Chinese immigrant men smokers’ sources of cigarettes in Canada: A qualitative study
More details
Hide details
Kiang Wu Nursing College of Macau, Macau, China
Institute for Healthy Living and Chronic Disease Prevention, University of British Columbia, Kelowna, Canada
Faculty of Health Sciences, Australian Catholic University, Melbourne, Australia
School of Nursing, University of British Columbia, Vancouver, Canada
Submission date: 2016-07-20
Acceptance date: 2017-03-16
Publication date: 2017-03-21
Corresponding author
Aimei Mao   

Kiang Wu Nursing College of Macau, Est. Repouso No.35, R/C, Macau, China
Tob. Induc. Dis. 2017;15(March):18
Immigrants often experience economic hardship in their host country and tend to belong to economically disadvantaged groups. Individuals of lower socioeconomic status tend to be more sensitive to cigarette price changes. This study explores the cigarette purchasing patterns among Chinese Canadian male immigrants.

Semi-structured in-depth interviews were conducted with 22 Chinese Canadian immigrants who were smoking or had quit smoking in the last five years.

Because of financial pressures experienced by participants, the high price of Canadian cigarettes posed a significant challenge to their continued smoking. While some immigrants bought fully-taxed cigarettes from licensed retailers, more often they sought low-cost cigarettes from a variety of sources. The two most important sources were cigarettes imported during travels to China and online purchases of Chinese cigarettes. The cigarettes obtained through online transactions were imported by smoking or non-smoking Chinese immigrants and visitors, suggesting the Chinese community were involved or complicit in sustaining this form of purchasing behavior. Other less common sources included Canada-USA cross border purchasing, roll your-own pouch tobacco, and buying cigarettes available on First Nations reserves.

Chinese Canadian immigrant men used various means to obtain cheap cigarettes. Future research studies could explore more detailed features of access to expose gaps in policy and improve tobacco regulatory frameworks.

World Health Organization: Tobacco. factsheets/fs339/en. Accessed 12 June 2016.
US Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress. Rockville, MD: Office of the Surgeon General; 2014.
Verguet S, Gauvreau CL, Mishra S, MacLennan M, Murphy SM, Brouwer ED, Nugent RA, Zhao K, Jha P, Jamison DT. The consequences of tobacco tax on household health and finances in rich and poor smokers in China: An extended cost-effectiveness analysis. Lancet Glob Health. 2015;3:206–16.
Yang T, Peng S, Yu L, Jiang S, Stroub WB, Cottrell RR, Rockett IR. Chinese smokers’ behavioral response toward cigarette price: individual and regional correlates. Tob Induc Dis. 2016;14:13.
Huang J, Zheng R, Chaloupka FJ, Fong GT, Li Q, Jiang Y. Chinese smokers’ cigarette purchase behaviours, cigarette prices and consumption: findings from the ITC China Survey. Tob Control. 2014;23 Suppl 1:i67–72.
Cornelius ME, Driezen P, Fong GT, Chaloupka FJ, Hyland A, Bansal-Travers M, Carpenter MJ, Cummings KM. Trends in the use of premium and discount cigarette brands: findings from the ITC US Surveys (2002–2011). Tob Control. 2014;23 Suppl 1:i48–53.
Golden SD, Kong AY, Ribisl KM: Racial and Ethnic Differences in What Smokers Report Paying for Their Cigarettes. Nicotine Tob Res 2016. [Epub ahead of print].
van Walbeek C, Blecher E, Gilmore A, Ross H. Price and tax measures and illicit trade in the framework convention on tobacco control: what we know and what research is required. Nicotine Tob Res. 2013;15:767–76.
Guindon GE, Driezen P, Chaloupka FJ, Fong GT. Cigarette tax avoidance and evasion: findings from the International Tobacco Control Policy Evaluation (ITC) Project. Tob Control. 2014;23 Suppl 1:i13–22.
Nagelhout GE, van den Putte B, Allwright S, Mons U, McNeill A, Guignard R, Beck F, Siahpush M, Joossens L, Fong GT, et al. Socioeconomic and country variations in cross-border cigarette purchasing as tobacco tax avoidance strategy. Findings from the ITC Europe Surveys. Tob Control. 2014;23 Suppl 1:i30–38.
Li Q, Hsia J, Yang G. Prevalence of Smoking in China in 2010. N Engl J Med. 2011;364:2469–70.
Dean JA, Wilson K. ‘Education? It is irrelevant to my job now. It makes me very depressed …': exploring the health impacts of under/unemployment among highly skilled recent immigrants in Canada. Ethn Health. 2009;14:185–204.
de Castro AB, Rue T, Takeuchi DT. Associations of employment frustration with self-rated physical and mental health among Asian American immigrants in the U.S. Labor force. Public Health Nurs. 2010;27:492–503.
Vahabi M, Damba C. Perceived barriers in accessing food among recent Latin American immigrants in Toronto. Int J Equity Health. 2013;12:1.
Crollard A, de Castro AB, Tsai JH. Occupational trajectories and immigrant worker health. Workplace Health Saf. 2012;60:497–502. quiz 503.
De Maio FG. Immigration as pathogenic: a systematic review of the health of immigrants to Canada. Int J Equity Health. 2010;9:27.
Van Hook J, Quiros S, Frisco ML, Fikru E. It is Hard to Swim Upstream: Dietary Acculturation Among Mexican-Origin Children. Popul Res Policy Rev. 2016;35:177–96.
Reiss K, Lehnhardt J, Razum O. Factors associated with smoking in immigrants from non-western to western countries - what role does acculturation play? A systematic review. Tob Induc Dis. 2015;13:11.
An N, Cochran SD, Mays VM, McCarthy WJ. Influence of American acculturation on cigarette smoking behaviors among Asian American subpopulations in California. Nicotine Tob Res. 2008;10:579–87.
Li S, Kwon SC, Weerasinghe I, Rey MJ, Trinh-Shevrin C. Smoking among Asian Americans: acculturation and gender in the context of tobacco control policies in New York City. Health Promot Pract. 2013;14:18S–28S.
Liao Y, Tsoh JY, Chen R, Foo MA, Garvin CC, Grigg-Saito D, Liang S, McPhee S, Nguyen TT, Tran JH, Giles WH. Decreases in smoking prevalence in Asian communities served by the Racial and Ethnic Approaches to Community Health (REACH) project. Am J Public Health. 2010;100:853–60.
Tong EK, Tang H, Chen Jr MS, McPhee SJ. Provider smoking cessation advice among California Asian-American smokers. Am J Health Promot. 2011;25:S70–74.
Gotay CC, Reid MS, Dawson MY, Wang S. Acculturation and smoking in North Americans of Chinese ancestry: A systematic review. Can J Public Health. 2015;106:e333–340.
Mao A, Bottorff JL, Oliffe JL, Sarbit G, Kelly MT. A qualitative study of Chinese Canadian fathers’ smoking behaviors: intersecting cultures and masculinities. BMC Public Health. 2015;15:286.
Mao A: A Qualitative Study on Unassisted Smoking Cessation Among Chinese Canadian Immigrants. Am J Mens Health 2016 Jan 27. [Epub ahead of print]
Propel Centre for Population Health Impact: Tobacco Use in Canada: Patterns and Trends, 2015 edition. Waterloo, ON: Propel Centre for Population Health Impact, University of Waterloo, 2015.
The Canadian Magazine of Immigration: Chinese Immigrants to Canada. Accessed 12 June 2016.
Sandelowski M. Whatever happened to qualitative description? Res Nurs Health. 2000;23:334–40.
Sandelowski M. What's in a name? Qualitative description revisited. Res Nurs Health. 2010;33:77–84.
Gupta V. Conducting a Telephone Interview. Birmingham, UK: Impactkt Publishing Ltd.; 2014.
Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005;15:1277–88.
Levinson B. An Inquiry into the Nature, Causes and Impacts of Contraband Cigarettes. Washington, DC: Center for Regulatory Effectiveness; 2011.
Young D, Borland R, Hammond D, Cummings KM, Devlin E, Yong HH, O'Connnor RJ. Prevalence and attributes of roll-your-own smokers in the International Tobacco Control (ITC) Four Country Survey. Tob Control. 2006;15 Suppl 3:iii76–82.
Cantrell J, Hung D, Fahs MC, Shelley D. Purchasing patterns and smoking behaviors after a large tobacco tax increase: a study of Chinese Americans living in New York City. Public Health Rep. 2008;123:135–46.
Ribisl KM, Williams RS, Gizlice Z, Herring AH. Effectiveness of state and federal government agreements with major credit card and shipping companies to block illegal Internet cigarette sales. PLoS One. 2011;6:e16754.
Journals System - logo
Scroll to top