“It’s not a life or death thing”: A grounded theory study of smoking decisions among Chinese Americans

Smoking results in a high mortality rate for Chinese Americans. Little is known, however, about the decisions members of this group make that lead to these unhealthy behaviors. Examining smoking decisions could help us understand these choices as well as develop effective prevention strategies. This grounded theory study was conducted to understand Chinese Americans’ smoking decisions. Fifty-four individual interviews and three focus groups were conducted with Chinese Americans of different smoking statuses. The findings describe five smoking decisions including the trajectory of these behaviors. Optimistic bias is identified as one of the main reasons that regular smokers decide not to quit. Some Chinese Americans decide to smoke in order to protect themselves from secondhand smoke because of the perception that secondhand smoke is more dangerous than active smoking. Finally, many Chinese Americans change their smoking behaviors after immigration, with their social environment after immigration playing a key role.