Asian Americans and Lung Health

The American Lung Association pays tribute to the history, heritage and contributions of Asian American and Pacific Islander people in the United States.

Asian American and Pacific Islander Heritage Month

Asian American and Pacific Islander Heritage Month (May1 - June 1) is a celebration of Asians and Pacific Islanders in the United States. A rather broad term, Asian/Pacific encompasses all of the Asian continent and the Pacific islands of Melanesia (New Guinea, New Caledonia, Vanuatu, Fiji and the Solomon Islands), Micronesia (Marianas, Guam, Wake Island, Palau, Marshall Islands, Kiribati, Nauru and the Federated States of Micronesia) and Polynesia (New Zealand, Hawaiian Islands, Rotuma, Midway Islands, Samoa, American Samoa, Tonga, Tuvalu, Cook Islands, French Polynesia and Easter Island).

Lung Health and Asian American and Pacific Islander Communities

Lung Cancer

Lung cancer is the leading cause of cancer death among Asian Americans/Native Hawaiians/Pacific Islanders. Within this population, Hawaiian men and women have the highest rates of lung cancer deaths. Filipino men and women have the lowest rates of lung cancer deaths.1

National data on the rate of new lung cancer cases among specific Asian populations is limited. Nationally, rates are significantly lower among AAPIs compared to white and Black Americans for both men and women. Ultimately, AAPI men have the 3rd highest rate of new lung cancer cases, after Black men and white men respectively (more than Latino and Indigenous (American Indian/Alaska Native) populations). Rates of news cases, per 100,000 are as follows:3

  • AAPI men - 46.2
  • White men - 62.2
  • Black men - 71.2

Like other racial and ethnic groups, AAPI women are significantly less likely than men to be diagnosed with lung cancer. The disparity between the sexes is greatest for Black Americans and AAPIs, with AAPI men being about 62% more likely than AAPI women to be diagnosed with lung cancer.3

Learn more in our State of Lung Cancer Report.

Flu & Pneumonia

Pneumococcal vaccination rates are significantly lower among Filipinos than non-Asians, and significantly lower among other Asians, Asian Indians, and Chinese compared to Filipinos. Pneumococcal vaccination rates do not vary significantly by sex among Asian populations nationally.1

In 2018, Asian Americans had the highest rate of influenza vaccination, and the second lowest death rate among racial and ethnic groups. Data are not available for more specific Asian populations due to limited sample sizes and survey limitations.i 

Learn more about the flu and pneumonia.

Asthma

Asthma rates are lower for Asian than non-Asian populations, except for Filipinos and Japanese in California, who are statistically like non-Asians nationally. Asthma rates do not vary significantly by sex for most Asian populations. Asthma rates in the U.S. among AAPI communities:1

  • 228,000 Chinese 
  • 659,000 Filipino 
  • 283,000 Asian Indian*
  • 527,000 other Asian 
  • 40 million non-Asian
COPD

COPD rates are generally low among AAPI populations nationally. The rates also do not vary significantly by sex among Asian populations. Rates are significantly lower for Asian than non-Asian populations, but are significantly higher among Filipinos compared to other Asian populations. COPD rates among Asian and Pacific Islander Americans:1

  • 170,000 Chinese
  • 573,000 Filipino
  • 126,000 Asian Indian*
  • 449,000 other Asian
  • 54.8 million non-Asian

Wildfires and Lung Health 

During a wildfire, people throughout the surrounding area may suffer the effects of the smoke. Talk with your doctor about how to prepare for this smoke, especially if you or someone in the family fits into one of these categories: works outdoors; is under age 18 or over age 65; or has asthma, COPD or other lung diseases, chronic heart disease, or diabetes. Monitor your breathing and exposure to the smoke. Learn more here.

In collaboration with the California Fire Foundation, as part of the San Diego County wildfire outreach/education grant project this past fall, the American Lung Association shared information about how to protect lung health during wildfire season in Mandarin, Vietnamese, and Tagalog. Materials in these languages were distributed via culturally vibrant community "hubs" with high concentrations of multi-ethnic businesses and residents. For example, many Vietnamese and Chinese Americans reside in Mira Mesa and City Heights, and many Filipino-American owned businesses and residents live in National City, etc.

Tobacco Industry Marketing and Influence

According to the Centers for Disease Control and Prevention (CDC), “Tobacco companies have been creative in their efforts to reach different racial/ethnic groups. AAPI smokers are a key market for tobacco companies since cigarette smoking prevalence in most Asian countries is considerably higher than in the U.S.”1

In many cases, the tobacco industry has sponsored key religious observances and festivals during Asian American and Pacific Islander Heritage Month, as a means to secure branding opportunities.  From billboards to retail advertisements, the marketing tactics employed by the tobacco industry illustrate a targeted approach to gaining trust in densely Asian Americans neighborhoods.4

Reports also indicate that AAPI business owners are approached with special sales opportunities through business associations to leverage their relationships with AAPI customers in their communities.4

Therefore, culturally sensitive marketing initiatives are needed to combat the strategic influences of the tobacco industry. Smoking cessation programs like the CDC’s Tips From Former Smokers national tobacco education campaign, as well as the American Lung Association’s Freedom from Smoking cessation program, can help reduce the burden of disease among the Asian American/Pacific Islander/Native Hawaiian population.

Cigarette Smoking

The three leading causes of death among Asian Americans/Native Hawaiians/Pacific Islanders are cancer, heart disease, and stroke, all of which can be caused by cigarette smoking. National data on smoking rates is only available for select Asian populations.1

However, California includes additional groups which are listed here for greater detail. Multiple years of data are included to allow for more accurate estimates.2

Among most Asian populations, smoking rates are much lower among women than men. Smoking rates are lower among Asian women compared to non-Asian women for every group, although there are significant differences between groups, such as Filipino and Asian Indian women.1

While smoking rates are lower among many Asian groups, compared to non-Asian men, Korean and Vietnamese Californian men reported the highest smoking rates compared to all Asian and non-Asian men alike.1

Electronic Cigarettes

National data on e-cigarette use is also very limited, however a 2015-2019 California report provided the greatest representation of the variety of Asian populations included in the AAPI community.1

Results indicated e-cigarette use in California is greater among men than women among most groups, and this trend is reflected among most Asian populations in California even if the differences are not statistically significant due to small sample sizes. Rates also differ among men from different Asian populations, ranging from 2.5% for Chinese men to 13.7% among Filipino men.2

Quit Tobacco Use for Good

Quitting isn't easy but more than 50 million ex-smokers in the United States are proof that it's possible. Despite what e-cigarette companies want you to believe, switching to vaping (e-cigarettes) is not quitting smoking. E-cigarettes are tobacco products, they contain nicotine, and FDA has not approved any e-cigarette as a quit smoking device. Enrolling in a tobacco counseling program, such as American Lung Association’s Freedom From Smoking®, can increase your chances of success by up to 60% when used in combination with FDA-approved medication.

Key Takeaways

  • AAPI men have the 3rd highest rate of new lung cancer cases, after Black men and white men respectively. 
  • AAPI females have the lowest rates of new lung cancer cases.
  • Asian Americans had the highest rate of influenza vaccination, and the second lowest death rate among racial and ethnic groups.
  • More research and analysis needs to be conducted to accurately convey the lung health impacts to AAPI communities.
  • Smoking rates for cigarettes and e-cigarettes are significantly higher in males than females within the overall AAPI population.
  • Members of the Korean, Vietnamese and Filipino communities have the highest cigarette smoking rates compared to those of other Asian backgrounds and non-Asian men.
  • Members of the Korean, Vietnamese and South Asian communities have the highest e-cigarette smoking rates compared to those of other Asian backgrounds and non-Asian men.

*Selection options for “Asian” offered by the CDC for respondents were Chinese, Filipino, Japanese, Asian Indian, Korean, or Vietnamese.

  1. NCI SEER CSR 1975-2017.
  2. Centers for Disease Control and Prevention. Asian Americans, Native Hawaiians or Pacific Islanders and Tobacco Use. 2019. https://www.cdc.gov/tobacco/disparities/asian-americans/index.htm.
  3. Centers for Disease Control and Prevention, National Center for Health Statistics. National Health Interview Survey, 2014-2018.
  4. UCLA Fielding School of Public Health. California Health Interview Survey 2015-2019.
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