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Health Groups Fight Tradition in Asian Anti-Smoking Campaigns


Antonio Vivero smoked about a pack of cigarettes a day for 50 years. Coughing fits racked his body, but Vivero saw nothing wrong. After all, everyone around him puffed away without a second thought while he was growing up in the Philippines.

"There was a pleasure in smoking," said the 75-year-old Glassell Park resident. "It was something of a status symbol because everybody, practically, smoked in my day."

But after he moved to the United States five years ago, Vivero noticed a marked difference in the numbers of smokers and attitudes toward smoking. While the dangers of smoking were seldom mentioned in his native country, in Los Angeles even Filipino friends bugged him to quit.

Still, it took a doctor to persuade Vivero to kick the habit. He learned how at a free course at the Filipino American Service Group Inc. and hasn't smoked for about a year.

Asian and Asian-Pacific Islander smokers like Vivero are among the prime targets of a year-old effort by county and state health officials to snuff out smoking.

Last year, the state Department of Health Services, with $221 million in cigarette tax money, began an 18-month tobacco education program. The money goes to schools, local health departments and community groups to drum the anti-smoking message into youths and, for adults, run classes on how to stop smoking.

Trying to get Asian immigrants to quit, or at least convince them of its dangers, is difficult because smoking is such a part of Asian cultures, according to community workers.

In the Philippines, where tobacco crops may finance a college education, cigars are "bread and butter," said Andy Ramacho, health educator at the Filipino American Service Group. "Tobacco is very friendly to Filipinos."

Older immigrants, in particular, have a hard time giving up smoking because it is a respected symbol of adulthood in some Asian cultures.

Ramacho said that many older Asians have left comfortable jobs and lifestyles to come live with sons and daughters in an unfamiliar, foreign country. For these immigrants, whether or not to light up is often one of the few personal choices they have left.

"You remove that and what have you got left? Nothing," Ramacho said. "It makes this person think, 'Should I give up this last symbol of myself?' "

Then there's marketing. In Japan, cigarette brands such as Hope and Peace conjure up pleasant images, Akiko Mimura told a group of Japanese and Japanese-American smokers at a recent anti-smoking meeting at the Little Tokyo Service Center. "They give you the feeling that if you smoke, you'll feel good, peaceful, hopeful," said Mimura, a counselor with the center's tobacco program.

Such cultural and language concerns prompted county and state health officials to turn to local service groups to take the anti-tobacco programs to the Asian communities. The groups print pamphlets in Chinese, Japanese and Korean; bilingual counselors lead the stop-smoking sessions provided by the Little Tokyo Service Center and Filipino American Service Group.

A survey last year by the Korean Health Education, Information and Referral Center of 285 Korean immigrants in Los Angeles showed 59% were smokers and an additional 11% had quit. The Korean referral agency and the Korean Youth Center concentrated on education and prevention rather than stop-smoking courses. So has the Chinatown Service Center, which began its outreach program Oct. 1.

All the programs try to discourage smoking with facts on diseases and deaths linked to smoking. Brochures warn that more than 31,000 Californians die each year of smoking-related diseases; graphic photographs show smokers' reddened, swollen lungs and other diseased organs.

There's even an appeal to economics. The Little Tokyo Service Center's bilingual leaflets note that at $1.50 per pack, a two-pack-a-day smoker spends more than $1,000 a year on cigarettes.

"If this amount had been invested at 10% and compounded, at the end of 40 years, there would be close to $500,000," the brochure says. "Now that's a lot of money to burn."

The programs also warn of second-hand smoke's effects on nonsmokers and encourage family members to become more vocal about their concern.

Soo Young Lim's father's smoking sparked her to enter the Korean Youth Center's anti-smoking poster contest. "I told my dad a lot of times to stop smoking, but it's hard for him," said Lim, a 15-year-old sophomore at Beverly Hills High. "So I thought it would be great to tell other people how bad smoking is."

Lim's poster, which won a third-place prize, shows a pregnant woman smoking, with a baby inside her stomach crying, "I want to live."

The Filipino American Service Group has parties and steers youths toward local basketball leagues to divert them from not only smoking, but gangs and crime.

Although the programs' effectiveness could be debated, county officials say they are optimistic.

Of 11,000 youths in Los Angeles County who attended anti-tobacco events last year, 56% said their knowledge of the dangers of smoking had increased, while 25% actually quit smoking, said Ingrid Lamirault, director of the county Department of Health Services Tobacco Control program.

Of 1,100 adults countywide who enrolled in the cessation courses last year, 45% quit smoking and were sticking to their goal when polled six weeks later, she said. The county did not break the figures down by ethnicity.

Individually, the agencies' statistics are less heartening. For example, of the 70 people who took the Filipino American Service Group's smoking-cessation course last year, only 14 quit. "That's a very low success rate, but that was our first year," Ramacho said.

Still, the few successful ones like Vivero say they are happy the took the course. "Smoking is hard to quit, but I really wanted to stop," he said. "I haven't smoked for almost a year now, and I am OK."

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