A qualitative study on Chinese Canadian male immigrants’ perspectives on stopping smoking: Implications for tobacco control in China

China has the largest number of smokers in the world; more than half of adult men smoke. Chinese immigrants smoke at lower rates than the mainstream population and other immigrant groups do. This qualitative study was to explore the influence of denormalization in Canada on male Chinese immigrant smoking after migration. Semistructured interviews were conducted with 22 male Chinese Canadian immigrants who were currently smoking or had quit smoking in the past 5 years. The study identified that, while becoming a prospective/father prompted the Chinese smokers to quit or reduce their smoking due to concern of the impacts of their smoking on the health of their young children, changes in smoking were also associated with the smoking environment. Four facilitators were identified which were related to the denomormalized smoking environment in Canada: (a) the stigma related to being a smoker in Canada, (b) conformity with Canadian smoking bans in public places, (c) the reduced social function of smoking in Canadian culture, and (d) the impact of graphic health messages on cigarette packs. Denormalization of tobacco in Canada in combination with collectivist values among Chinese smokers appeared to contribute to participants’ reducing and quitting smoking. Although findings of the study cannot be claimed as generalizable to the wider population of Chinese Canadian immigrants due to the small number of the participants, this study provides lessons for the development of tobacco control measures in China to reverse the current prosmoking social environment

The impacts of tobacco control legislation on public view of e-cigarette usage in Macao—The co-word analysis of Macao daily

IntroductionMacao has been certified as a “Healthy City” by the World Health Organization, and has been adhering to the principle of combining prevention with proper medical care to build its medical system. As tobacco epidemic is a risk factor leading to a series of non-communicable diseases, the Macao SAR Government has continuously improved tobacco control measures.MethodsThe data for this study were derived from a news report on “e-cigarettes” published in Macao Daily. Co-word analysis and thematic analysis were conducted to analyze the development of tobacco control legislation against e-cigarettes. Co-word analysis examined the association and frequency of keywords, while thematic analysis identified prevalent themes within the data.ResultsThe study identified three stages of legislation against e-cigarettes: the pre-implementation stage, the early implementation stage, and the epidemic period. Each stage exhibited distinct characteristics and attention toward specific groups, particularly “teenagers” and “students,” increased significantly. Thematic analysis further highlighted the potential issues of drug use and smuggling associated with e-cigarettes.DiscussionThe findings suggest that the Macao SAR Government should prioritize the development of healthy behaviors among adolescents in the context of e-cigarette control. Additionally, considering regional cooperation to promote the “Healthy Bay Area” could be beneficial. Social media platforms and effective data management should be utilized as tools in these efforts

Exploring children’s exposure to household tobacco smoke in rural China

Gender differences are marked in China in terms of smoking prevalence, with over half of Chinese adult men smoking while few women smoke. While studies have suggested that the women’s role be taken into account regarding anti-smoking initiatives, few in-depth studies have exclusively explored women’s constructions of their male family members’ smoking, particularly in rural contexts where smoking is rampant. Using a gender lens, the current study explores the role of mothers of young children to protect their children from exposure to SHS (Secondhand smoke). The study applies a micro-sociological approach using ethnography as the primary research methodology. Fieldwork for the study was conducted between November, 2008 and August, 2009 in a rural area of Central Jiangsu, China. Recruitment of the participants was guided by feminist theory about the values and limitations of the women’s experiences in constructing knowledge about their social life. While mothers of young children were the primary target participants, other family members were also recruited to complement the data from the mothers. In total 16 mothers of young children, four fathers, four grandfathers and five grandmothers were invited to participate in the study. In addition to field observations in home and public settings, interviews carried out with the 29 family members constituted a substantial part of the data. The study revealed that, while father’s smoking was a source of SHS exposure for children in their family, grandfathers’ smoking had become a more important source, posing challenges for mothers in their efforts to protect their children from SHS. Despite limited knowledge about the risks of tobacco smoke to their children’s health, mothers were highly motivated to reduce SHS for their children, who were generally the only child in the family as a result of the one-child policy. The initiation and selection of the strategies to reduce children’s SHS exposure were mediated by gender relationships between mothers and smokers. The lower status of women in the wider social structure, along with the broad acceptance of smoking in the social environment, further limited mothers’ agency in dealing with home smoking. This study calls for re-thinking of the development of home smoking control initiatives which rely solely on expectant/mothers’ roles because of their influence on men’s smoking. Interventions involving family members in a stronger position of power within the family, particularly the grandparents of children, can ease the moral pressure on young mothers to regulate men’s smoking and reduce the potential damage to family harmony caused by junior members’ confronting the smoking behaviours of patriarchal authorities in the family. Furthermore, policies are needed to tackle the pro-smoking culture in rural China

Home smoking restrictions before, during and after pregnancy—a qualitative study in rural China

Worldwide, many nonsmokers (often women and children) are exposed to second-hand smoke (SHS) in home settings, as men retain their traditional power and control within their family and women and children have limited agency to intervene. This study, set up to explore home smoking management in rural China, found that some women were able to positively intervene to restrict men's smoking at three key stages: prior to conception, during their pregnancy and at the early years of their children's lives. By utilizing dominant social, health and political narratives about the importance of raising a healthy child supported by the One-Child Policy in China, combined with the fear of health risks of SHS to young children, the women were able to use their elevated status as bearer and carers of the only children to subvert the pre-eminence of men in domestic environments, enabling them to positively influence home smoking. While this study highlights the possibility for future smoking cessation initiatives in China by incorporating family carers' elevated awareness of protection of children's health in key stages of childhood, there is also a need for further health education, as family members were unsure why they needed to keep children smoke-free, which may partially explain why few households were smoke-free

A qualitative study on unassisted smoking cessation among Chinese Canadian immigrants

It is well-known that majority of smokers worldwide quit smoking without any assistance. This is even more evident among Chinese smokers. The aim of this qualitative study was to explore how Chinese Canadian immigrant men who smoked cigarettes perceived smoking cessation aids and services and how they used any form of the smoking cessation assistance to help them quit smoking. The study was conducted in British Columbia, Canada. Twenty-two Chinese immigrants were recruited by internet advertisement and through connections with local Chinese communities. Ten of the 22 participants were current smokers and the other 12 had quit smoking in the past 5 years. Data were collected using semistructured interviews. Although all participants, including both the ex-smokers and current smokers, had made more than one quit attempt, they rarely used cessation aids or services even after they had immigrated to Canada. The barriers to seeking the cessation assistance were grouped into two categories: practical barriers and cultural barriers. The practical barriers included “Lack of available information on smoking cessation assistance” and “Difficulty in accessing smoking cessation assistance,” while cultural barriers included “Denial of physiological addiction to nicotine,” “Mistrust in the effectiveness of smoking cessation assistance,” “Tendency of self-reliance in solving problems,” and “Concern of privacy revelation related to utilization of smoking cessation assistance.” The findings revealed Chinese immigrants’ unwillingness to use smoking cessation assistance as the result of vulnerability as immigrants and culturally cultivated masculinities of self-control and self-reliance

Exploring children's exposure to household tobacco smoke in rural China

Gender differences are marked in China in terms of smoking prevalence, with over half of Chinese adult men smoking while few women smoke. While studies have suggested that the women’s role be taken into account regarding anti-smoking initiatives, few in-depth studies have exclusively explored women’s constructions of their male family members’ smoking, particularly in rural contexts where smoking is rampant. Using a gender lens, the current study explores the role of mothers of young children to protect their children from exposure to SHS (Secondhand smoke). The study applies a micro-sociological approach using ethnography as the primary research methodology. Fieldwork for the study was conducted between November, 2008 and August, 2009 in a rural area of Central Jiangsu, China. Recruitment of the participants was guided by feminist theory about the values and limitations of the women’s experiences in constructing knowledge about their social life. While mothers of young children were the primary target participants, other family members were also recruited to complement the data from the mothers. In total 16 mothers of young children, four fathers, four grandfathers and five grandmothers were invited to participate in the study. In addition to field observations in home and public settings, interviews carried out with the 29 family members constituted a substantial part of the data. The study revealed that, while father’s smoking was a source of SHS exposure for children in their family, grandfathers’ smoking had become a more important source, posing challenges for mothers in their efforts to protect their children from SHS. Despite limited knowledge about the risks of tobacco smoke to their children’s health, mothers were highly motivated to reduce SHS for their children, who were generally the only child in the family as a result of the one-child policy. The initiation and selection of the strategies to reduce children’s SHS exposure were mediated by gender relationships between mothers and smokers. The lower status of women in the wider social structure, along with the broad acceptance of smoking in the social environment, further limited mothers’ agency in dealing with home smoking. This study calls for re-thinking of the development of home smoking control initiatives which rely solely on expectant/mothers’ roles because of their influence on men’s smoking. Interventions involving family members in a stronger position of power within the family, particularly the grandparents of children, can ease the moral pressure on young mothers to regulate men’s smoking and reduce the potential damage to family harmony caused by junior members’ confronting the smoking behaviours of patriarchal authorities in the family. Furthermore, policies are needed to tackle the pro-smoking culture in rural China.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Caught in a dilemma: why do non-smoking women in China support the smoking behaviors of men in their families?

Intimate relationships influence family members’ health practices. Although cigarette smoking in China is predominantly a male behavior, (non-smoking) women’s roles should be taken into account for the development of home-smoking interventions. Drawing on ethnographic interviews with 22 families in a rural area of China, this article explores non-smoking women’s attitudes towards male smoking. The findings suggest that women’s ability to influence male behavior is largely determined by culturally defined gender roles, underpinned by ideologies of familism and collectivism. Despite concerns about the adverse results of smoking to their family members and households, non-smoking women ultimately maintain the (male) smokers’ argument that smoking plays an important role in construction and maintenance of intra- and extra-family relationships. By accepting male smoking and men’s engagement in the social practice of smoking and cigarette exchanges, women maintain their identities as supportive wives, filial daughters/in-law and responsible family members who pursue family collective interests at the expense of their own personal beliefs. Future smoking control initiatives that target non-smoking women to influence male smoking should take into account the women’s overarching need to maintain the status and harmony of their families

“My Friends are at the Bottom of My Schedule”: A Qualitative Study on Social Health among Nursing Students during Clinical Placement

Clinical placement is an essential component for nursing students, allowing them to transfer professional knowledge into practice. The quality of life among nursing students and nurses was reviewed to examine its impact on the quality of provided care. However, it is unclear how social health among nursing students is affected during clinical placement. Final-year students who had finished clinical placement were invited to participate in this qualitative study. Twenty-one in-depth interviews were conducted and transcribed verbatim for thematic analysis. Two main themes, i.e., contributors to lack of social health, and manifestations of lack of social health, emerged from seven sub-themes. Students experienced different challenges during the clinical placement, but some of these did contribute to effects on their social health. Lack of social health might further influence career development after graduation. Supportive strategies from colleagues, nursing colleges and hospitals might potentially improve students’ social health during the clinical placement

Personal and social determinants sustaining smoking practices in rural China: a qualitative study

Introduction: Tobacco use in China is disproportionally distributed among rural and urban populations with rural people smoking more. While there is a wealth of evidence on the association between tobacco use among rural people and their lower socio-economic status (SES), how social structural factors contribute to rural smoking is not well understood. Guided by a socio-ecological model, the objective of this study was to explore the personal and social determinants that play a key role in sustaining smoking practices among Chinese rural people. Methods: An ethnographic study was conducted in a rural area of Central Jiangsu, China. Participants (n = 29) were recruited from families where there was at least one smoking resident and there were young children. In-depth interviews and unstructured observations were used to collect data, which were then analyzed with an interpretive lens. Results: Although individuals had limited knowledge about the risks of smoking and lack of motivation to quit, social factors were in effect the main barriers to quitting smoking. Cigarette exchange and cigarette gifting permeated every aspect of rural family life, from economic activities to leisure pastimes, in family and wider social interactions. Traditional familism and collectivism interplayed with the pro-smoking environment and supported rural people’s smoking practices at the community level. Living in the rural area was also a barrier to quitting smoking because of the lack of information on smoking cessation and the influence of courtyard-based leisure activities that facilitated smoking. Conclusion: Development of comprehensive smoking cessation interventions in rural China needs to extend beyond an individual level to take into account the social determinants influencing smoking practices.Other UBCReviewedFacult

Chinese immigrant men smokers’ sources of cigarettes in Canada: A qualitative study

Introduction Immigrants often experience economic hardship in their host country and tend to belong to economically disadvantaged groups. Individuals of lower socioeconomic status tend to be more sensitive to cigarette price changes. This study explores the cigarette purchasing patterns among Chinese Canadian male immigrants. Material and Methods Semi-structured in-depth interviews were conducted with 22 Chinese Canadian immigrants who were smoking or had quit smoking in the last five years. Results Because of financial pressures experienced by participants, the high price of Canadian cigarettes posed a significant challenge to their continued smoking. While some immigrants bought fully-taxed cigarettes from licensed retailers, more often they sought low-cost cigarettes from a variety of sources. The two most important sources were cigarettes imported during travels to China and online purchases of Chinese cigarettes. The cigarettes obtained through online transactions were imported by smoking or non-smoking Chinese immigrants and visitors, suggesting the Chinese community were involved or complicit in sustaining this form of purchasing behavior. Other less common sources included Canada-USA cross border purchasing, roll your-own pouch tobacco, and buying cigarettes available on First Nations reserves. Conclusions Chinese Canadian immigrant men used various means to obtain cheap cigarettes. Future research studies could explore more detailed features of access to expose gaps in policy and improve tobacco regulatory frameworks