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Social Context of Tobacco Use among Asian Americans in Ohio: Policy Implications Surendra Bir Adhikari, Ph.D. “Impact of Tobacco Use on Special Populations” [Eval-32]. Learning Objectives.

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Social Context of Tobacco Use among Asian Americans in Ohio: Policy ImplicationsSurendra Bir Adhikari, Ph.D.“Impact of Tobacco Use on Special Populations” [Eval-32]

learning objectives
Learning Objectives
  • Enhanced understanding of disparities in tobacco use behavior and cessation efforts among select Asian communities.
  • Drawing policy implications for appropriate interventions in concert with the prevalent social acceptance of smoking in these communities.
  • Culturally sensitive programming to transcend cultural and linguistic barriers and to address high tobacco use in select Asian communities .
problem current state of affairs
Problem: Current State of Affairs
  • Lack of statewide baseline data on tobacco use among Asian Americans in Ohio.
  • Cultural and linguistic barriers to data collection.
  • Wide diversity in tobacco use among various Asian communities and social acceptance of tobacco use.
  • A few Asian communities are still hard to outreach.
  • Considerable variation in the demographic characteristics for various ethnic communities.
study method
Study Method
  • Adult Tobacco Use Survey (2000 and 2002; n=1,070); select Counties in Northeast Ohio (Cuyahoga, Asian pop. 24,531; and Summit, Asian pop., 7,078).
  • Eight Asian communities represented; majority of respondents: Chinese, Vietnamese, and Korean.
  • To transcend language barriers, the survey was translated into: Cambodian, Chinese, H’mong, Korean, Laotian, and Vietnamese languages.
  • Some non-financial incentives to survey participants.
results tobacco use behavior
Results: Tobacco Use Behavior
  • Of the 1,010 total adult respondents, 22% (n=229) were ever smokers, and 13.10% (n=140) current smokers.
  • Smoking prevalence by gender: 22%, men; 5%, women.
results stages of behavior change
Results: Stages of Behavior Change
  • Fifty-nine percent (n=72/122) were in pre-contemplation stage (typical), 13% (16/122) in contemplation stage (low), and 28% (34/122) in preparation stage (high).
results influencers and smoking
Results: Influencers and Smoking
  • Social acceptance of smoking: Of those responses on smoking, 36% reported the pressure to be sociable as one major influencer to continue smoking.
results nicotine addiction
Results: Nicotine Addiction
  • Fagerstrom Test for Nicotine Dependence (FTND)—measured by Time to First (TTF) Cigarette.
  • 32% (n=37) of current smokers (n=117) smoked within five minutes of waking–representing a higher level of dependence as indicated by TTF (3 points).
  • 39% (n=46) smoked within 6 to 30 minutes (a medium level of dependence—2 points).
  • 17% (n=19) within 31 to 60 minutes representing the lowest level of dependence (one point).
understanding tobacco use behavior
Understanding Tobacco Use Behavior
  • Challenge: Outreaching all of the diverse Asian communities still problematic (non-participation; distrust; past negative experience).
  • Solution 1: Community based prevalence studies (surveys in multiple languages).
  • Solution 2: Capacity building: resource networking with mainstream agencies; engaging community leaders.
  • Solution 3: Tobacco use and cessation efforts require the involvement of a broader cross-section of ethnic communities and resource providers.
interventions to change social norm
Interventions to Change Social Norm
  • Challenge: Understanding: social acceptance of tobacco use in Asian communities, low capacity to respond to tobacco use (APPEAL), and aggressive AAPI targeting.
  • Solution 1: Need assessment and community based prevalence studies for a better understanding of the prevalent social norm and the impact of tobacco.
  • Solution 2: Building communities’ capacities and confidence in tobacco use prevention and control through coalitions, advocacy and empowerment.
  • Solution 3: Support to cultural festivals and events (New Year; Health Fairs; Annual Party) and gaining trust.
culturally sensitive programming
Culturally Sensitive Programming
  • Challenge: Engagement (cultural/linguistic barriers).
  • Solution 1: Development and distribution of relevant literature in multiple Asian languages; surveys in multiple languages.
  • Solution 2: Enabling culturally competent program to comprehensively address tobacco use.
  • Solution 3: Support to cultural festivals and events (New Year; Health Fairs); relating tobacco issues to their concerns (APPEAL).
conclusion and policy implications
Conclusion and Policy Implications
  • Community programming to facilitate those interested in quitting within one month (preparation: 28%) and in six months (contemplation: 13%).
  • Find ways to motivate those not interested in quitting within six months (pre-contemplation, 58%).
  • Culturally sensitive programming to change the social norm and address higher social acceptance of smoking among select Asian communities (particularly males).
  • OTUPCF’ Hi-Risk grants and disparities in tobacco use.
references and resources 1
References and Resources…[1]
  • Adhikari, Surendra B. 2002. “Tobacco Use, Preventive Health Practices, and Depression Issues among Adult Asian Americans in Northeast Ohio.” Research Results from Asians for Tobacco Free Ohio Survey, Report 3: Results from Expanded Adult Survey 2002. Asian Services in Action: Akron, Ohio (October).
  • DiClemente, C. C., J. O. Prochaska, S. K. Fairhurst, W. F. Velicer, M. M. Velasquez, and J. S. Rossi. 1991. “The Process of Smoking Cessation: An Analysis of Precontemplation, Contemplation, and Preparation Stages of Change.” Journal of Consulting and Clinical Psychology 59:295-304.
  • Fagerstrom, K. O. and N. G. Schneider. 1989. “Measuring Nicotine Dependence: A Review of the Fagerstrom Tolerance Questionnaire.” Journal of Behavioral Medicine 12:159-182.
  • Prochaska, J. O. and C. C. DiClemente. 1983. “Stages and Processes of Self-Change of Smoking: Toward an Integrative Model of Change.” Journal of Consulting and Clinical Psychology 51:390-95.
references and resources 2
References and Resources…[2]
  • Asian Pacific Partners for Empowerment and Leadership (APPEAL) publications:

* A Policy Framework for Preventing and Reducing Tobacco Use in the Asian American and Pacific Islander Community.

* Critical Research and Data Issues on Tobacco Use, Prevention and Control for Asian Americans and Pacific Islanders.

*Making Tobacco Relevant for Asian American and Pacific Islander Communities.

* Achieving Parity through Tobacco Control for all communities.

* Integrating Evaluation into Tobacco Programs for Asian American and Pacific Islander Communities.

*Conducting Needs Assessments for Tobacco Control in Asian American and Pacific Islander Communities.

*Enhancing Cultural and Community Competence for Tobacco Control for Asian American and Pacific Islanders.

  • CDC. 1998. Tobacco Use Among U.S. Racial/Ethnic Minority Groups: A Report of the Surgeon –General.

Surendra Bir Adhikari, Ph.D.sadhikari@standohio.orgOTUPCF, 300 E. Broad St., Ste. 310, Columbus OH 43215. tel.: 614 466 7716 fax.: 614 995 4575


Social Context of Tobacco Use among Asian Americans in Ohio: Policy ImplicationsSurendra Bir Adhikari, Ph.D.Impact of Tobacco Use on Special Populations” [Eval-32]