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The purpose of this proposal is to investigate the prevalence and determinants of tobacco use, non-smoking policies, and second hand smoke (SHS) exposure among San Diego Arab American residents, a rapidly growing minority group. Smoking rate for Arab American male adults is estimated to range between 40.6% and 52%, two times higher than the national average rate. The theoretical foundation of this study will be the Learning Theory and its extension to the Behavioral Ecological Model. A sample of 400 adult San Diego resident of Arab descent will be surveyed by telephone. Study participants will be identified via a screening form that will be distributed to San Diego Middle Eastern grocery stores, restaurants, churches, and Mosques. Screening forms, questionnaire, flyers and educational materials will be provided in English and Arabic. Beside cigarettes, this study will investigate the water pipe as a tobacco use method that may be re-emerging among Arabic speaking populations in alarming proportions. The water pipe is also known as shisha, sheesha, boory, goza (Egypt, Saudi Arabia), narghile, nargile, arghile (Jordan, Lebanon, Syria), hookah (Africa, India), and hubble bubble. The term “water pipe” will be used in this study and it refers to a centuries-old tobacco use method in which smoke passes through a filter in a water container connected to a mouthpiece by a tube made of vacuolated bamboo or rubber. The tobacco used in water pipe smoking is a mixture of crude types of tobacco fermented with molasses and fruits. Charcoal heats the tobacco which produces the smoke that the user inhales. Understanding water pipe use is important because it contains a considerable amount of nicotine and has been shown to produce high levels cotinine in plasma, saliva and urine of smokers. Moreover, the water pipe has been associated with pulmonary disease, coronary heart disease, squamous cell carcinoma, keratoacanthoma, eczema, and pregnancy related complications. Because the water pipe is typically shared in groups, both smoking and passive smoke exposure may be increased and socially supported by family and friends. This is alarming since hookah lounges are spreading at an increasing rate near college campuses and inside malls across the United States.
Specific Aims
1. To estimate the prevalence of cigarette and water pipe smoking among San Diego Arab American residents, and the influence of acculturation, social factors, home tobacco policies and demographic and contextual variables on tobacco use.
2. To estimate the prevalence of smoking cessation from cigarettes and water pipes among San Diego Arab American residents, and the influence of acculturation, social factors, home tobacco policies and demographic and contextual variables on cessation history.
3. To estimate the prevalence of cigarette and water pipe smoke-free home policies and the influence of acculturation, social factors, and demographic and contextual variables on their establishment and nature.
4. To estimate the prevalence of cigarette and water pipe second hand smoke exposure and the influence of acculturation, social factors, home tobacco policies and demographic and contextual variables on residents’ exposure to SHS.
5. To explore the popularity of water pipes and hookah lounges among Arab American college students.
Data will be analyzed with descriptive statistics and multivariate analyses. This proposal is responsive to TRDRP research priorities for funding studies that address the role of acculturation in tobacco use and SHS exposure among minority groups. Results of this study will provide current population estimates among understudied Arab Americans and will help design culturally tailored tobacco control programs. |
