Chinese-American men are more likely to smoke cigarettes if they are poorly educated, have little access to Western healthcare and have no knowledge of cancer warning signs, a new study shows.

Those who have less than an elementary school education were more than twice as likely as those with more education to be a current smoker, according to the study. The findings are published in the current issue of the American Journal of Public Health, the journal of the American Public Health Association.

Elena Yu, a professor of epidemiology at San Diego State University's Graduate School of Public Health in California and her colleagues surveyed 644 Chinese Americans aged 40 to 69 living in Chicago's Chinatown section. Cigarette use was defined as having smoked at least 100 cigarettes within the course of one's lifetime and to be a current smoker.

Of those surveyed, 34 percent said they were current smokers, a prevalence rate higher than that among American males, but lower than that in mainland China, where three quarters of men over age 40 reportedly use cigarettes. The researchers found only 2 percent of Chinese-American women in this age group reported smoking.

Yu's team also found that men who had no knowledge of any early warning signs of cancer were more than twice as likely to be current smokers than other men. And Chinese-American men who lacked contact with mainstream medicine were more than twice as likely to smoke.

However, the majority of the men lacked the information on the dangers of smoking not because they visited only Chinese herbalists but probably because they had no regular access to healthcare, the study showed.

"Our study showed that many men tried to quit, but the only method they knew was cold turkey, and they would always fail," Yu said.