Smoking Behavior in Arab Americans: Acculturation and Health Beliefs

Background: Arab Americans, a growing population in the U.S., tend to have high rates of smoking and low rates of smoking cessation. Arab Americans and their families are at a high risk for poor health outcomes related to smoking. Objective: The purpose of this study is to better understand the smoking behaviors of Arabs in the U.S., using the two publishable manuscripts format. The first manuscript is a systematic review of the literature exploring the smoking behavior, prevalence and use among Arab Americans and examining studies addressing the effect of acculturation on this behavior. The second manuscript is a cross-sectional quantitative study investigating factors influencing desire to quit smoking among Arab Americans, and their association with acculturation and health beliefs. Results: The majority of the studies included in the first manuscript focused on smoking prevalence and cessation. Some discussed the impact of acculturation and health beliefs only two smoking cessation programs have been developed. Thus a cross-sectional descriptive study among adult Arab American smokers was conducted to measure tobacco use, nicotine dependence, desire to quit smoking, acculturation, and health beliefs. The desire to quit smoking was positively associated with perceived severity and susceptibility to cancer, perceived benefits of quitting smoking; and negatively associated with smoking barriers and nicotine dependence. Being female, having lower level of nicotine dependence, and higher perception of cancer severity predicted higher desire to quit smoking. Conclusion: Smoking cessation intervention studies need to target appropriate health beliefs, especially cancer severity of smoking among male Arab Americans

Comparison of Barriers to Cessation among Arab American Smokers of Cigarettes and Waterpipe

This cross-sectional study examined the differences in barriers to cessation and reasons for quitting smoking among dual smokers of cigarettes and waterpipe tobacco, exclusive cigarette smokers and exclusive waterpipe smokers. Participants were Arab American adults residing in Richmond, Virginia, who were recruited from Middle Eastern grocery stores, restaurants/lounges and faith and charity organizations. The study yielded several key findings: (1) Exclusive cigarette and waterpipe smokers had similar mean barriers to quitting and were more concerned about their health than dual smokers. (F(2, 150) = 5.594, p = 0.0045). This implies that barriers to smoking and health concerns could be a function of the individual who smokes rather than the modality of smoking itself. (2) Exclusive cigarette or waterpipe smokers and dual smokers may have different reasons for quitting, since they have different reasons for smoking. The proportion of smokers who endorsed smoking as a messy habit as the reason among exclusive cigarette smokers was 0.37, whereas the proportion among exclusive waterpipe smokers was 0.04 and among dual smokers 0.39. The difference in proportions is significant, χ2 (df = 2, N = 154) = 13.17, p = 0.0014. In summary, this study supports the need to further investigate dual cigarette and waterpipe smokers, as the study results indicate greater barriers to smoking cessation in this group. Recognition and understanding of these barriers among dual tobacco users would be important for any future tobacco intervention among waterpipe smokers

Effectiveness of a Culturally-Tailored Smoking Cessation Intervention for Arab-American Men

To date, no smoking cessation programs are available for Arab American (ARA) men, who are a vulnerable population with high rates of smoking. Thus, the primary aim of this one group pre-test/post-test study was to assess the effectiveness of Sehatack—a culturally and linguistically tailored smoking cessation program for ARA men. The study sample was 79 ARA men with a mean age of 43 years who smoked between 5 and 40 cigarettes (mean = 19.75, SD = 9.1) per day (98.7%). All of the participants reported more interest in smoking cessation post-intervention and many of the participants in the baseline (38.5%) and post-intervention phases (47.7%) wanted to quit smoking ”very much”. For daily smokers who completed the smoking cessation program, the median number of cigarettes smoked daily was significantly lower than those in the post-intervention phase (Z = −6.915, p < 0.001). Results of this preliminary study indicate that: (a) Sehatack may be a promising way for ARA men to quit smoking, and (b) culturally relevant smoking cessation counselors can be trained to recruit and retain ARA smokers in an intensive group smoking cessation program. Strengths of this study were community engagement and rapport between three faith organizations and the University of Florida College of Nursing. However, a larger trial is needed to address study limitations and to confirm benefits in this population

Waterpipe Smoking and Regulation in the United States: A Comprehensive Review of the Literature

Background: Researchers in tobacco control are concerned about the increasing prevalence of waterpipe smoking in the United States, which may pose similar risks as cigarette smoking. This review explores the prevalence of waterpipe smoking in the United States as well as the shortcomings of current U.S. policy for waterpipe control and regulation. Methods: Researchers conducted a literature review for waterpipe articles dated between 2004 and 2015 using five online databases: MEDLINE, CINHAHL, ScienceDirect, PMC, and Cochrane Library. Results: To date, few studies have explored the marketing and regulation of waterpipe smoking in the U.S., which has increased in the last ten years, especially among women, adolescents, and young adults. Data indicate that the majority of waterpipe smokers are unaware of the potential risks of use. In addition, current tobacco control policies do not address waterpipe smoking, enabling tobacco companies to readily market and sell waterpipe products to young adults, who are at risk for becoming lifelong smokers. Conclusion: Policy makers in the area of public health need to update existing tobacco regulations to include waterpipe smoking. Similarly, public health researchers should develop public health campaigns and interventions to address the increasing rates of waterpipe smoking in the United States