits. Overall, totalalcohol consumption was similar for these two ethnicgroups and was considerably higher than consumptionamong the three Asian groups. This pattern wasobserved when either daily or lifetime use of alcoholwas compared and was rather consistent betweensexes and age groups. Although alcohol use was notunusually high among Native Hawaiians, NativeHawaiians who drank tended to COMM mom alcoholthan drinkers in the other groups. Weekly drinkingpatterns were very similar among races and did notsuggest that binge or regular drinking was morelikely among any particular group.

LUBBEN, JAMES L; CHI, IRIS; ANDKITANO, HARRY H.L. 1988. Exploring FilipinoAmerican drinking behavior. Journal of Studies onAlcohol 49(1) :26 -29.12 refit.

The purpose of this study, the first to studyFilipino-American drinking, was to explorecharacteristics that distinguished levels of drinkingamong Filipino Americans through interviews with asample of 298 adult Filipinos in Los Angeles. Twologistic regression analyses were conducted, one toidentify social factors that distinguished femaledrinkers from female abstainers, the other todetermine factors that differentiated heavy drinkersfrom light drinkers among males.

Use Levels. Over half (55%) of females and 19%of males were abstainers, whereas heavy drinking wasreported by 3.5% of females and 29% of males.Heavy drinking was thus almost exclusively a maleactivity.

Correlates of Use. The only significant variablecommon to both logistic regression models wasregular participation in religious service (frequentattendance was associated with lower consumption).The other significant variable for females waseducation (those with higher education were more

Substwtce Abate Among Asian American Youth

likely to drink). For males, additional significantvariables were income (low income men drank more)and having friends who drank.

Conclusions. It was concluded that drinkingbehavior among Filipino females conformed to thetraditional Asian drinking pattern, whereas Filipinomen were more similar in their drinking to Americanpatterns.

LUBBEN, JAMES E.; CHI, IRIS; ANDKITANO, HARRY H.L. 1989. The relativeinfluence of selected social factors on Koreandrinking behavior ht Los Angeles. Advances inAlcohol & Substance Abuse 8(1):1-17. 11 refs.

A sample of Korean - American adults in LosAngeles (n-280) was interviewed in order to identifycharacteristics that distinguish Korean-Americandrinkers from abstainers and to determinecharacteristics that distinguish heavy drinkers fromlight/moderate drinkers. Logistic regression was usedto determine the relative influence of various socialfactors on drinking behavior.

Use Levels. Over half (58%) of the sample wereabstainers, and only about 15% were heavy drinkers.All but one of the heavy drinkers were men, wifile75% of the abstainers were female. Still, a highpercentage of males (45%) were abstainers.

Correlates of Use. The logistic model identifiedfive characteristics that differentiated abstainers fromdrinkers: gender (male), college education, parentalopposition, playing indoor games (e.g., cards), andgoing to bars or nightclubs. A second logistic modelwas used to determine the characteristics thatinfluenced the level of drinking. Males and thosewho went to bars or nightclubs were most apt to beheavy drinkers, while participation in sports and beingProtestant were associated with more moderatedrinking.

MCLAUGHLIN, DENNIS G.; RAYMOND,JONATHAN S.; MURAKAMI, SHARON R.;AND GOEBERT, DEBORAH. 1987. Drug useamong Asian Americans in Hawaii. Journal ofPsychoactive Drugs 19(1):85.94.17 rent.

In order to determine patterns of drug use amongAsian Americans in Hawaii, a statewide sample ofadults from 2,503 households was obtained. Theinterview schedule consisted of questions relating todemographic characteristics, alcohol and other druguse, psychiatric symptomatology, and psychologicalstress. The alcohol and drug use patterns of ChineseAmericans, Japanese Americans, and FilipinoAmericans were compared with those of NativeHawaiians and Caucasians. The drugs included inpresent report were barbiturates, tranquilizers,marijuana/hashish, inhalants, LSD, PCP.amphetamines. cocaine, methadone, heroin, pain drugs(morphine, Peremlan. Demerol), and alcohol.Psychosocial predictors of substance use werecaamined across ethnic groups.

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Prevention Research Update S

Use Levels. With one exception, lifetime use ofall drugs was higher among Caucasians and NativeHawaiians than among those of Chinese, Japanese, andFilipino ancestry; the exception was tranquilizers.where Native Hawaiians had lower use than didChinese and Japanese Americans. For all drugs,Caucasians had the highest rates of use. There weredifferences in the relative rankings of the three Asian -American groups. Filipino Americans reported thelowest overall drug use Chinese-American andJapanese-American respondents were similar to oneanother in vs* drug use.

Correlates of Use. No consistently clear patternof predictors of alcohol and other drug use amongAsian Americans was found. Different variables (age.sex, age, marital status, mental health symptoms)predicted drug use for some poops but not forothers. There was some indication that AsianAmericans were more likely to use drugs to self-medicate than were Caucasians, suggesting that theyare reluctant to seek existing psychiatric orpsychological services compared with Caucasian.

MADDAHIAN, EBRAIHM; NEWCOMB,MICHAEL; D.; AND BENTLER, PETER M.1988. Risk factors for substance sham Ethnicdifferences among adolescents. Journal ofSubstance Abuse 1(1):11-23. 30 refs.

Differences among ethnic groups in terms of riskfactors for substance use were explored, based onresults from a sample of students in 10th, 11th, and12th grades in Los Angeles (n=994) who were part ofa longitudinal survey of drug use. Five substance-usescales measuring frequency of use during the past sixmonths were included in the analysis: cigarettes.alcohol, cannabis, nonprescription medication, andhard drugs. In addition, prevalence of use of aspecific drug was defined as use at least once in thepast six months; heavy use was defined as at leastdaily use of a substance, except for hard drugs, forwhich heavy use was defined as use at least once aweek. The ten risk factors were low academicachievement, lack of religiosity, early alcohol use,low self-esteem, psychopathology (depression), poorfamily relationship, social deviance, sensation seeking,perceived peer drug use, and perceived adult drug use.

Risk Factors. Differences among the ethnicgroups (Asian, Black, Hispanic, White) were notsignificant for three risk factors: low academicachievement. psychopathology, and poor relationshipwith family. Of the other variables, Asians had thehighest level of risk for low religiosity and poorself-esteem; they had the lowest level of risk inregard to four risk factory early alcohol use, socialdeviance. peer drug use, and adult drug use. Ingeneral, ethnic differences among the mean risk factorscore were significant, with Whites having thehighest mean score, followed by Hispanics, Asians,and Blacks. Heavy use of alcohol was associated withincreasing number of risk factors only for Blackstudents. For every ethnic group, heavy use of

cannabis was associated with increasing risk factors.There was no relation between number of risk factorsand heavy use of nonprescription medications. Heavyuse of had drugs was associated with increasingnumber of risk factors for Hispsaics. Asians, andWhites, but not for Blccks. For all ethnic groups,the rick factors score was significantly related to theprevalence of alcohol, cannabis, and hard drugs; fornonprescription medications, the association wassignificant for all groups except Hispanics. Overall.30% of the White students and 31% of the Hispanicstudents had a high risk for using drugs (four or morerisk factors), compared with 25% of Asians and 10%of Blacks.

Conclusions. Prevention programs shouldconsider all the risk factors that contribute tosubsume abuse among adolescents, but they also needto consider that young people from different ethnicgroups have different sets of risk factors forsubstance use. For Asian students specifically, themain high-risk factors were low religiosity, poorself-esteem. poor relationships with family, andsensation seeking, This would indicate thatprevention programs directed to Asian adolescentsshould include elements that provide psychologicalsupport.

MURAKAMI, SHARON R. 1989. Anepidemiological survey of alcohol, drug, andmental health problems in Hawaii: A comparisonof four ethnic groups. In: National Institute onAlcohol Abuse and Alcoholism. Alcohol Use amongU.S. Ethnic Minorities. Rockville, Md.: NationalInstitute on Alcohol Abuse and Alcoholism. pp.343- 353.14 refs.

The Hawaiian Department of Health, MentalHealth Division conducted a statewideepidemiological survey in 1984. using a two-stagecluster sampling procedure within each of the eightmental health catchment areas in Hawaii. A samplecomprising 2,503 individuals aged 18 and older wasobtained, yielding a significant proportion ofCaucasians (28.5%), Japanese (21.6%), Filipinos(11.4%), and Native Hawaiians (18.9%). A interviewquestionnaire elicited information on individualalcohol consumption, problems related to drinking,drug use, psychiatric symptomatology, and othercorrelates of alcohol use. This paper examined therate of alcohol use and abuse, the extent of alcoholconsumption, and correlates of alcohol consumptionamong four ethnic groups in Hawaii.

Use Levels. The percentage of Native Hawaiiandrinkers, although lower than that for Caucasians,exceeded the percentage of Japanese and Filipinodrinkers. Moreover, Native Hawaiians consumed lessalcohol than Caucasians but more than other ethnicgroups such as the Japanese and Filipinos.

Problems. A similar pattern was also foundwith problems related to alcohol consumption.Barriers to seeking professional help were reported byeach ethnic group. Higher percentages of Native

20

21

Hawaiians, Japanese, and Filipinos reportedthan did Caucasians.

SCHWITTERS, SYLVIA Y.; JOHN:,ON,RONALD C.; WILSON, JAMES R.; t 'IDMCCLEARN, GERALD E. 1982. Ethnicity andalcohol. Hawaii Medical Journal 41(2):6C 43. 14refs.

In order to examine ethnic differences in alcoholuse and the effects of alcohol, questionnaires wereadministered to 3,714 adults (age 20 years and over)on the Island of Oahu. The subjects were from sixethnic groups on Hawaii: Caucasian. Chinese,Filipino, Hapa Huge. Hawaiian/Part-Hawaiian, andJapanese. Approximately equal numbers in eachethnic group were sampled.

Use Levels. Considerable differences were foundin drinking behavior among the six groups. Thepercentage of abstainers in each groups was as follows(from low to high): Caucasian 4.3%; Haps Hao le7.0%; Hawaiian/Part-Hawaiian 11.1%; Japanese16.7%; Chinese 17.1%; and Filipino 31.1%. The rankorder of drinkers (from high to low) was similar tothat for abstinence, except that the order of theChinese and the Japanese are switched: Caucasian81.3%; Hapa Hao le 80.1%; Hawaiian/Part-Hawaiian69.5%; Chinese 69.2%; Japanese 67A%; and Filipino492%. The range in the percentage of formerdrinkers was much narrower than for abstainers ordrinkers: Haps Hao le 12.9%; Chinese 13.1%;Caucasian 14.2%; Japanese 15.8%; Hawaiian/Part-Hawaiian 19.4%; and Filipino 19.7%. Analysis ofdrinking scores (quantity-frequency) of formerdrinkers found that Caucasians were much heavierdrinkers than the other groups before they quit.

Problems. For all groups. the number ofsymptoms and problems associated with drinkingincreased with increasing alcohol use. Furthermore,former drinkers reported that they had experiencedmore symptoms and problems Cha those whocontinued to drink. Among current drinkers,Caucasians at all levels of use had at least as many,and often more, symptoms and problems than didmembers of any of the other ethnic groups.

Conclusions. It appears that differences indrinking behavior between Caucasians and Asiansresult from differences in preference rather than fromdifferences in tolerance. Also, while considerableethnic differences in drinking behavior were evident,the differences are not as great as popular belief ortreatment admissions would suggest.

SUE, STANLEY; ZANE, NOLAN; AND ITO,JOANNE. 1979. Alcohol drinking patterns amongAsian and Caucasian Americans. Journal of Cross.Caltxral Psychology 1O(1) :41 -56.15 refs.

This study was designed to explore possibleethnic and cultural influences on alcoholconsumption. A drinking habits questionnaire wascompleted by 47 Asian American (23 Chinese, 24

21

Substance Abuse Among Asian Americo: Youth

Japanese) and 77 Caucasian students from theUniversity of Washington. Five categories ofdrinking patterns were measured, ranging fromabstinence (or infrequent use of alcohol) to veryheavy drinking. The students subsequently completedan attitude questionnaire measuring degree ofagreement or disagreement with attitudes towarddrinking and toward controlling drinking.

Use Levels. Different patterns of drinking wereobserved across ethnic groups. Asians consumedalcohol less frequently and in lesser amounts thanCaucasians, although alcohol consumption by Asiansincreased with length of time living in the UnitedStates.

Attitudes. Attitudes toward drinking alsodiffered between the ethnic groups studied. Asianstudents reported greater self and parentaldisapproval of drunkenness, but apparently this hadlittle to do with negative attitudes toward alcoholharming the body. In addition, Asian Americans wereno more likely to regulate their drinking due tophysiological indicators of drunkenness than wereCaucasian.

Concluslons. Consistent with other studies,Asian Americans reported less drinking than didCaucasians. The findings are inconsistent with thegenetic hypothesis, which assumes physiologicaldifferences between races related to alcoholconsumption. The findings seem to support thecultural hypothesis in view of the following: mostassimilation measures indicated significant correlationwith Asian patterns of drinking; and negativeattitudes toward drinking instead of physiologicalreasons were related to less drinking by AsianAmericans.

WONG, HERBERT Z. n.d. Substance use andChinese American youth: Preliminary findings onan Interview study of 123 youths and implicationsfor services and programs. San Francisco: YouthEnvironment Study.

A community-based, pilot survey was conductedof substance use and problems among Chinese-American youth in the Chinatown section of SanFrancisco. The sample of 123 youths (ages 13 to 19years) was selected for interview by a chain referralmethod rather than randomly. The interview schedulehad been used in previous surveys of substance useamong Black, Latino, and White youth in SanFrancisco, which provided the opportunity to compareresults from the present survey with the earlier ones.

Use Lewis. The percentage of ever use of varioussubstances by Chinese youth was as follows: beer77.2%; cigarettes 74.6%; marijuana 58.5%; wine54.1%; hard liquor 48.8%; quaaludes 42.3%; cocaine39.8%; hashish 22.0%; Valium 16.3%; LSD 15.4%;amyl nitrates 2.4%; opium 1.6%; morphine 1.6%;PCP 0.8%; glue 0.8%; and heroin 0.0%. For alldrugs except Valium, Codeine, and quaaludes, maleswere more likely to use drugs than females. Use ofquaaludes was particularly high among Chinese-

Prevention lbsearck Update 5

American youths (42,3%) compared with Latinos(20.6%), Whites (19.0%). and Blacks (9.4%). ButChinese youth reported lower levels of use for PCP,Pia amphetamines, Valium, and heroin. For olderusers (ages 16 to 19 years), reported levels of ever useof most drugs was higher than those found in nationalsurvey studies or in the earlier surveys in SanFrancisco.

The most frequently used substances werecigarettes, marijuana, beer, baud liquor, and quaaludes.Substances that ranked in moderate to low frequencywere hashish, cocain, LSD, barbiturates, Valium, andCodeine. The least frequently used substances weremescaline, mushrooms, pill amphetamines,methedtine, and amyl nitrate.

Positive Experiences. The sample reported avariety of positive experiences to be associated withsubstance use the five most common responses were:feel relaxed (56.9%); feel happy and carefree (56.9%);feel less anxious and tense (54.5%); find music moreenjoyable (52.0%); and find it easier to rap withgirls/boys (37.4%).

Problems. Negative physiological andpsychological problems associated with substance useincluded: being sick because of alcohol (48.0%); had asmoker's cough (41.5%); had a hangover from alcohol(39.8%); had shortness of breath from smoking(38.2%); and suffered memory loss from alcohol ordrugs (24.4%).

Education and Treatment. Only 5.7% of thosewho used alcohol or drugs had sought out help, andonly 1.6% had received treatment in an alcohol ordrug program. Nearly tluee-quarters of the Chinese-American youth had some type of drug education and40.3% said that information they had received aboutdrugs made them less interested in trying them. Over80% believed that the drug education they hadreceived was of value.

Conclusions. Although the nonrandom nature ofthe sample should be kept in mind, the findings ofthis study suggest that substance use and abuse amongChinese-American youth is higher than previouslybelieved, with females exceeding males in the use ofsome drugs. It is recommended that Chinese andother Asian Americans be involved in planning andprogram development; that culturally sensitiveprevention and intervention programs be developed;that methods be found to overcome the reluctance toenter treatment; that prevention programs beconcerned with the substances actually used byChinese-American youth and with the cultural aspectsof substance use; and, finally, that further researchusing systematic and random sampling be carried out.

YEE, BARBARA W.K., AND THU, NGUYENDINH. 1987. Correlates of drug use and abuseamong Indochinese refugees: Mental healthimplication. Journal of Psychoar,rs Drags19(1):77 -83,15 refs.

Indochinese refugees (mainly Vietnamese) facemany problems of adjusting to life in the United

22

States, for which social and institutional support isoften not available. As a result, refugees may turn toalcohol or drugs to attempt to deal with or to forgettheir problems. The particular substance used isprobably affected by age, length of time in the UnitedStates, and degree of assimilation. Alcohol may beused mainly by older refugees, while younger refugeesmay be more likely to use drugs. In order to provideinformation on mental health and substance abuseamong Indochinese refugees, 840 refugees in Houston(90% Vietnamese) were interviewed. Nearly 60% hadarrived in the United States from 1975 to 1979.

Problems. Nearly half (45%) of the samplereported that they some time had trouble withalcohol or tobacco, while 7.9% had trouble withthese drugs all the time. Other drugs weresometimes a problem for 13.9% of the sample.

Correlates of Use. Drugs were fairly often usedas a coping mechanism; 40.4% or the refugees usedalcohol, 11.9% used other drugs, and 44.2% usedtobacco sometimes to help diminish the problems.Frequent use of these drugs to diminish problems wasreported by 5.8% for alcohol. 0.5% for other drugs,and 11.7% for tobacco. The use of drugs as a copingmechanism was significantly related to reports ofhaving trouble with tobacco, alcohol, and otherdrugs.

It was also found that she greater the worries andconcerns, troubles, and depression, the more likelywere chugs used as a coping mechanism. However,higher degree of satisfaction about living in theUnited States was also positively related to the useof drugs as a coping mechanism, possibly becauseyounger and less traditional refugees were both moresatisfied with their life in the U.S. and tended to usealcohol and other drugs more often than older andmore traditional refugees.

Conclusions. Although problems associated withthe use of alcohol and other drugs among Indochineserefugees are not as great as among some other ethnicand disadvantaged groups, it is likely that theseriousness of the problem will increase in the future.Part of the reason for the use of drugs within thispopulation is the need to face numerous adjustmentand mental health problems without adequate socialand institutional support; substance use becomes away to diminish stress and forget problems.

Substance Abuse Among Asian American Youth

REFERENCES

* am Abstracted Documents

Ahern, Frank M. 1989. Alcohol use and abuse among four ethnic groups in Hawaii: Native Hawaiians. Japanese,Filipinos, and Caucasians. In: National Institute on Alcohol Abuse and Alcoholism. Alcohol Use among U.S.Ethnic Minorities. NIAAA Research Monograph 18. DHHS Publication No. (ADM)89-1435. Rockville,Md.: National Institute on Alcohol Abuse and Alcoholism. pp. 315-328.

*Akutsu, Phillip D4 Sue. Stanley; Zane, Nolan W.S.; and Nakamura, Charles Y. 1989. Ethnic differences inalcohol consumption among Asians and Caucasians in the United States: An investigation of cultural andphysiological factors. Journal of Studies on Alcohol 50(3):261-267.

Mama, Kimo, and Whitney, Scott. 1989. Ka wad ken mai o maleka: 'Water from America": 7 intoxication ofthe Hawaiian people. Contemporary Drug Problems in press.

*Anderson, Patricia S., and Deck, Dennis. 1987. Student Substance Use and Abuse in Hawaii: Analytic Report.Portland, Ore.: Northwest Regional Educational Laboratory.

Austin, Gregory. 1989. Substance Abuse anzong Minority Youth: Native Americans. Preventkm Research Update2, Winter. Portland, Ore.; Los Alamitos and San Francisco, Calif.: Western Center for Drug-Free Schoolsand Communities.

Austin, Gregory, and Gilbert, M. Jean 1989. Substance Abuse among Latino Youth. Prevention Research Update3, Spring. Portland, Ore.; Los Alamitos and San Francisco, Calif.: Western Center for Drug-Free Schoolsand Communities.

Ball, LC., and Lan, M.P. 1966. The Chinese narcotic addict in the United States. Social Forces 45(1):68-72.Barnes, Grace M., and Woke, John W. 1986. Patterns and predictors of alcohol use among 7-12th grade students

in New York State. Journal of Studies on Alcohol 47(1):53-62.Barnett, M.L. 1955. Al.xiholism in the Cantonese of New York City: An suuhropological study. In; Dietheim,

0., ed. Etiology of Chronic Alcoholism Springfield, Charles C. Thomas. pp. 179-227.Bibliography on Asian AntericansiPadfic Islanders and Substance Abuse/Mental Health Issues. 1981. Center for

Multicultural Awareness, June 1981, 7 pp.California Senate. 1989. Select Committee on Border Issues, Drug Trafficking and Contraband. Hearings on Drug

Availability and Drug Abuse in California's Asian/Pacific Islander Communities, October 27, November 17,1989.

Chan, Arthur W.K. 1986. Racial differences in alcohol sensitivity. Alcohol and Alcoholism 21(1):93-104.Chang, Sang-Hee. Drug Abuse Prevention Strategies for Asian American Youth. Center for Multicultural

Awareness, June 1981, 14 pp.Chi, Iris, 1985. Chinese drinking behaviors in Las Angeles. D.S.W. thesis, University of California, Los

Angeles.*Chi, Iris; Kitano, Harry HL.; and Lubben, James F nai. Male Chinese drinking behavior in Los Angeles.

Journal of Studies on Alcohol 49(1):21-25.*Chi, Iris; Lubben, James E.; and Kitano, Harry H.L. 1989. Differences in drinking behavior among three Asian-

American groups. Journal of Studies on Alcohol 50(1):15-23.Chu, G. 1972. Drinking patterns and attitudes of rooming-house Chinese in San Francisco. Quarterly Journal of

Studies on Alcohol Suppl 6:58-68.Chu, I.: Ferris, M.; Surnii, S.; and Yefaky, G.A. 1978. A comparative study of alcohol: Drinking practices among

Chinese and Japanese in Los Angeles. M.S.W. thesis, University of California, Los Angeles.Chung, Roy. [1975]. Patterns of Drug Abuse among the Youth of Guam (Prepared for the Task Force on Drug

Problems, Guam). Social Science Institute, University of Guam.Clark, Walter B. 1988. A comparative analysis of facial flushing among alcohol drinkers in Japan, Hawaii, and

California. In: Towle, LH., and Harford, T.C., eds. Cultural Influences and Drinking Patterns: A Focus onHispanic and Japanese Populations. NIAAA Research Monograph No. 19. DHHS Publication No.(ADM)88 -1563. Washington, D.C.: GPO. pp. 197-220.

Clark, Walter B., and Hesselbrock, Machin. 1988. A comparative analysis of U.S. and Japanese drinking = uems.In: Towle, LIL, and Harked, T.C eds. Cultural Influences and Drinking Patterns: A Focus on Hispanicand Japanese Populations. NIAAA Research Monograph No. 19. DHHS Publication No. (ADM)88-1563.Washington, D.C.: GPO. pp. 79-9&

*Danko, George P.; Johnson, Ronald C.; Nagoshi. Craig T.; Yuan, Sylvia H.L.; (fifty, Jane E.; and Aim,Melinda. 1988. Judgments of "normal' and "problem" alcohol use as related to reported alcoholconsumption. Alcoholism Clinical and Experimental Research 12(6):760-768.

Department of Health and Human Services. 1987. Sixth Special Report to the U.S. Congress on Alcohol andHealth. DIMS Publication No. (ADM)87-1519. Rockville, Md.: Department of Health and Human Services.

Frankel, B. Gail, and Whitehead, Paul C. 1981. Drinking and Damage: Theoretical Advances and Implications forPrevention. New Brunswick, N.J.: Publications Division, Rutgers Center of Alcohol Studies.

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Prevention Research Update 5

Graham, John W.; Johnson, C. Anderson; Hansen, William B.; Flay, Brian R.; and Gee, Mimi. In press. Drug useprevention programs, gender, and ethnicity: Evaluation of three seventh-grade Pmject SMART cohorts.Forthcoming in Preventive Medicine.

Hansen, W.B.; Malone, CX.; and Fielding, J.E. 1988. Evaluation of a tobacco and alcohol abuse preventioncurriculum for adolescents. Health Education Quarterly 15(1):93-114.

Hawaii. 1979. Department of Health. Hawaii State Substance Abuse Survey. Honolulu: Hawaii Department ofHealth.

Hughes, Stella Rau. 1981. Cultural and ethnic patterns of alcohol consumption in a university environment.Ph.D. thesis, Oklahoma State University.

Johnson, Ronald C. 1989. The flushing response and alcohol use. In: National Institute on Alcohol Abuse andAlcoholism. Alcohol Use among U.S. Ethnic Minorities. NIAAA Research Monograph 18. DHHSPublication No. (ADM)89-1435. Rockville, Md.: National Institute on Alcohol Abuse and Alcoholism. pp.383-396.

*Johnson, Ronald C.; Nagoshi, Craig T.; Ahern, Frank M.; Wilson, James R.; and Yuen, Sylvia H.L. 1987.Cultural factors as explanations for ethnic group differences hi alcohol use in Hawaii. Journal ofPsychoactive Drugs 19(1):67-75.

*Johnson, Ronald C.; Schwitters, Sylvia HL.; Wilson, James R.; Nagoshi, Craig T.; and McClearn, Gerald E.1985. A cross-ethnic comparison of reasons given for using alcohol, not using alcohol, or ceasing to usealcohol Journal of Studies on Alcohol 46(4):283-288.

Kaufman, Edward, and Borders, Linda. 1988. Ethnic family differences in adolescent substance use. Journal ofChemical Dependency Treatment 1(2):99-121.

Kitano, Harry H.L. 1982. Alcohol drinking patterns: The Asian Americans, In: National Institute on AlcoholAbuse and Alcoholism. Special Population Imes. Alcohol and Health Monograph No. 4. DHHSPublication No. (ADM)82-1193. Washington, D.C.: GPO. pp, 411-430.

Kitano, Harry Hi., and Chi, Iris. 1987. Asian-Americans and alcohol use Exploring cultural differences in LosAngeles. Alcohol Health & Research World 11(2):42-47.

Kitano, Harry HL., and Chi, Iris. 1989. Asian Americans and alcohol: The Chinese, Japanese, Koreans, andFilipinos in Los Angeles. In: National Institute on Alcohol Abuse and Alcoholism. Alcohol Use among U.S.Ethnic Minorities. NIAAA Research Monograph 18. DHHS Publication No. (ADM)89-1435, Rockville.Md.: National Institute on Alcohol Abuse and Alcoholism. pp. 373-382.

*Kitano, Harry HI.; Chi, Iris; Law. CIL; Lubben, James; and Rhos, Si-yun. 1988. Alcohol consumption ofJapanese in JaPan. Hawaii, and California. In: Towle, LH., and Harfixd, T.C., eds. Cultural In uences andDrinking Patterns: A Focus on Hispanic and Japanese Populations. NIAAA Research Monograph No. 19.DHHS Publication No. (ADM) -1563. Washington, D.C.: GPO. pp. 99-133.

Kitano, Harry Hatanaka, R; Yews, W.-T.; and Sue, Stanley. 1985. Japanese-American drinking patterns.In: Bennett, LA., and Ames, G.M., eds. The American Experience with Alcohol: Contrasting CulturalPerspectives. New York: Plenum Press. pp. 335-357.

' Kitano, Harry H.L.; Lubben, James E.; and Chi, Iris. 1988. Predicting Japanese American drinking behaIruernational Journal of the Addictions 23(4):417-428.

Klatsky, A.L; Siegelaub, A.B.; Landy, C.; and Friedman, G.D. 1983. Racial patterns of alcoholic beverage use.Alcoholism: Clinical and Experimental Research 7:372-377.

Kotani, R. 1982. AJA's and alcohol abuse. Hawaii Herald June 2, p. 4, and July 16, p, 7.Kua, Kua Ee. 1987. Drinking in Chinese culture: Old stereotypes re-examined [Editorial]. British Journal of

Addiction 82(3):224-225.Le Marchand, Loic; Kolonel, Laurence N.; and Yoshizawa, Carl N. 1989. Alcohol consumption patterns among

five major ethnic groups in Hawaii: Correlations with incidence of esophageal and onapharyngeal cancer. In:National Institute on Alcohol Abuse and Alcoholism. Alcohol Use among U.S. Ethnic Minorities. NIAAAResearch Monograph 18. DHHS Publication No. (ADM)89-1435. Rockville, Md.: National Institute onAlcohol Abuse and Alcoholism. pp. 355-371.

Los Angeles Times October 8, 1989. Potent form of speed could be drug of '90s. By Miles Corwin. p. 1.Los Angeles Times October 14, 1989. S. Korea seen as major source of "ice narcotic. By Karl Schoenberger. p.

Al2.*Lubben, James E.; Chi, Iris; and Kitano, Harry HI. 1988, Exploring Filipino American drinking behavior.

Journal of Studies on Alcohol 49(1):26-29.*Lubben, James E.; Chi[, Iris; and Kitano, Harry H.L. 1989. The relative influence of selected social factors on

Korean drinking behavior in 1,03 Angeles. Advances in Alcohol & Substance Abuse 8(1):1-17.*McLaughlin, Dennis G. Raymond, Jonathan S.; Mumkami, Sharon R.; and Goebert, Deborah. 1987. Drug use

among Asian Americans in Hawaii. Journal of Psychoactive Drugs 19(1):85-94.Mad Bahian, Einahim; Newcomb, Michael D.; and Bentley, Peter M. 1986. Adolescents' substance use: Impact of

ethnicity, income, and availability. Advances in Alcohol & Substance Abuse 5(3):63-78.

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Substance Abuse Among Asian American Youth

Maddahian, Ebrahim: Newcomb, Michael D.; and Bender, Peter M. 1988. Adolescent drug use and intention touse drugs: Concurrent and longitudinal analyses of four ethnic groups. Addictive Behaviors 13(2):191-195.(Abstracted in Update 2)

*Maddahian, Ebmhim; Newcomb, Michael; D.; and Bender, Peter M. 1988. Risk factors for substance abuse:Ethnic differences among adolescents. Journal of Substance Abuse 1(1):11-23.

Malone, Thomas E., chair. 1985. Report of the Secretary's Task Force en Black and Minority Health.Washington, D.C.: GPO.

MSAPP (Minority Substance Abuse rievendon Program]. 1988. Ad Hoc Task Force Recommendations for EthnicMinorities on Alcohol and Other Drug Abuse.

Morgan, Maria C; Wingard, Deborah L; and Felice, Marianne E. 1984. Subcultural differences in alcohol useamong youth. Journal of Adolescent Health Care 5:191-195.

Murakami, Sharon R. 1989. An epidemiological survey of alcohol, drug, and mental health problems in Hawaii:A comparison of four ethnic groups. In: National Imitate on Alcohol Abuse and Alcoholism. Alcohol Useantong U.S. Ethnic Minorities. NIAAA Research Monograph 18. DHHS Publication No. (ADM)89.1435.Rockville, Md.: National Institute on Alcohol Abuse and Alcoholism. pp. 343-353.

Nagoshi, Craig T.; Dixon, Linda X. Johnson, Ronald C.; and Yeun, Sylvia H.L. 1988. Familial transmission ofalcohol consumption and the flushing 11W,01151C to alcohol in three Oriental groups. Journal of Studies onAlcohol 49(3):261-267.

NIDA (National Institute on Drug Abuse). 1988. Nadonal Household Survey on Drug Abuse: Main Findings1985. MIS Publication No. (ADM)88-1565.

Newcomb, Michael D.; Maddahian, Ebrahim; Skager, Rodney; and Bender, Peter M. 1987. Substance abuse andpsychosocial risk factors among teenagers: Associations with sex, age, ethnicity, and type of school.American Journal of Alcohol and Drug Abuse 13(4):413-433. (Abstracted in Update 2)

Rachel, J.V.; Williams, J.R.; Brehm, M.L.; Cavanaugh, G. Moore, R.P.; and Echermw, W.C. 1975. A NationalSurvey of Adolescent Drinking Behavior, Attitudes and Correlates: Final Report. Springfield, Va.: NationalTechnical Information Savice.

*Schwirrors, Sylvia Y.; Johnson, Ronald C.; Wilson, James R4 and Mcaearn, Gerald E. 1982. Ethnicity andalcohol. Hawaii Medical Journal 41(2):60-63.

Schwiuers, Sylvia Y.; Johnson, Ronald C.; McClean, Gerald E.; and Wilson, James R. 1982a. Alcohol use andthe flushing response in different racial- ethnic groups. Journal of Studies on Alcohol 43(11):1259-1262.

Sekiya, Cheryl. 1989. Asian youth and d. ng usage: When "Just say no" becomes "Just say yes". Rice Paper (AsianAmerican Drug Abuse Program, Los Angeles), Spring 1989, pp. 1-2.

Shon, Steven P., and Ja, Davis Y. 1982. Asian families. In: McGoldrick, M., ed. Ethnicity and Family Therapy.New York Guilford Press. pp. 208-228.

Singer, K. 1972. Drinking patterns and alcoholism in the Chinese. British Journal of Addiction 67:3-14.Skager, Rodney; Frith, Sandra L.; and Maddahian, Ebraltim. 1:189. Piennial Survey of Drug and Alcohol Use

among California Students in Grades 7, 9, and 11: Winter i".97-1988. Sacramento: Office of the AttorneyGeneral, Crime Prevention Center.

Stoll, Michael J. 1987/1988. The case of the missing gene: Hereditary protection against alcoholism. AlcoholHealth & Research World 12(2):130-136.

Sue, David. 1987. Use and abuse of akohol by Asian Americans. Journal of Psychoactive Drugs 19(1):57-66.Sue, Stanley. and Nakamura, Charles Y. 1984. An Integrative model of physiological and social/psychological

factors in alcohol consumption among Chinese and Japanese Americans. Journal of Drug Issues 14(2):349-364.Sue, Stanley; Kitano, Harry H.L., Hatanaka, H.; and Yeung, W.-T. 1985. Alcohol consumption among Chinese in

the United States. In: Bennett, LA., and Ames, 0.14, eds. The American Experience with Alcohol:Contrasting Cultural Perspectives. New York: Plenum Press. pp. 359-371.

*Sue, Stanley; Zane, Nolan; and Ito, Joanne. 1979. Alcohol drinking patterns among Asian and CaucasianAmericans. Journal of Cross-Cultural Psychology 10(1):41-56.

Towle, Leland IL 1988. Japanese-American drinking: Some results from the joint Japanese-U.S. alcoholepidemiology project. Alcohol Health & Research World 12(3):216-223. (more detail in NIAAA 1989)

Trimble, Joseph E.; Padilla, Amado; and Bell, Catherine S., eds. 1987. Drug Abuse among Ethnic Minorities.DHHS Publication No. (ADM)87-1474. Rockville, Md.: National Institute on Drug Abuse.

Wang, R.P. 1968. A study of alcoholism in Chinatown. International Journal of Social Psychiatry 14:260-267.Washington State Commission on Asian American Affairs. 1981 Report to the Governor. Olympia, Washington.Weibel-Orlando, Joan. 1986. Women and alcohol: Special populations and cross-cultural variations In: National

Institute on Alcohol Abuse and Alcoholism. Women and Alcohol: Health-related Issues. ResearchMonograph No 16. (DHHS Publication No. (ADM)86-1139.) Rockville, Maryland: NIAAA. pp. 161-187.

Waite, John W., and Barnes. Grace M. 1985. Alcohol: The gateway to other drug use among secondary - schoolstudents. Journal of Youth and Adolescence 14(6):487-498.

Welte, John W., and Barnes, Grace M. 1987. Alcohol use among adolescent minority groups. Journal of Studieson Alcohol 48(4):329-336. (Abstracted in Update 2)

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Prevention Research Update 5

Whitney, Scott. 1986. Getting sober local style: Strategies for alcoholism counseling in Hawaii. AlcoholismTreatment Quarterly 3(1).

Williams, Mariee. 1984/1985. Alcohol and ethnic minorities. Asian/Pacific Americans: An update. AlcoholHealth & Research World 9(2):64-66.

Wilson, James R.; McClean, Gerald E; and Johnson, Ronald C. 1978. Ethnic variation in use and effects ofalcohol. Drug and Alcohol Dependence 3:147-151.

Wong, Herbert Z. n.d. Substance use and Chinese American youth: Preliminary findings on an interview studyof 123 youths and implications for services and programs. San Francisco: Youth Environment Study.

*Yee, Barbara W.K., and Thu, Nguyen Dinh. 1987. Correlates of drug use and abuse among Indochinese refugees:Mental health implicadons. Journal of Psychoactive Drugs 19(1):77-83.

Yu, Elena S.H., and Liu, William T. 1987. Alcohol use and abuse among Chinese-Americans: Epidendoksic data.Alcohol Health & Research World 11(2):14-17, 60.

Yu. Elena SR.; Liu, Witham T.; Ma. Zhengyi; and Zhang, Mingyuan. 1989. Alcohol use, abuse, and alcoholismamong Chir-se Americans: A review of the epidemiological data. In: National Institute on Alcohol Abuseand Alcoholism. Alcohol Use among U.S. Ethnic Minorities. NIAAA Research Monograph 18. DHHSPublication No. (ADM)89-1435. Rockville. Md.: National Institute on Alcohol Abuse and Alcoholism. pp.329-341.

Yuen, Sylvia HL., and Johnson, Ronald C. 1986. Mother-daughter comparisons in reported alcohol use.Unpublished manuscript, Behavioral Biology Laboratory, University of Hawaii.

OTHER SUGGESTED READINGS

Hurh, W.M., and Kim, K.C. 1984. Korean Immigrants in America. Cranbury, NJ.: Associated UniversityPresses.

Kim, B-L.C. 1978. The Asian America= Patterns, Changing Needs. Montclair, NJ.: Association ofKorean Christian Scholars in North America.

Kitano, Harry H.L. 1976. Japanese Americans: The Evolution of a Subculture. Englewood Cliffs, NJ.: Pentice-Hall.

Lebra, T.S. 1976. Japanese Patterns of Behavior. Honolulu: University of Hawaii Press.Okano, Y. 1977. Japanese Americans and Mental Health. Los Angeles: Coalition for Mental Health.Owan, T.C., ecL 1985. Southeast Asian Mental Health: Treatment, Prevention, Services, Training, and Research.

Washington, D.C.: Department of Health and Human Services.Strand, PJ., and Jones, W. 1985. Indochinese Refugees in America Durham, N.C.: Duke University Press.Sue, Stanley, and McKinney. IL 1975. Asian Americans in the community mental health care system. American

Journal of Orthopsychiatry 45(1):111-118.Sue, Stanley, and Morishima, J.K. 1982. The Mental Health of Asian Americans. San Francisco: Jossey-Bass.Yamamoto, J., and Kubota, M. 1983. The Japanese-American family. In: Powell, G.L., ed. The Psychosocial

Development of Minority Group Children. New York: Brunner/Maul.

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Fubstanee Abuse Among Asian American Youth

AUTHOR AND INFORMATION SOURCE ADDRESSES

The following is a list of the institutional affiliations of the first author of the abstracted documents and theaddresses of other information sources.

AUTHOR AFFILIATIONS

Akutsu, Phillip D.Department of PsychologyUniversity of California, Los AngelesLos Angeles, California 90024

Anderson, Patricia S.Northwest Regional Educational Laboratory101 S.W. Main Street, Suite 500Portland, Oregon 97204

Chi, IrisDepartment of Social WorkUniversity of Hong Kong

Danko, George P.Behavioral Biology LaboratoryUniversity of HawaiiHonolulu, Hawaii 96822

Johnson, Ronald C.Behavioral Biology LaboratoryUniversity of HawaiiHonolulu, Hawaii 96822

Kitano, Harry H.L.School of Social WelfareUniversity of California, Los AngelesLos Angeles, California 90024

Le Marchand, LoacEpidemiology Program, Cancer Research CenterUniversity of Hawaii1236 Lauhala Street, Suite 407Honolulu, Hawaii 96813

Lubben, James E.School of Social WelfareUniversity of California, Los AngelesLos Angeles, California 90024

McLaughlin, Dennis G.Mental }lea/,.h DivisionState Department of HealthP.O. Box 3378Honolulu, Hawaii 96801

Maddahian, EbrahimDepartment of PsychologyUniversity of California, Las AngelesLos Angeles, California 90024

Murakami, Sharon R.Mental Health Division, State Department of HealthP.O. Box 3378Honolulu, Hawaii 96801

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Sue. StanleyUniversity of WashingtonSeattle, Washington 98105

Wong, Herbert W.Richmond Area Multi-Services, Inc.3626 BalboaSan Francisco, California 94121

Yee, Barbara W.K.School of Allied Health SciencesUniversity of Texas Medical BranchRoute J 28Galveston. Texas 77550

OTHER INFORMATION SOURCES ANDPROGRAMS

Asian American Drug Abuse Program5318 S. Crenshaw Blvd.Los Angeles. CA 90043(213) 293-6284

Asian American Recovery Services300 4th StSan Francisco, CA 94107(425) 896-5213

Minority Advisory CommitteeOffice of the AdministratorAlcohol, Drug Abuse and Mental HealthAdministration5600 Fishers LaneRockville, Maryland 20857

Minority ProgramsNational Council on Alcoholism733 3rd AvenueNew York, New York 10017

National Asian American Health Forum835 Jackson StSan Francisco, CA 94133(415) 391-8494

National Asian Pacific American Families AgainstSubstance Abuse (NAPASASA)6303 Friendship CourtBethesda, MD 20817(301) 530-0945

National Clearinghouse for Alcohol and DrugInformationP.O. Box 2345Rockville, Maryland 20852

Prevention Research UpdateGregory A. Austin, Editor

Michael L. Prendergast. Asst. EditorSouthwest Regional Laboratory

Western Center for Drug-Free Schools and CommunitiesJudith A. Johnson, Director

Northwest Regional Educational Laboratory

Northwest Regional Educational Laboratory101 S.W. Main Street, Suite 500

Penland, Oregon 97204(503) 275-9500

Center for the Advancement of Pacific Education1164 Bishop Street, Suite 1409

Honolulu, Hawaii 96813(808) 533-1748

Far West Laboratory for Educational Research & Development1855 Folsom Street

San Francisco, California 94103(415) 565-3000

Southwest Regional Laboratory4665 Lampson Avenue

Las Alamitos, California 90720(213) 598-7661

This publication is based on work sponsored wholly or in part by the U.S. Department of Education under CooperativeAgreement Number S188A80003. The content of this publication does not necessarily reflect the views of theDepartment or any other agency of the U.S. Government.

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