
































Finalized Digital Files.pdf


COLUMBIA SOCIAL WORK REVIEW, VOL. XXII  |   115   114  |  COLUMBIA SOCIAL WORK REVIEW, VOL. XXII 

INSPIRATION FOR ARTICLE

After moving from the other side of the globe to the U.S., I realized I 
am viewed just as ‘Asian’ here. It was as if all my cultural experiences 
and diverse ethnic backgrounds were deliberately ignored. After I 
started talking to other BIPOC folks who are non-citizens, immigrants, 
or first-generation immigrants, I found that many feel the same as I 
did. Eventually, I learned about different ethnicities that fall under the 
Asian, Latinx, and Black umbrella terms and how different they are. 
For instance, it is rare to find an Indonesian American to drink beyond 
their capacity due to the extremely conservative culture in Indonesia. 
On the other hand, Korean Americans are likelier to drink because it is 
part of their culture in Korea. This was basic knowledge for myself and 
many around me. Hence, when finding that data collection in the U.S. 
disregards, I instinctively knew that many ethnic groups are currently 
overlooked, but also ironically very much acknowledged though only  
as a monolithic group. This inspired me to look into disparities in  
social and health issues impacting different ethnicities under the  
same racial umbrella.

I’m a proud Southeast Asian, born and bred in Indonesia. Before 
pursuing a Master’s in Social Work at Columbia, I served as the 
youngest policy analyst in the Governor’s Delivery Unit of Jakarta, the 
capital of Indonesia. My research interests are mainly in social and 
psychosocial determinants of health and empowerment of vulnerable 
communities.

ADELA
JANSEN



COLUMBIA SOCIAL WORK REVIEW, VOL. XXII  |   117   116  |  COLUMBIA SOCIAL WORK REVIEW, VOL. XXII

ALCOHOL AND SUBSTANCE USE AMONG EAST ASIAN AMERICAN YOUTH ADELA JANSEN

ABSTRACT

This reading challenges the prevailing Model Minority Myth perspective 
which influences the examination of substance use patterns 
among different subgroups of East Asian American (EAA) youth. 
A disaggregated analysis of existing literature reveals significant 
variations in substance use across EAA subgroups. This article explores 
influencing factors such as acculturation, cultural norms, and peer 
dynamics, emphasizing distinctions between Chinese Americans, 
Taiwanese Americans, Korean Americans, and Japanese Americans. 
Several EAA subgroups show a higher prevalence of cigarette or 
alcohol use than their white counterparts, a finding normally hidden by 
the aggregation of Asian American data. These unrealized differences 
prompt a call for tailored and culturally appropriate treatment 
approaches. Data shows EAA youth are more likely to not seek 
treatment or to drop out after beginning treatment (Wang & Kim, 2010 
as cited in Ong, 2023). Understanding the typical family dynamics as 
well as the discrimination faced by EAA communities, including cultural 
stigma and culture-specific syndromes, plays a crucial role in improving 
treatment adherence. Additionally, studies of treatment preferences 
show that implementing family-based programs, outreach efforts, and 
involving culturally attuned treatment providers is crucial to actively 
address the unique needs of youth of different EAA subgroups (Lee et 
al., 2004). 

Keywords: substance use, treatment approach, culturally appropriate 
care, East Asian American, model minority

Asian Americans (AA) are the fastest-growing minority 
group in the United States (Budiman & Ruiz, 2021). Often 
referred to as the “model minority,” the AA community is 
perceived as a monolithic group that is successful and 

stays out of trouble. The Model Minority Myth has created distortions 
and misperceptions about the actual struggles of many Asian Americans 
which range from mental health to other areas of health (Blackburn, 
2019). The stereotype that Asian Americans are “doing well” ignores 
how many Asian American youth face dual exposure to strict parenting 
(i.e. tiger parenting with punishment and shaming tactics) and holding 
a bicultural identity, which can result in poor coping behaviors such as 
substance abuse (Saraiya et al., 2019). In reality, a 2002 study shows 
that compared to girls of other ethnocultural groups, Asian American 
girls have the largest increase in use of alcohol (from 9.5% to 28.4%), 
cigarettes (from 7.4% to 17.1%), marijuana (from 2.4% to 9.1%), and 
other stimulants (from 1.5% to 2.3%) from 8th to 12th grade (Wallace et 
al., 2003). Moreover, since research on alcohol and substance use often 
lumps all subgroups within the Asian American (and sometimes Pacific 
Islander) community together, this aggregate data masks high rates of 
substance use within specific groups (Kane et al., 2017). This creates 
an increased danger of overlooking and ignoring the needs of the AA 
community.

EAST ASIAN AMERICAN (EAA) YOUTH

Compared to other Asian American subcultures, East Asian Americans 
currently fit the mold of the Model Minority Myth the most. EAA 
ethnicities include Chinese Americans, Hong Kong Americans, Japanese 
Americans, Macau Americans, Mongolian Americans, North Korean 
Americans, South Korean Americans, and Taiwanese Americans (Asia 
Society, n.d.). The 2019 American Community Survey (ACS) data from 
the U.S. Census Bureau shows that the Asian American groups with 
the highest median household income and the highest percentages of 
adults (age 25 and above) with at least a bachelor’s degree are mainly in 
the EAA category (Jin, 2021). Within this group, the Taiwanese, Chinese, 



COLUMBIA SOCIAL WORK REVIEW, VOL. XXII  |   119   118  |  COLUMBIA SOCIAL WORK REVIEW, VOL. XXII

Japanese, and Korean American subgroups stand out the most in 
terms of economic and educational achievement. When referring to 
Asian Americans in the U.S., most only consider East Asians, further 
perpetuating the misconception of Asian Americans as a “successful” 
monolithic model minority. The common perception is that Asian 
Americans in general are as successful as their white counterparts, at 
least from an economic and educational standpoint. This translates 
into a double-layered assumption that East Asian Americans are 
economically successful and, therefore, not at high risk of substance 
use. However, simply earning a high income or a bachelor’s degree does 
not define the population’s well-being, especially in terms of mental 
health and substance use. Additionally, even if rates of substance use 
for Asian Americans are lower than other racial groups, most data do 
not show the variances among different Asian American subgroups/
ethnicities nor their experiences of racial or minority stress (National 
Survey on Drug Use and Health, 2021).

Many East Asian Americans are from immigrant families where using 
certain substances, namely alcohol, is common or seen as a norm 
in their country of origin. This paper focuses on the high prevalence 
of substance use, especially alcohol and cigarette use, among some 
EAA subgroups. Furthermore, cultural norms in the Asian American 
community mean these groups are already less likely to seek 
professional help, and false assumptions of substance use among 
different EAA subgroups have further contributed to limited availability 
and accessibility to treatment for those who do need help (Guarnotta, 
2023). In general, public health researchers and practitioners have been 
led to deprioritize analyzing the patterns of substance use among East 
Asian Americans and Asian Americans (Kane et al., 2017). Hence, it 
is unsurprising that policies and programs tend to ignore the need for 
prevention and treatment for this population. 

The relationship between different subgroups of EAA youth and 
substance use, as well as treatment approaches appropriate for this 
population, should be examined. Youth populations are prioritized in this 

paper since this is a crucial stage for intervention in the development of 
alcohol and substance use issues.

FACTORS INFLUENCING SUBSTANCE USE ACROSS 
SUBGROUPS

The 2019 ACS data from the U.S. Census Bureau shows that the East 
Asian American subgroup has the highest percentage population (8.6 
million) in the U.S compared to other Asian American subgroups. 
Acknowledging the distribution of ethnicities of Asian Americans is 
crucial to understanding how current aggregated data concerning Asian 
American substance use has created biases and oversight of substance 
use prevention and treatment for Asian American subgroups that need 
them the most.

ALCOHOL AND SUBSTANCE USE AMONG EAST ASIAN AMERICAN YOUTH ADELA JANSEN

TABLE 1 
ETHNICITIES UNDER THE ASIAN AMERICAN UMBRELLA

P
O

P
U

LA
TI

O
N

Source: U.S. Census Bureau, 2019 American Community Survey as 
cited in Jin’s (2021) article.



COLUMBIA SOCIAL WORK REVIEW, VOL. XXII  |   121   120  |  COLUMBIA SOCIAL WORK REVIEW, VOL. XXII

The 2013 U.S. National Survey on Drug Use and Health (NSDUH) 
reveals that Asian American youth have the lowest prevalence of past-
month alcohol use and binge drinking compared to other races or ethnic 
groups (Substance Abuse and Mental Health Services Administration, 
2013). However, data which combine all Asian American sub ethnicities 
under one category hide and ignore the reality of high-risk groups. A 
2017 study found prevalence estimates of alcohol use among Korean, 
Japanese, and Filipino American adolescents were in fact very similar 
to other racial groups (i.e. white and Black populations) that experience 
a high risk of alcohol use (Kane et al., 2017). Another study by Cook et 
al. (2015) found the culture of drinking in the country of origin, namely 
Korea, Japan, and the Philippines, predicted heavy episodic drinking 
among these young adults. Low levels of alcohol use among Chinese 
Americans and Asian Indian Americans–the two largest Asian American 
subgroups in the United States, skew the data when evaluating alcohol 
use among Asian Americans as a whole (Saraiya et al., 2019; U.S. 
Census Bureau, 2021). Collectively, these findings accentuate the 
existing alcohol use amongst Asian American youth and the importance 
of disaggregating this data by ethnicity.

There is limited research on illicit substance use (e.g. cannabis, opioids, 
and illicit stimulants) among Asian Americans. The existing small body 
of research depicts Japanese and Korean ethnicities reporting higher 
use of illicit substances compared to other Asian American ethnicities 
(Ryabov, 2015; Saraiya et al., 2019 as cited in Ahmmad & Adkins, 2021).

CHINESE AMERICANS & TAIWANESE AMERICANS

Although Chinese Americans comprise over half of the East Asian 
population in the U.S., this group consistently reports low alcohol use 
prevalence compared to other Asian American subgroups (Chang et al., 
2008). However, this does not mean alcohol and substance use is non-
existent among Chinese American youth. 

This phenomenon requires examining the process of acculturation–how 
closely one adheres to cultural norms in the U.S–which appears to be a 

strong predictor of substance use for other ethnicities. For instance, one 
study highlights how Chinese Americans are more influenced by specific 
cultural values (i.e., family obligation and expectations of autonomy). 
This means that Chinese American youth with a higher internalized 
sense of these values engaged in less misconduct (Juang & Nguyen, 
2009). Although family values are a strong predictor of substance use 
in Chinese American youth, it is important to note that substance use 
is part of Chinese culture. Moreover, Chinese and Taiwanese American 
youth are greatly impacted by the recent history of immigration in their 
families. Immigration can greatly alter family dynamics and values and 
affect how these values contribute to substance use. 

In existing research on substance use in Taiwanese Americans, this 
group is often combined with Chinese Americans, perhaps due to the 
very similar culture and the comparatively lower population of Taiwanese 
Americans. A study on smoking behavior among Chinese American 
and Taiwanese American college students found personal meanings 
associated with smoking are powerful predictors of smoking for this 
population (Spruijt-Metz & Hsia, 2003). Specifically, participants of this 
study reported that personal feelings about smoking are closely related 
to culture and smoking customs in some regions in China and Taiwan 
where smoking is socially accepted and even encouraged among 
men. In comparison, the personal feelings about smoking in female 
participants are more influenced by family education and parental 
attitudes compared to social customs.

KOREAN AMERICANS

On the other hand, Korean American college students are found to be 
drinking alcohol more frequently and in higher amounts compared to 
Chinese American students. Particularly, Korean Americans are more 
likely than Chinese American students to view drinking as a socially 
acceptable practice and a way to facilitate social interactions (Chang 
et al., 2008). The two most common environments where Korean 
Americans drank alcohol were drinking at night with friends or at 
parties (Nakashima & Wong, 2000). Drinking behavior among Korean 

ALCOHOL AND SUBSTANCE USE AMONG EAST ASIAN AMERICAN YOUTH ADELA JANSEN



COLUMBIA SOCIAL WORK REVIEW, VOL. XXII  |   123   122  |  COLUMBIA SOCIAL WORK REVIEW, VOL. XXII

American students is closely associated with the drinking behaviors 
of their parents and friends. They are more likely to drink frequently 
when they have more spending money and are more likely to engage 
in substance misuse if their parents or friends use alcohol or tobacco 
(Chang et al., 2008). Similarly, along with their Chinese American 
counterparts, acculturation is not a significant predictor of drinking for 
Korean American teenagers. Peer influence, scholastic achievement or 
aspirations, and current smoking habits are stronger predictors (Cook 
et al., 2009). Contrary to their Chinese American counterparts, gender 
difference does not significantly change the measure of alcohol use 
among Korean American teenagers. 

Regarding smoking, a 2002 study (Price et al.) found that 33.5% of 
Korean Americans use cigarettes, which is higher than the percentage 
of Caucasian Americans who do so (30%). Moreover, from 2010 to 
2013, the prevalence of cigarette use among Korean Americans was 
20%, a number that is almost twice the average of the aggregate Asian 
American population (10.9%) in the same period. This means the risk 
of cigarette smoking among Korean Americans is comparable to other 
higher-risk U.S. demographic groups (Martell, Garrett, and Caraballo, 
2016 as cited in Ahmmad & Adkins, 2021).

JAPANESE AMERICANS

As discussed above, the use of alcohol among Japanese American 
youth is prevalent (Kane et al., 2017). The influence of acculturation to 
U.S. cultural norms is especially significant for Japanese Americans and 
their relationship with alcohol and substance use (Ahmmad & Adkins, 
2021). The drinking culture of their country of origin is also a significant 
determining factor (Cook et al., 2015). These findings are unsurprising 
since Japan is to this day known for its drinking culture. The drinking 
culture in Japan has become so normalized that the Japanese 
government encouraged its younger generation to drink more to support 
the alcohol industry during the COVID-19 pandemic, exacerbating the 
existing prolific drinking culture (Hida & Yoon, 2022). 

A separate study in Hawaii indicates that the onset of smoking and 
drinking among Japanese American students is closely associated with 
Japanese culture. The findings emphasize that although acculturation 
is an influential factor, nationality and level of education have stronger 
associations with smoking, and education is a stronger predictor of 
alcohol use (Tomioka & Maddock, 2007). This research shows that social 
workers are needed to ensure a quality of education which centers 
the experiences of East Asian Americans, namely concerning their 
experience in American public education. 

MULTIETHNICITY ASIAN AMERICANS & PART-ASIAN 
AMERICANS

Literature (cited in Ahmmad & Adkins, 2021) shows that marriages 
between two Asian ethnicities and between Asians and other racial 
or ethnic groups are increasing, resulting in more youth identifying as 
multiple Asian ethnicities (e.g. Vietnamese and Chinese).

These individuals often identify as multiracial (e.g. Japanese and white); 
however, there is no research exploring the prevalence and patterns 
of substance use among these groups. The failure to consider Asian 
identities beyond mono-ethnic and mono-racial studies will increasingly 
create confusion and misinterpretations regarding the relationships 
between race, ethnicity, and substance use.

TREATMENT CHALLENGES AND RECOMMENDED 
TREATMENT APPROACHES

Unfortunately, research on treatment approaches for Asian Americans, 
including East Asian Americans and particularly EAA youth, is limited. 
Regardless, available studies do show that Asian Americans have 
certain preferences for substance use treatment (Wang & Kim, 2010). 
Most studies group East Asian Americans with other Asian American 
subgroups. Regardless, there is a common denominator showing Asian 
Americans require culturally appropriate care and approaches that take 
into consideration discrimination based on race and ethnicity.

ALCOHOL AND SUBSTANCE USE AMONG EAST ASIAN AMERICAN YOUTH ADELA JANSEN



COLUMBIA SOCIAL WORK REVIEW, VOL. XXII  |   125   124  |  COLUMBIA SOCIAL WORK REVIEW, VOL. XXII

CULTURALLY-APPROPRIATE CARE

Research shows that when Asian Americans participate in therapy 
services, they are more likely to drop out than their white counterparts 
(Wang & Kim, 2010 as cited in Ong, 2023). One potential explanation 
for this may be the cultural practice of shaming substance use and 
mental illness and the pressure to maintain the family’s image. These 
tendencies may cause families to encourage their youth to avoid going 
to professionals and choose to address these issues in private or deny 
their existence altogether (Gateway Foundation, n.d.; Gemme, 2023). 
Hence, the Asian American population as a whole can benefit from 
family support for people who misuse substances, open discussion 
of the cultural stigma of substance-use problems, and culturally 
appropriate localized knowledge of drug misuse (Lee et al., 2004). 

Due to the aforementioned reasons, Asian Americans are less likely 
to seek help and treatment services compared to other racial groups 
(Guarnotta, 2023; Spencer et al., 2010). In fact, only 3.3% of Asian 
Americans needing substance abuse treatment receive such treatment 
(SAMHSA, 2019). Compared to the rest of the country, Asian Americans 
are three times less likely to seek and receive treatment compared to 
the general population (SAMHSA, 2014 as cited in Kaliszewski, 2022). 
Therefore, more outreach efforts regarding treatment options and 
processes are needed in the communities of EAA youth. 

As such, Asian Americans would benefit from shame and stigma 
reduction programs. Two studies in 2007 and 2013 on Japanese 
American youth highlight the need for culturally specific interventions for 
Japanese, Japanese American, and part-Japanese American teenagers 
and youth. Culturally appropriate care requires therapy providers to 
better understand the influences and effects that culture, ethnicity, 
and regional customs have on alcohol and substance use among 
adolescents (Tomioka & Maddock, 2007; Williams et al., 2013). 

As treatment adherence is also associated with how much the client 
can relate to and understand the treatment provider’s explanation 

of symptoms and illnesses, treatment providers should be trained 
in acknowledging and understanding the existence, prevalence, 
manifestation, and treatment of Asian culture-specific syndromes. 
Examples of these include:

"hwa-byung" (Korean syndrome similar to, yet different from 
DSM-IV major depression), "taijin kyofyusho" (Japanese disorder 
similar to, yet different from DSM-IV social phobia), and "koro" 
(Southeast Asian syndrome now referred to as genital retraction 
syndrome in the global mental health literature) [which] are 
all psychological disorders that have been documented in 
Asian-Americans/Pacific Islanders. Clinicians unaware of such 
disorders are at higher risk for misdiagnosing such problems 
and, thus, implementing culturally inappropriate interventions. 
(Iwamasa, 2012, Inadequacies section)

Additionally, American treatments and methodologies may be dismissive 
of culturally specific healing practices that are unknown or unfamiliar 
in the U.S. Treatment providers must not only be aware of culturally 
specific practice, but also understand how Asian healing practices 
have been ignored and looked down upon. Asian American youth who 
grow up in the U.S. may have complicated feelings regarding these 
practices. All in all, providers can use this as an opportunity to explore 
the complexities of discrimination and healing instead of ignoring them.

OPPRESSION AND DISCRIMINATION

Due to the myth of the model minority, oppression and racism can also 
be the causes of mental health issues and substance use among Asian 
Americans. Asian Americans and Pacific Islanders often experience 
discrimination in their places of employment, where they may 
experience the “glass ceiling effect:” 

Although trained and competent, in many companies, Asian 
Americans and Pacific Islanders find it difficult to move beyond 
mid-level positions. Stereotypes of Asian-American/Pacific 

ALCOHOL AND SUBSTANCE USE AMONG EAST ASIAN AMERICAN YOUTH ADELA JANSEN



COLUMBIA SOCIAL WORK REVIEW, VOL. XXII  |   127   126  |  COLUMBIA SOCIAL WORK REVIEW, VOL. XXII

Islander employees as being smart, hardworking, and reliable, 
yet passive and quiet, result in many individuals being passed 
over for much-deserved promotions and recognition. Implications 
for negative effects on self-worth are clear. (Iwamasa, 2012, 
Oppression section)

Accordingly, the American Psychological Association recommends 
treatment providers serving the Asian American population be aware of 
inaccurate historical stereotypes and myths of Asian Americans (e.g. the 
Model Minority Myth). Treatment providers should gain knowledge of the 
diversity in educational and occupational achievement, socioeconomic 
status, and the frequent need for family members to have multiple jobs 
to make ends meet among Asian Americans (Iwamasa, 2012). As in 
treatments with any other racial group, treatment providers should not 
make assumptions regarding a client’s experiences and how much an 
Asian American individual adheres to their cultural values and practices. 
Thus, recruiting treatment providers who identify as East Asian American 
and have lived experiences similar to EAA youth is extremely beneficial–
although not always required. Additionally, hiring treatment providers 
who speak East Asian languages is important. Although language 
barriers can generally be a challenge for Asian Americans who are 
recent immigrants as well as first-generation EAA youth, it may not be a 
challenge for second and third-generation EAA youth. 

Lastly, treatment providers should be aware of the common 
substances used by EAA youth. For instance, between 2000 and 
2010, methamphetamine and marijuana were the two most commonly 
reported illicit drugs among Asian Americans (SAMHSA, 2014 as 
cited in Guarnotta, 2023). Part of exercising due diligence in providing 
the best support for Asian American youth includes recognizing the 
common causes of substance misuse among different EAA ethnicities 
as outlined in this paper. For example, alcohol misuse among Korean 
American youth is mostly a peer-reinforced phenomenon (Nakashima 
& Wong, 2000). Hence, strategies and goals have to be set accordingly 
depending on the tendencies of each population.

PREFERENCES FOR PREVENTION APPROACHES
RESILIENCY-FOCUSED PREVENTION PROGRAMS

A 2004 study on perceptions of substance use in Asian American 
communities, namely the Chinese, Indian, Korean, and Vietnamese 
populations, shows that these populations lack interest in using support 
groups such as Alcoholics Anonymous or Narcotics Anonymous 
because of their cultural preferences to confide in family and friends 
(Lee et al., 2004). The study recommends drug-prevention programs for 
the Asian American population to focus on a range of other available 
treatment options as well as the pros, cons, and feasibility of using 
personal resources to address substance-use problems. Also, Asian 
American populations tend to respond favorably to topics such as 
wellness, health promotion, and resiliency (Fang & Schinke, 2013). 
As such, family-based prevention programs focusing on strength and 
resiliency rather than pathology and deficits may be particularly relevant 
to East Asian Americans.

Asian American participants in another study reported they would be 
more attracted to programs made specifically for Asian Americans, 
but very few such programs exist. Schools and community centers 
(e.g., health clinics, YMCA, etc.) were the most frequently mentioned 
locations to hold such a program. Some participants felt an online 
program that targeted the Asian community would be appropriate, and 
some also showed preferences for family-based programs (Fang et al., 
2011). However, other participants noted that Asian parents’ “ordering” 
communication style tends to create a negative atmosphere and tense 
relationships with their children even in treatment settings. Many also 
mentioned that Asian American parents are generally more focused 
on their children’s academic performance than other supplemental or 
extracurricular activities, so parents may overlook the need for a family-
based prevention program.

ALCOHOL AND SUBSTANCE USE AMONG EAST ASIAN AMERICAN YOUTH ADELA JANSEN



COLUMBIA SOCIAL WORK REVIEW, VOL. XXII  |   129   128  |  COLUMBIA SOCIAL WORK REVIEW, VOL. XXII

FURTHER RESEARCH

Generally, there needs to be more research on the preferences of 
Asian American individuals for prevention approaches. One consistent 
finding among most Asian American subgroups is the importance of 
considering the perspectives of the family. Consequently, ensuring that 
treatment approaches are aligned with an individual’s family preferences 
and culture is crucial. There is a lack of research on prevention among 
Taiwanese Americans and other ethnicities with smaller populations 
such as Hong Kong Americans, Macau Americans, and Mongolian 
Americans. Moreover, due to the minute population of North Korean 
Americans, the term Korean Americans generally refers to South Korean 
Americans, although North Korean Americans have distinctly different 
alcohol and substance use behaviors in their country of origin. 

There is minimal research and data on effective treatments for East 
Asian Americans, much less EAA youth. More and updated research, 
as well as disaggregated data alongside studies on appropriate 
treatment approaches, specifically on EAA youth, is needed for public 
health professionals, social workers, and treatment providers to create 
appropriate policies and programs to help EAA youth who require 
support. Future research must look into separate Asian American 
subgroups/ethnicities and consider the distinct cultural differences 
among these groups. Research must also include South and Southeast 
Asian subgroups, especially groups with a high population in the U.S. 
(i.e. Filipino Americans and Vietnamese Americans). Ultimately, efforts 
for further research are increasingly needed as these populations 
continue to grow. 

CONCLUSION

There are clear differences in substance use between ethnicities that 
fall under the East Asian American term or identity, notwithstanding 
the similarities among Chinese American, Taiwanese American, Korean 
American, and Japanese American youth, which include less likelihood 
to seek help and a higher likelihood to drop out of therapy services 

compared to their white counterparts. Differences such as drinking 
habits and social norms are influential determinants for higher-risk 
ethnicities such as Korean Americans and Japanese Americans. Due to 
the history of systemic racism against Asian Americans, more advocacy 
and cultural representation in treatment, such as understanding culture-
specific explanations of certain symptoms and illnesses, is necessary 
(Gemme, 2023). On a macro level, efforts to dismantle stereotypes 
and the Model Minority Myth are also necessary as these can lead to 
mental health issues and substance use among Asian Americans. Lastly, 
the familiarity of providers with the treatment preferences of the Asian 
American population may improve treatment adherence and willingness 
to continue treatment. Consideration of family perspectives on treatment 
approaches and acknowledging the pressure from stigmatization of 
mental health among Asian Americans is crucial to the well-being of this 
community.

REFERENCES

Ahmmad, Z., & Adkins, D. E. (2021). Ethnicity and acculturation: Asian American 
substance use from early adolescence to mature adulthood. Journal of Ethnic and 
Migration Studies, 47(19). https://doi.org/10.1101/19002048 

Asia Society. (n.d.). East Asia. https://asiasociety.org/countries-regions/east-
asia#:~:text=East%20Asia%20includes%20China%2C%20Hong,territories%20
can%20be%20found%20below   

Blackburn, S.-S. (2019, March 21). What Is the Model Minority Myth? Southern Poverty 
Law Center: Learning for Justice. https://www.learningforjustice.org/magazine/what-is-
the-model-minority-myth  

Budiman, A., & Ruiz, N. G. (2021, April 9). Asian Americans are the fastest-growing racial 
or ethnic group in the U.S. Pew Research Center. https://www.pewresearch.org/short-
reads/2021/04/09/asian-americans-are-the-fastest-growing-racial-or-ethnic-group-in-
the-u-s/   

Chang, J., Shrake, E., & Rhee, S. (2008). Patterns of alcohol use and attitudes toward 
drinking among Chinese and Korean American college students. Journal of Ethnicity in 
Substance Abuse, 7(3), 341–356. https://doi.org/10.1080/15332640802313346  

Cook, W. K., Hofstetter, C. R., Kang, M., Hovell, M. F., & Irvin, V. (2009). Rethinking 
acculturation: A study of alcohol use of Korean American adolescents in 
Southern California. Contemporary Drug Problems, 36(1–2), 217–244. https://doi.
org/10.1177/009145090903600111 

ALCOHOL AND SUBSTANCE USE AMONG EAST ASIAN AMERICAN YOUTH ADELA JANSEN



COLUMBIA SOCIAL WORK REVIEW, VOL. XXII  |   131   130  |  COLUMBIA SOCIAL WORK REVIEW, VOL. XXII

Cook, W. K., Karriker-Jaffe, K. J., Bond, J., & Lui, C. (2015). Asian American problem 
drinking trajectories during the transition to adulthood: Ethnic drinking cultures and 
neighborhood contexts. American Journal of Public Health, 105(5), 1020–1027. https://
doi.org/10.2105/ajph.2014.302196  

Fang, L., & Schinke, S. P. (2013). Two-year outcomes of a randomized, family-based 
substance use prevention trial for Asian American adolescent girls. Psychology of 
Addictive Behaviors, 27(3), 788–798. https://doi.org/10.1037/a0030925  

Fang, L., Barnes-Ceeney, K., Lee, R. A., & Tao, J. (2011). Substance use among Asian-
American adolescents: Perceptions of use and preferences for prevention programming. 
Social Work in Health Care, 50(8), 606–624. https://doi.org/10.1080/00981389.2011.58
8115  

Gateway Foundation. (n.d.). Addiction Recovery for Asian Americans. https://www.
gatewayfoundation.org/addiction-blog/asian-american-drug-abuse/ 

Gemme, M. (2023, June 19). Asian American discrimination and substance use. Drug 
Rehab Services. https://www.addicted.org/asian-american-discrimination-and-
substance-abuse.html 

Guarnotta, E. (2023, June 2). A guide to drug addiction & recovery for Asian Americans. 
American Addiction Centers. https://recovery.org/addiction/demographics/asian-
americans/    

Hida, H., & Yoon, J. (2022, August 19). Drink up, Japan tells young people. I’ll pass, many 
reply. The New York Times. https://www.nytimes.com/2022/08/19/world/asia/japan-
alcohol-contest.html 

Iwamasa, G. Y. (2012). Recommendations for the treatment of Asian-American/Pacific 
Islander populations. American Psychological Association. https://www.apa.org/pi/
oema/resources/ethnicity-health/asian-american/psychological-treatment  

Jin, C. H. (2021, May 25). 6 charts that dismantle the trope of Asian Americans as a model 
minority. NPR. https://www.npr.org/2021/05/25/999874296/6-charts-that-dismantle-the-
trope-of-asian-americans-as-a-model-minority   

Juang, L. P., & Nguyen, H. H. (2009). Misconduct among Chinese American 
adolescents. Journal of Cross-Cultural Psychology, 40(4), 649–666. https://doi.
org/10.1177/0022022109335185  

Kaliszewski, M. (2022, September 14). Alcohol and drug abuse among Asian Americans. 
American Addiction Centers. https://americanaddictioncenters.org/addiction-statistics/
asian-americans 

Kane, J. C., Damian, A. J., Fairman, B., Bass, J. K., Iwamoto, D. K., & Johnson, R. 
M. (2017). Differences in alcohol use patterns between adolescent Asian American 
ethnic groups: Representative estimates from the National Survey on Drug Use and 
Health 2002–2013. Addictive Behaviors, 64, 154–158. https://doi.org/10.1016/j.
addbeh.2016.08.045  

Lee, M. Y., Law, P. F., & Eo, E. (2004). Perception of substance use problems in Asian 
American communities by Chinese, Indian, Korean, and Vietnamese populations. 
Journal of Ethnicity in Substance Abuse, 2(3), 1–29. https://doi.org/10.1300/
j233v02n03_01

Martell, B. N., Garrett, B. E., & Caraballo, R. S. (2016). Disparities in adult cigarette 
smoking — United States, 2002–2005 and 2010–2013. MMWR: Morbidity and Mortality 
Weekly Report, 65(30), 753–758. https://doi.org/10.15585/mmwr.mm6530a1 

Nakashima, J., & Wong, M. M. (2000). Characteristics of alcohol consumption, correlates 
of alcohol misuse among Korean American adolescents. Journal of Drug Education, 
30(3), 343–359. https://doi.org/10.2190/xv42-mw3u-vgy9-7m0x  

National Survey on Drug Use and Health. (2021, October 3). Racial/ethnic differences in 
substance use, substance use disorders, and substance use treatment utilization among 
people aged 12 or older (2015-2019). Retrieved from Substance Abuse and Mental 
Health Services Administration. https://www.samhsa.gov/data/report/racialethnic-
differences-substance-use  

Ong, S. (2023). Differences in therapy satisfaction among East Asian and Southeast Asian 
Americans. ProQuest Dissertations & Theses Global. 

Price, R. K., Risk, N. K., Wong, M. M., & Klingle, R. S. (2002). Substance use and abuse 
by Asian Americans and Pacific Islanders: Preliminary results from four national 
epidemiologic studies. Public Health Reports, 117(1), S39–S50.

Ryabov, I. (2015). Relation of peer effects and school climate to substance use among 
Asian American adolescents. Journal of Adolescence, 42, 115–127. https://doi.
org/10.1016/j.adolescence.2015.04.007 

Saraiya, T., Smith, K. Z., Campbell, A. N. C., & Hien, D. (2019). Posttraumatic stress 
symptoms, shame, and substance use among Asian Americans. Journal of Substance 
Abuse Treatment, 96, 1–11. https://doi.org/10.1016/j.jsat.2018.10.002 

Spencer, M. S., Chen, J., Gee, G. C., Fabian, C. G., & Takeuchi, D. T. (2010). Discrimination 
and mental health–related service use in a national study of Asian Americans. American 
Journal of Public Health, 100(12), 2410–2417. https://doi.org/10.2105/ajph.2009.176321  

Spruijt-Metz, D., & Hsia, F.-N. (2003). The meanings of smoking among Chinese American 
and Taiwanese American college students. Nicotine & Tobacco Research, 5(6), 837–850. 
https://doi.org/10.1080/14622200310001615259  

Substance Abuse and Mental Health Services Administration (SAMHSA). (2013). National 
survey of drug use and health: Alcohol use in lifetime, past year, and past month among 
persons aged 12 to 17, by demographic characteristics: Percentages, 2012 and 2013. 
https://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs2013/NSDUH-
DetTabs2013.htm#tab2.38b/  

ALCOHOL AND SUBSTANCE USE AMONG EAST ASIAN AMERICAN YOUTH ADELA JANSEN



COLUMBIA SOCIAL WORK REVIEW, VOL. XXII  |   133   132  |  COLUMBIA SOCIAL WORK REVIEW, VOL. XXII

Substance Abuse and Mental Health Services Administration (SAMHSA). (2014). 
A treatment improvement protocol: Improving cultural competence treatment 
improvement protocol (TIP) series No. 59. Substance Abuse and Mental Health Services 
Administration Center for Substance Abuse Treatment.

Tomioka, M., & Maddock, J. (2007). Predictors of smoking and alcohol use in Japanese 
and Japanese-American college students. Californian Journal of Health Promotion, 5(2), 
45–57. https://doi.org/10.32398/cjhp.v5i2.1231  

United States Census Bureau. (2021). 2019 American Community Survey 1-year estimates.

Wallace, J. M., Bachman, J. G., O’Malley, P. M., Schulenberg, J. E., Cooper, S. M., & 
Johnston, L. D. (2003). Gender and ethnic differences in smoking, drinking and illicit 
drug use among American 8th, 10th and 12th grade students, 1976-2000. Addiction, 
98(2), 225–234. https://doi.org/10.1046/j.1360-0443.2003.00282.x  

Wang, S., & Kim, B. S. K. (2010). Therapist multicultural competence, Asian American 
participants’ cultural values, and counseling process. Journal of Counseling Psychology, 
57(4), 394–401. https://doi.org/10.1037/a0020359 

Williams, J. K. Y., Else, ’Iwalani R. N., Goebert, D. A., Nishimura, S. T., Hishinuma, E. S., 
& Andrade, N. N. (2013). A confirmatory model for substance use among Japanese 
American and part-Japanese American adolescents. Journal of ethnicity in substance 
abuse. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3923518/ 

ALCOHOL AND SUBSTANCE USE AMONG EAST ASIAN AMERICAN YOUTH ADELA JANSEN


