Social and cultural influences on tobacco-related health disparities among South Asians in the USA

• Published in: Tobacco control Vol. 21; no. 4; pp. 422 - 428
• Main Authors: Mukherjea, Arnab, Morgan, Patricia A, Snowden, Lonnie R, Ling, Pamela M, Ivey, Susan L
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd 01.07.2012; BMJ Publishing Group; BMJ Publishing Group LTD
• Subjects: Adolescent; Adult; Aged; Asia, Western - ethnology; Asian people; Asians; Behavior; Cardiovascular disease; Community; Cross-Cultural Comparison; Cultural identity; Cultural values; Data analysis; Demography; Ethnic identity; Female; Focus Groups; Gender; Health Knowledge, Attitudes, Practice; Health risks; Health Status Disparities; Hookahs; Humans; Influence; Male; Middle Aged; Migration; Minority & ethnic groups; Noncitizens; Nuts; Paan; Population; Qualitative study; Researchers; smokeless tobacco products; Smoking - ethnology; Social Class; Social Values; Socioeconomics; South Asian culture; Studies; Surveillance; Tobacco; Tobacco products; Tobacco use; Tobacco, Smokeless; Traditions; Transients and Migrants - psychology; United States - epidemiology; Young Adult; United States; Asia, Western; South Asia
• ISSN: 0964-4563; 1468-3318; 1468-3318
• DOI: 10.1136/tc.2010.042309

ObjectiveTo explore and understand key cultural contexts of tobacco use among South Asian communities in the USA.DesignFocus groups, with homogeneous compositions of gender, generational status and length of time in the USA, were conducted in two distinct South Asian ethnic enclaves. Focus group findings were triangulated with observational data regarding the availability of culturally specific tobacco from commercial ethnic outlets and cultural events.SubjectsRespondents included 88 men and women of South Asian descent, aged 18–65 years, immigrant and native born, representing diversity of religion, socioeconomic status and region of origin, with the use of at least one culturally specific tobacco product in previous 24 months.ResultsA large number of culturally specific products were commonly used by community members. Knowledge of product-specific health risks was lacking or inaccurate. Many culturally specific tobacco products were considered to have beneficial properties. South Asian tobacco items were used to preserve cultural traditions and express ethnic identity in a new dominant culture. The social and cultural values ascribed to use helped distinguish community members from mainstream society and from other minority populations.ConclusionsMany cultural factors govern tobacco use among diverse global populations. Especially for migrants with a common regional origin, the role of ethnic identity may strongly influence culturally specific tobacco patterns. Qualitative inquiry helps elucidate such culturally framed behaviour in culturally diverse populations. These cultural contexts should be integrated into research and practice. Understanding multidimensional factors influencing non-traditional tobacco use is essential to ensure that comprehensive tobacco control strategies address tobacco-related disparities.