Article

Contexts of tobacco use and perspectives on smoking cessation among a sample of urban American Indians.

Friends Research Institute (FRI), Social Research Center, Baltimore, MD 21201, USA.
Journal of Health Care for the Poor and Underserved (Impact Factor: 1.1). 01/2010; 21(2):544-58. DOI: 10.1353/hpu.0.0276
Source: PubMed

ABSTRACT American Indians have the highest prevalence of cigarette use in the United States, but there is a shortage of knowledge about American Indians' own perspectives on smoking and cessation. The purpose of this exploratory qualitative study was to obtain information on American Indians' views that would be useful for subsequent intervention planning and development. Four focus groups were conducted with urban American Indians living in Maryland to explore the sociocultural contexts of tobacco use and their perspectives on various mainstream and culturally-specific smoking cessation strategies and service delivery models. Tobacco interventions targeting American Indians should increase service access, address negative experiences with medications, emphasize empowerment for behavior change, explicitly distinguish ceremonial tobacco from cigarette use, and send culturally-relevant messages. Smoking cessation programs and health promotion efforts may be perceived as more relevant by the target population if they incorporate an understanding of the social and cultural facets of smoking behavior.

1 Follower
 · 
65 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Significant advances in tobacco cessation and prevention initiatives have occurred over recent years, yet smoking amongst Indigenous populations remain double that of the relevant non-Indigenous population. As such tobacco use is considered a significant risk factor contributing to health disparities among these populations. Two Cochrane systematic reviews, one evaluating tobacco cessation and the other tobacco prevention initiatives for Indigenous populations summarise the available evidence for use by policy makers, researchers and consumers alike. Culturally tailored tobacco cessation initiatives show evidence of long-term abstinence, however, both cessation and prevention initiatives specifically designed in collaboration with Indigenous cohorts are lacking. Despite the significant health burden attributed to tobacco use including the development of tobacco related illnesses and associated economic expenditures, there remains a paucity of data in this field. Methodologically rigorous collaborative research is needed to highlight the barriers and facilitators for tobacco cessation and prevention programs in order to effectively reduce the prevalence of tobacco use and subsequent co-morbidities. NOTE: This chapter (text, tables and figures) contain excerpts from articles published previously. Please refer to Carson and colleagues (2012a, 2012b and 2012c) in the reference list at the end of this chapter.
    Health Disparities: Epidemiology, Racial/Ethnic and Socioeconomic Risk Factors and Strategies for Elimination, 1 edited by Owen T. Jackson, Kathleen A. Evan, 06/2013: chapter 1: pages 1-38; Nova Publishers., ISBN: 978-1-62618-570-8
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To identify barriers that are common and unique to six selected vulnerable groups: low socioeconomic status; Indigenous; mental illness and substance abuse; homeless; prisoners; and at-risk youth. A systematic review was carried out to identify the perceived barriers to smoking cessation within six vulnerable groups. MEDLINE, EMBASE, CINAHL and PsycInfo were searched using keywords and MeSH terms from each database's inception published prior to March 2014. Studies that provided either qualitative or quantitative (ie, longitudinal, cross-sectional or cohort surveys) descriptions of self-reported perceived barriers to quitting smoking in one of the six aforementioned vulnerable groups were included. Two authors independently assessed studies for inclusion and extracted data. 65 eligible papers were identified: 24 with low socioeconomic groups, 16 with Indigenous groups, 18 involving people with a mental illness, 3 with homeless groups, 2 involving prisoners and 1 involving at-risk youth. One study identified was carried out with participants who were homeless and addicted to alcohol and/or other drugs. Barriers common to all vulnerable groups included: smoking for stress management, lack of support from health and other service providers, and the high prevalence and acceptability of smoking in vulnerable communities. Unique barriers were identified for people with a mental illness (eg, maintenance of mental health), Indigenous groups (eg, cultural and historical norms), prisoners (eg, living conditions), people who are homeless (eg, competing priorities) and at-risk youth (eg, high accessibility of tobacco). Vulnerable groups experience common barriers to smoking cessation, in addition to barriers that are unique to specific vulnerable groups. Individual-level, community-level and social network-level interventions are priority areas for future smoking cessation interventions within vulnerable groups. A protocol for this review has been registered with PROSPERO International Prospective Register of Systematic Reviews (Identifier: CRD42013005761). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
    BMJ Open 12/2014; 4(12):e006414. DOI:10.1136/bmjopen-2014-006414 · 2.06 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Smokers of all ages can benefit by quitting, but many smokers continue to smoke. Older Greek-Australian smokers, one of the largest ethnic groups in Australia, have higher rates of smoking than other groups of older Australians. This qualitative study aimed to explore older Greek-Australians' views about socio-cultural influences on their smoking. A snowball sampling technique was used to identify twenty Greek-Australian smokers (12 males and eight females), aged ≥ 50 years. They were recruited through the Greek Orthodox Community Center of South Australia (GOCSA). Qualitative data were collected using semi-structured face-to-face interviews. The audio-taped interviews were translated and transcribed, and then analysed using content analysis. Results suggested that smoking was considered as the "norm" by older Greek-Australian smokers. There were four groups embedded in the participants' social networks that were reported to be important in relation to either encouraging smoking or, smoking abstinence. These support groups included: family members, friends, the Greek community, and physicians. Smokers' family members (brothers) and friends were identified as facilitators of smoking whereas non-smoker family members (children and spouses) were reported as providing barriers to smoking. Different approaches were used by supporter groups to assist smokers to quit smoking-both planned and unplanned. Knowledge, planning of social and cultural supports, and addressing barriers to smoking cessation are a important part of health planning for older Greek-Australians. Social norms, including those arising from social interactions, and predisposing traits can influence smoking behaviour. Addressing the specific barriers to smoking cessation of older Greek-Australians is critical to addressing the risk for chronic disease in this group.
    International Journal of Environmental Research and Public Health 03/2015; 12(3):2718-34. DOI:10.3390/ijerph120302718 · 1.99 Impact Factor