73 Role of Families in Combustible Tobacco Product Use Among Immigrant Youth from Africa and the Middle East

Faculty Mentor: Dr. Ola Onigbigi (Family & Preventative Medicine, University of Utah)

Abstract

Immigration can lead to environmental, social, and economic disruptions in families. Immigrant families who arrive in the United States from Africa and the Middle East also experience these changes which can result in residency in low-income areas with experiences of health disparities. The separation of the family unit due to inability of some family members to obtain entry visas to the US and the expectation of integration into a new culture also pose challenges to members. There is also the possibility of disruptions in leadership structure due to a sudden attempt at replacing the extended family structure prevalent in many African and Middle Eastern cultures with the American nuclear family arrangement. We therefore sought to determine the role of the family in combustible tobacco product use among Immigrants from Africa and the Middle East who currently live in the Greater Salt Lake City area. We hypothesized by the use of the social learning theory of modeling, positive or negative reinforcement, and the experiential learning theory of experience that families play a role in the initiation, maintenance and cessation of smoking among immigrant youth.

Introduction

Immigrant families in the United States (US) experience social, cultural and economic disruptions which can lead to changes in health-related decision making. An understanding of the effect of these disruptions on health may help in planning effective interventions. We therefore sought to determine the role of the family in combustible tobacco product use among US immigrants from Africa and the Middle East.

Materials/Methods

Results/Discussion

There were 14 respondents from Somalia, five from Senegal, three from Ethiopia and one from Ghana who all identified as Muslims. Respondents understood the concept of family in four contexts namely, biological, national/cultural, religious, and racial relationships. Four themes were identified on the effect of families on initiation and cessation of tobacco smoking: (1) Family structures – breakdown of traditional headship of families due to loss of members; (2) Family role models – due to distrust of the official system and unfulfilled expectations; (3) Early financial independence of immigrant youth; (4) impulsiveness in decision making among immigrant youth. All participants agreed that Ramadan presented a good opportunity for introduction of tobacco cessation programs although the Islamic religion prescribes no particular
punishment for culprits.

Conclusion

Our study found out that with respect to tobacco smoking, the perception of family was in this order: biological; cultural; religious; racial relationships. These findings highlight potential roles for families in the understanding of and addressing tobacco use in this population.