Increasing Awareness of Smoking Cessation Needs among Michigans Multicultural Populations

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Increasing Awareness of Smoking Cessation Needs
among Michigans Multicultural Populations

• Findings from the Michigan Multicultural Tobacco
  Prevention Network (MCN)
• Focus Group Study
• The MCN is comprised of Arab American and
  Chaldean Council (ACC), Arab Community Center for
  Economic and Social Services (ACCESS), The Asian
  Center, Faith Access to Community Development
  (FACED), Latino Family Services, and South
  Eastern Michigan Indians, Inc. (SEMII) Though
  not a member of the MCN, Migrant Health Promotion
  also participated in this study.

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Background OverviewDinah Ayna, ACCESS

• Minorities in Michigan lack culturally
  appropriate and effective smoking cessation
  models
• MCN agencies recognized the need to determine
  such a model
• Focus group study was designed and conducted

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MethodsDinah Ayna, ACCESS

• 7 groups were conducted, one per agency
• Participants
• Total 59
• Selection identified by agency staff
• Compensation received 25.00 stipend for
  completion of focus group
• Tools
• Six questions guided the discussion
• Language was used as appropriate Arabic, Chinese
  and Spanish translations

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Arab/Chaldean AmericansWali AlTahif, ACC

• Quitting History
• Obstacles to Quit
• Support to Quit
• Role of Family
• Challenges Faced when Quitting
• Moderator Insights

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Arab/Chaldean AmericansWali AlTahif, ACC

• Groups conducted at ACC and ACCESS
• 18 total participants (11 females and 7 males)
• Years of tobacco use ranged from 3 to 30 years
  (average 16 years)
• 22 (4) of the participants report smoking the
  arghileh alone (hookah or water pipe)
• 78 (14) participants smoke arghileh or cigars,
  in combination with cigarettes

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Arab/Chaldean AmericansSupport to Quit

• Belief that success with quitting is dependent on
  the individuals willpower (regardless of support
  provided)
• Support that would be helpful
• socializing with people who do not smoke
• being a part of a group of people who are
  quitting together
• workshop about quitting smoking
• talking with someone who has been successful with
  quitting
• availability of facilities for exercise
• NOT helpful
• information about the harmful effects of smoking
• getting advice

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Challenges faced in the Arab/Chaldean American
Community

• Smoking is a social custom
• Cultural practice to offer guests the hookah and
  to smoke the hookah when it is offered
• Disrespectful to ask a guest not to smoke in the
  home.
• Conflicting opinions about the culture
• The opinion that Arab/Chaldean persons do not
  respect the laws/boundaries in relation to not
  smoking
• Some adults are concerned about children smoking
  and refrain from smoking in the presence of
  children
• Some adults share arghileh with minors in their
  company

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Asian AmericansDr. Douglas Chung, Asian Center

• Quitting History
• Obstacles to Quit
• Support to Quit
• Role of Family
• Challenges Faced when Quitting
• Moderator Insights

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Asian AmericansObstacles to Quit

• Peer pressure/social influence
• Means of socializing with friends, guests, and
  business acquaintances
• Difficult to reject a cigarette that is offered
  by a friend or one that is shared with a friend
  or coworker
• Lack of willpower
• Decisive mind is important
• Belief that the individual has to make the
  decision to quit to be successful
• Cultural Factors
• I am the main bread winner
• I am entitled to have this treatment
• Age as an issue old enough

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Challenges faced in the Asian American Community

• The influence of the peer group
• Working environment
• Industries (such as the restaurant business)
  where smoking is used for stress relief or as a
  major factor in business hospitality.
• Culture as an obstacle and an opportunity

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African AmericansAbby White, FACED

• Quitting History
• Obstacles to Quit
• Support to Quit
• Role of Family
• Challenges Faced when Quitting
• Moderator Insights

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Challenges faced in the African American Community

• Being taken advantage of by tobacco companies and
  those who sell cigarettes
• Underlying racism in the advertisement and sale
  of tobacco
• Educating the youth and having a strong community
  leader were suggestions from participants

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African Americans Moderator Insights

• Participants felt they are targeted by tobacco
  companies through advertisements.
• There is high prevalence in Urban neighborhoods
• Advertisement strategically catered to their
  desires for success and good life
• There would not be enough community support to
  stop marketing activities because of the strong
  advertisement in Urban communities.
• Participants felt smoking addiction should be
  treated the same as drug addiction.
• Participants expressed a strong desire for
  support groups to help with the tobacco
  addiction.

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Hispanic / Latino Americans Hispanic Migrant
WorkersTori Booker, Migrant Health Promotion

• Quitting History
• Obstacles to Quit
• Support to Quit
• Role of Family
• Challenges Faced when Quitting
• Moderator Insights

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Hispanic/Latino Americans Hispanic Migrant
Workers Quitting History

• Hispanic / Latino
• Efforts to quit smoking cigarettes lead to the
  use of cigars, water pipes, and marijuana

• Hispanic Migrant Worker
• Length of tobacco use ranged from a few months to
  16 years (average of 10 years)
• Most reported smoking cigarettes while at least
  one participant reported using snuff
• Three of the participants were former smokers

• Common to both groups
• Most participants have made repeated attempts to
  quit

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Hispanic/Latino Americans Hispanic Migrant
Workers Obstacles to Quit

• Hispanic / Latino
• Use smoking as a coping mechanism for managing
  anxiety and stressful situations

• Hispanic Migrant Worker
• Cost of smoking cessation medications

• Common to both groups
• Habit of smoking a cigarette in certain
  situations. Alcohol
• identified as a trigger in the Migrant
  population.
• Addiction and the Intense Cravings
• ?Its something that the nicotine has that
  forces you to think
• that you have to have it.
• ?Use alternatives such as cigars, water pipes,
  marijuana
• while try to quit cigarettes
• ?Switched to smoking light or ultra light
  cigarettes

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Hispanic/Latino Americans Hispanic Migrant
Workers Support to Quit

• Hispanic / Latino
• Support from people who have quit
• Culturally relevant programs

• Hispanic Migrant Worker
• Use of candy and beverages to keep from smoking
• Avoid the consumption of alcoholic beverages

• Common to both groups
• Access to low cost smoking cessation medications,
  like the patch

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Hispanic/Latino Americans Hispanic Migrant
Workers Role of the Family

• Hispanic / Latino

• Hispanic Migrant Worker
• Financial support

• Common to both groups
• The family was esteemed as the most important
  support
• system.
• Family is a major influencing factor in the
  decision to use
• tobacco. Not sure what role the family
  could play when
• the family members also smoke.
• Children were mentioned as a key motivation to
  stop
• smoking and live a healthier lifestyle.
  Children can ask
• them not to smoke and give reminders that
  it is bad for
• them.

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Hispanic/Latino Americans Hispanic Migrant
Workers Challenges to Quitting

• Hispanic / Latino
• Lack of culturally relevant smoking cessation and
  prevention programs
• Living in urban neighborhoods
• More liquor stores and bars, which lead to
  increased alcohol use, which provokes tobacco use
• Advertisements which link alcohol consumption and
  tobacco use to a fun and carefree lifestyle

• Hispanic Migrant Worker
• No cessation programs which involve the family or
  church

• Common to both groups
• Strength Culture promotes abstinence from
  tobacco
• Tobacco use is frowned upon and discouraged
  (The exception to this standard is individuals
  who grew up in a household where the parents
  smoked).
• Shame and embarrassment Sometimes pressure from
  the family make a person smoke because of the
  feelings of separation and failure

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Hispanic/Latino Americans Hispanic Migrant
Workers Moderator Insights

• Hispanic / Latino
• Sense of failure due to repeated unsuccessful
  efforts to quit smoking and lack of willpower
• Culturally imposed emphasis on willpower and
  self-determination
• The family seems to function as both a trigger
  and inhibitor to smoking.

• Hispanic Migrant Worker
• Importance of cultural events, like
  Quinceañeras, where smoking is oftentimes
  present, is challenging for people who are
  attempting to quit.
• Notable lack of awareness about formal tobacco
  cessation resources including educational or
  support programs or tools apart from the Patch.

• Common to both groups
• Difficult for participants to initially identify
  challenges to tobacco use cessation. They were
  able to identify what their triggers for
  smoking are, but did not necessarily acknowledge
  them as triggers

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Native AmericansSue Parrish, South Eastern
Michigan Indians, Inc.

• Quitting History
• Obstacles to Quit
• Support to Quit
• Role of Family
• Challenges Faced when Quitting
• Moderator Insights

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Challenges to Quitting in the Native American
Community

• Have a need to use tobacco to relieve stress
• Addicted to commercial tobacco
• Aware that tobacco is sacred medicine and they
  are not using is properly
• Tobacco is a sacred medicine, and a powerful
  one. When it is used to pray with, the results
  are powerful. When abused, the results are
  devastating, what it does to the human body.

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Native Americans Moderator Insights

• Participant recruitment was difficult because
  people thought they were going to make them stop
  smoking
• Many of the participants began smoking as a
  coping mechanism during military service
• Concerned that by quitting smoking they will
  develop another habit such as eating or gambling

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Increasing Awareness of Smoking Cessation Needs
among Michigans Multicultural Populations Dinah
Ayna, ACCESS

• Findings Across Groups / Results
• Recommendations
• In Your TFM Packet
• Copy of full MCN Smoking Cessation Report
• Complete summary of the Report and this
  presentation in powerpoint handout

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Michigan Multicultural Tobacco Prevention Network
(MCN) Co-Authors Contact Information

• Arab American and Chaldean Council (ACC)
• 62 W. 7 Mile, Detroit, MI 48203
• Wali Altahif [phone]
• Arab Community Center for Economic Social
  Services (ACCESS)
• 6450 Maple Road, Dearborn, MI 48126
• Bashar Shamo / Dinah Ayna [phone]
• Asian Center
• 1444 Michigan St NE, Grand Rapids, MI 49503
• Dr. Douglas Chung / Elizabeth MacLachlan -
  [phone]
• Faith Access to Community Economic Development
  (FACED)
• 310 E. Third St., 5th Floor, Flint, MI 48502
• E. Yvonne Lewis / Abby White [phone]

• Latino Family Services
• 3815 W. Fort, Detroit, MI 48216
• Mitzi Cortes / Maria Thacker- [phone]
• Migrant Health Promotion
• 224 West Michigan Ave., Saline, MI 48176
• Tori Booker [phone]
• South Eastern Michigan Indians, Inc. (SEMII)
• 26641 Lawrence, Center Line, MI 48015
• Euphemia "Sue" Parrish [phone]

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THANK YOU!

• Questions???