Smoke-free policies are not always effective among Asian American women, a majority of whom don't smoke but may be at risk for secondhand smoke exposure, a recent study has found.

UC Davis researcher Elisa Tong, an assistant professor of medicine, found that while California has a longstanding history of smoke-free social norms and regulations, their effectiveness in Asian-American communities depends largely upon socioeconomic status.

Tong's study, "Smoke-Free Policies Among Asian-American Women: Comparisons by Education Status," was published recently in a special supplement of the American Journal of Preventive Medicine. The supplement, funded by the National Cancer Institute and American Legacy Foundation, was dedicated to the unintended consequences of tobacco control policies in women of low socioeconomic status.

In her work, Tong acknowledged that California has significantly decreased racial, ethnic and educational disparities in its smoke-free home and indoor work policies. But she wanted to know specifically how Asian- American women were faring.

"Asians are half of the world's smokers," she says. "But this is a population that hasn't been looked at traditionally in the U.S. because it is difficult to study."

Tong and her colleagues used the California Tobacco Use Surveys for Chinese Americans and Korean Americans, which were conducted in 2003 by senior author Moon Chen, UC Davis professor of medicine and principal investigator of the Asian American Network for Cancer Awareness, Research and Training. Tong analyzed the data in 2008 to compare women with lower and higher education status in terms of their adoption and enforcement of smoke-free policies.

Tong found that regardless of educational status, most respondents reported that they prohibit smoking in their homes and indoor workplaces, and understand the dangers of exposure to secondhand smoke. But lower-educated women were more likely than their higher-educated counterparts to report someone smoking in their home or having recently been exposed to smoke at their indoor workplace.

Tong concluded that an unintended consequence of the success in California's tobacco-control efforts is that disparities exist in how they are enforced among Asian-American women due to educational status. Lower-educated women, she said, may need assistance with empowerment in enforcing rules around exposure to secondhand smoke.

"We learned that almost all women know secondhand smoke is bad for you, so that means that having policies is not enough," Tong says. "There has to be an additional component. Maybe this is where a health-care provider can step in and be an advocate for these women."