Treatment access and tobacco use by priority population
Secondhand Smoke Exposure, Awareness, and Prevention Among African-Born Women

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Background

Little research exists on exposure to the health risks of secondhand smoke among women and children in African immigrant communities.

Purpose

This exploratory study aims to understand the prevalence of secondhand smoke exposure; assess levels of awareness of the dangers of secondhand smoke; and identify strategies for building increased awareness of these issues in African immigrant communities in Minnesota.

Methods

Key informant interviews with ten African women community leaders, focus groups with 29 female African youth, and surveys of 223 African women were conducted between August 2008 and March 2009. The focus groups and key informant interviews were in English, and the surveys were in English, French, Oromo, and Somali.

Results

Over one quarter of African women reported daily exposure to cigarette smoke, and one in ten women reported daily exposure to smoke from shisha (fruit-flavored tobacco smoked in a hookah or waterpipe). Many respondents had general awareness of the health impacts of tobacco smoke, but some were unsure. The majority felt that increased awareness was badly needed in their communities. Awareness of the health impacts of shisha smoking was particularly low. Strategies for increasing awareness include: using media and visual images, attending large gatherings, and appealing to community members' priorities, including protecting their children.

Conclusions

Exposure to secondhand smoke among women and children in African immigrant communities in Minnesota is substantial. Awareness about the health impacts of secondhand smoke exposure in these communities needs to be increased. Disseminating visual information at existing community gatherings or appealing to individual priorities may be the best approaches to increase awareness and motivate change.

Introduction

The WHO predicted that by 2030 tobacco use would cause more deaths worldwide among people from developing nations than AIDS, malaria, tuberculosis, maternal mortality, motor vehicle accidents, homicides, and suicides combined.1 In 2006, the U.S. Surgeon General reported, based on 20 years of scientific research, that there is no risk-free level of exposure to secondhand smoke.2

Recent surveys have found that many African people are not aware of the negative health effects associated with smoking.3, 4, 5 A 2007 ClearWay MinnesotaSM study of West African smokers found that study participants reported general awareness of smokers' health risks, but much less knowledge about the impacts of secondhand smoke exposure. Of the 136 West African immigrant smokers interviewed, a high percentage reported that their smoking increased after settling in the U.S. The prevalence of smoking increased particularly for West African men.6 A number of studies have found that African-born men are much more likely to smoke than African-born women.3, 6, 7, 8

Higher smoking prevalence among men is often linked to higher levels of secondhand smoke exposure among nonsmoking women and children living in the smoker's household.9 Women have been found to impose restrictions on smoking behavior in specific spaces within the home in an attempt to create a smokefree environment for their children, but these restrictions are often limited by the physical environment of their homes.10

The dangers of secondhand smoke exposure, combined with increased tobacco use and limited awareness of health impacts among African immigrants, indicate a strong need for additional information to be gathered from and disseminated back to African communities. The goals of this study were to:

  • 1

    understand the prevalence and contexts of secondhand smoke exposure among African women and girls in Minnesota;

  • 2

    assess levels of awareness of the dangers of secondhand smoke in African women and their broader communities; and,

  • 3

    identify strategies for building increased awareness of the risks associated with secondhand smoke exposure in African immigrant communities in Minnesota.

Section snippets

Methods

The research methods used in the project included: key informant interviews with African women leaders in the community, focus groups with African adolescent girls, and a survey of African women. All methods were reviewed and approved by the Minnesota Department of Health IRB. Methods for each are described below.

Key informant interviews were conducted with ten community leaders during July and August 2008. Community leaders were nominated by members of a diverse African advisory board based on

Exposure to Secondhand Smoke

Questions about personal experiences with exposure to smoke in multiple contexts were asked in the survey of African women (Table 1) and the focus groups of African female youth.

In the surveys, nearly one third of women reported exposure to smoke in the past month, and over one quarter reported exposure in the past day; however, the locations of this exposure varied. In the focus groups, the youth identified four primary situations in which they are exposed to secondhand smoke: with family or

Strategies for Building Awareness

In order to continue to help community members learn more or care more about the health impacts of secondhand smoke, this study explored strategies for building awareness in African communities.

Discussion

The current study reinforces findings from previous studies regarding limited awareness among African people of the negative health impacts of smoke exposure.3, 4 This has been shown to be especially true when examining awareness of specific risks, as opposed to health risks in general.6 It may be that community members are more familiar with general information, but as information becomes more specific or nuanced, community members may not be provided with or be able to retain the information.

References (14)

  • WHO report on the global tobacco epidemic, 2008: the MPOWER package

  • The health consequences of involuntary exposure to tobacco smoke: a report of the Surgeon General. USDHHS, CDC, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2006

  • M.E. Kurtz et al.

    Nigerian urban married women's perceptions of exposure to secondary tobacco smoke

    Health Care Women Int

    (1993)
  • G. Martin et al.

    Beliefs about smoking and health and attitudes toward tobacco control measures

    S Afr Med J

    (1992)
  • J.O. Pobee et al.

    The profile of the African smoker: the Ghana smoking studies

    East Afr Med J

    (1984)
  • A. Pierce et al.

    Tobacco use and attitudes among West African communities in Minnesota St

    (2007)
  • M.L. Adelekan et al.

    Monitoring trends in substance use through a repeat cross-sectional survey in a Nigerian university

    Drugs Educ Prev Pol

    (1996)
There are more references available in the full text version of this article.

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Copyright © 2010 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.