Migration-related changes in smoking among non-Western immigrants in France

Background: Migrants make up a growing share of European populations, and very little is known about the impact of migration on their smoking patterns. We develop a longitudinal analysis of smoking prevalence among native-born and immigrants in France based on retrospective data collected in the 2010 national Barome` tre sante ' health survey. Methods: Analyses concerned 19 578 individuals aged 18-70 years and born in metropolitan France, in the Maghreb or in sub-Saharan Africa. Person-years with and without smoking were reconstructed using migration and smoking histories and analyzed with discrete-time regression models. Results: Prior to migration, immigrants from both the Maghreb and sub-Saharan Africa had lower smoking prevalence than the native-born of similar birth cohort, age and education. After migration, the prevalence increased over time among Maghrebin men up to levels beyond those of the native-born (odds ratio: 1.54 [1.09-2.17] for 10 years of residence or more), while it remained much lower throughout among men from sub-Saharan Africa (odds ratio: 0.36 [0.19-0.68] for 10 years of residence or more). Starting at extremely low levels, the prevalence in both groups of women rose considerably after migration. Women from sub-Saharan Africa nearly caught up to the native-born (odds ratio: 0.70 [0.37-1.32] for 10 years of residence or more), but this was not the case for those from the Maghreb (odds ratio: 0.52 [0.33-0.81] for 10 years of residence or more). Conclusion: The findings uncover the low pre-migration prevalence and the diversity of post-migration trajectories. Tobacco control programs targeting recently arrived migrants would contribute to prevent unhealthy assimilation.