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Determinants of Smoking Prevalence among Cambodian Americans

Institution: California State University, Long Beach Foundation
Investigator(s): Robert Friis, Ph.D. Kimthai Kuoch,
Award Cycle: 2007 (Cycle 16) Grant #: 16AT-1300H Award: $693,630
Subject Area: Tobacco-Use Prevention and Cessation
Award Type: Full CARA
Abstracts

Initial Award Abstract
A pilot CARA grant received from the TRDRP (Grant #12BT-2201) funded the Cambodian Tobacco Research Initiative (CTRI). The CTRI is an ongoing collaborative effort between the Department of Health Science at California State University, Long Beach, and the Cambodian Association of America, Long Beach. This initiative addresses the challenges of tobacco use among the Cambodian population in this Southern California community. The specific aims were to obtain information about tobacco use and factors that influence avoidance, beginning, and stopping of smoking as well as to develop a strong alliance between the community and academic partners in order to collect data regarding smoking and other forms of tobacco use. Smoking rates among the Cambodian American population are believed to be high, ranging in some prevalence studies up to 50 percent for the total population and as high as 70 percent among men. In our pilot study that was based on focus groups derived from self-selected samples, we confirmed that rates of smoking are four times higher among men than among women. The reasons for the high rates of cigarette smoking included the fact that smoking is a part of Cambodian culture, is seen to have medicinal advantages, and is used to relieve stress. As a part of the pilot study, we conducted an extensive literature review. The results suggested that to date prevalence studies of tobacco use among Cambodian Americans have provided only limited information. Because of inconsistent findings among small-scale studies, further information is needed regarding frequency of cigarette smoking among the Cambodian population. The REACH 2010 study surveyed 1,026 Cambodian residents of Lowell, Massachusetts. Although the REACH study provided useful prevalence data, in-depth information on the culturally related reasons for smoking was not collected. Furthermore, there have been no large-scale prevalence studies of tobacco use in the city of Long Beach, which has the largest population of Cambodian residents outside of Cambodia. In order to augment previous research, the proposed project for a full CARA award will expand on the pilot CARA by addressing among the Cambodian population in the city of Long Beach the following specific aims: 1. Obtain prevalence estimates of tobacco use among adults; 2. Further elucidate the cultural dimensions of cigarette smoking and other forms of tobacco use; and 3. Develop a multivariate model of sociodemographic and cultural factors associated with tobacco use. The investigators have identified a geographic region (the study population) within the city of Long Beach that has a high density of Cambodian residents. A representative random sample (n = 2,000) of the population will be selected by using a three-stage process. Stage one will include random selection of city blocks from census tracts within the Cambodian district. Stage two will involve selection of a stratified sample of the households that are likely to contain residents of Cambodian origin. In the third stage, we will interview all members of selected households who meet the criterion of being of Cambodian heritage. All selected community residents will be contacted by door-to-door bilingual interviewers. After informed consent is obtained, a tobacco use prevalence interview questionnaire will be administered. The community and academic partners will collaborate in conducting data analyses and disseminating research findings. The information gathered in the research project will be distributed widely within the community via local media outlets as well as published in professional journals and presented at scientific meetings. This project will contribute much needed information regarding cigarette smoking and other forms of tobacco use among a population that is afflicted by numerous health disparities.
Publications

Sociocultural determinants of tobacco use among Cambodian Americans.
Periodical: Health Education Research Index Medicus:
Authors: Friis, RH; Forouzesh, M; Chhim, H; Nonga, S; and Sze, D ART
Yr: 2006 Vol: 21 Nbr: 3 Abs: Pg: 355-365