1
|
O’Donnell R, Tigova O, Teodorowski P, Villarroel-Williams N, Shevchuk A, Nesterova O, Arabska Y, Ylli A, Qirjako G, Fernández E, Semple S. Supporting migrant groups to reduce tobacco-related harms and create smoke-free family environments: Future priorities and research gaps. Tob Induc Dis 2024; 22:TID-22-105. [PMID: 38873182 PMCID: PMC11170976 DOI: 10.18332/tid/189356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 05/27/2024] [Indexed: 06/15/2024] Open
Affiliation(s)
- Rachel O’Donnell
- Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling, Stirling, United Kingdom
| | - Olena Tigova
- World Health Organization Collaborating Center on Tobacco Control, Catalan Institute of Oncology (ICO), L'Hospitalet de Llobregat, Barcelona, Spain
- CIBER of Respiratory Diseases (CIBERES), Madrid, Spain
- Tobacco Control Research Group, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
- School of Medicine and Health Sciences, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Piotr Teodorowski
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, United Kingdom
| | - Nazmy Villarroel-Williams
- Department of Psychology, Sociology and Politics, Sheffield Hallam University, Sheffield, United Kingdom
| | - Anzhelika Shevchuk
- Public Health Center of the Ministry of Health of Ukraine, Kyiv, Ukraine
| | - Olena Nesterova
- Public Health Center of the Ministry of Health of Ukraine, Kyiv, Ukraine
| | - Yuliia Arabska
- Public Health Center of the Ministry of Health of Ukraine, Kyiv, Ukraine
| | - Alban Ylli
- Faculty of Medicine, University of Medicine Tirana, Tirana, Albania
| | - Gentiana Qirjako
- Faculty of Medicine, University of Medicine Tirana, Tirana, Albania
| | - Esteve Fernández
- World Health Organization Collaborating Center on Tobacco Control, Catalan Institute of Oncology (ICO), L'Hospitalet de Llobregat, Barcelona, Spain
- CIBER of Respiratory Diseases (CIBERES), Madrid, Spain
- Tobacco Control Research Group, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
- School of Medicine and Health Sciences, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Sean Semple
- Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling, Stirling, United Kingdom
| |
Collapse
|
2
|
Paz Castro R, Henninger M, Schaub MP, Salis Gross C. Changes in attitudes towards smoking during smoking cessation courses for Turkish- and Albanian-speaking migrants in Switzerland and its association with smoking behavior: A latent change score approach. Front Psychol 2022; 13:1032091. [PMID: 36619056 PMCID: PMC9813416 DOI: 10.3389/fpsyg.2022.1032091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 11/28/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction Migrant populations usually report higher smoking rates than locals. At the same time, people with a migration background have little or no access to regular smoking cessation treatment. In the last two decades, regular smoking cessation courses were adapted to reach out to Turkish- and Albanian-speaking migrants living in Switzerland. The main aims of the current study were (1) to analyze the effects of an adapted smoking cessation course for Turkish- and Albanian-speaking migrants in Switzerland on attitudes toward smoking and smoking behavior; and (2) to elucidate whether changes in attitudes toward smoking were associated to changes in smoking behavior in the short- and in the long-term. Methods A total of 59 smoking cessation courses (Turkish: 37; Albanian: 22) with 436 participants (T: 268; A: 168) held between 2014 and 2019 were evaluated. Attitudes toward smoking and cigarettes smoked per day were assessed at baseline and 3-months follow-up. One-year follow-up calls included assessment of cigarettes smoked per day. Data were analyzed by means of structural equation modeling with latent change scores. Results Participation in an adapted smoking cessation course led to a decrease of positive attitudes toward smoking (T: β = -0.65, p < 0.001; A: β = -0.68, p < 0.001) and a decrease of cigarettes smoked per day in the short-term (T: β = -0.58, p < 0.001; A: β = -0.43, p < 0.001) with only Turkish-speaking migrants further reducing their smoking in the long-term (T: β = -0.59, p < 0.001; A: β = -0.14, p = 0.57). Greater decreases in positive attitudes were associated with greater reductions of smoking in the short-term (T: r = 0.39, p < 0.001; A: r = 0.32, p = 0.03), but not in the long-term (T: r = -0.01, p = 0.88; A: r = -0.001, p = 0.99). Conclusion The adapted smoking cessation courses fostered changes in positive attitudes toward smoking that were associated with intended behavior change in the short-term. The importance of socio-cognitive characteristics related to behavior change maintenance to further increase treatment effectiveness in the long-term is discussed.
Collapse
Affiliation(s)
- Raquel Paz Castro
- Swiss Research Institute for Public Health and Addiction at the University of Zurich, Zurich, Switzerland,Marie Meierhofer Institut für das Kind, Zurich, Switzerland,*Correspondence: Raquel Paz Castro,
| | - Mirka Henninger
- Psychological Methods, Evaluation and Statistics, Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Michael P. Schaub
- Swiss Research Institute for Public Health and Addiction at the University of Zurich, Zurich, Switzerland
| | - Corina Salis Gross
- Swiss Research Institute for Public Health and Addiction at the University of Zurich, Zurich, Switzerland
| |
Collapse
|
3
|
Paz Castro R, Schaub MP, Salis Gross C. An adapted smoking-cessation intervention for Turkish-speaking migrants in Switzerland: Predictors of smoking outcomes at one-year follow-up. PLoS One 2021; 16:e0247157. [PMID: 33735227 PMCID: PMC7971503 DOI: 10.1371/journal.pone.0247157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 02/02/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Migrant populations usually report higher smoking rates. Among those migrant populations, Turkish- and Kurdish-speaking migrants are often overrepresented. Providing equal access to health services is one of the major challenges of our time. The need for adapted smoking-cessation treatments for Turkish-speaking populations to achieve equity in health led, in 2006, to the development and implementation of the Tiryaki-Kukla smoking-cessation program. The aims of the current study were to evaluate one-year quit rates for smoking-cessation courses held from 2006-2018 and investigate whether certain characteristics predict long-term smoking cessation or reduction. METHODS Program evaluation included a pre/post questionnaire (session 1/ 3 months after the quit day) and a follow-up telephone call twelve months after the quit day. To elucidate factors associated with long-term smoking cessation and reduction, Cox regression analysis and Weighted Generalized Equation Models were used. RESULTS Of the 478 who participated in smoking-cessation courses, 45.4% declared themselves non-smokers at one-year follow-up. This quit rate is higher than that achieved during the preliminary evaluation of the program involving 61 participants (37.7%). Predictors of long-term smoking cessation were course length (eight vs. six sessions) (95% CI = 1.04-1.36, p = .01), adherence to the course (95% CI = 0.98-0.99, p<0.01), use of pharmacotherapy or nicotine replacement therapy products (95% CI = 0.74-0.98, p = .02), and time passed in the morning until the first cigarette is smoked (95% CI5min = 1.17-1.77, p<0.001; 95% CI30min = 1.09-1.65, p<0.01). Predictors of change in cigarettes smoked per day among smokers were-the time passed until the first cigarette in the morning (5min p < .001; 30min p < .001; 60min p < .01)-, gender (p < .001), and level of motivation to quit at baseline (p = .04). CONCLUSIONS Our findings are consistent with existing evidence supporting adapted smoking cessation interventions to reduce health inequity in migrant populations. However, achieving harm reduction in smokers with higher dependence scores remains challenging.
Collapse
Affiliation(s)
- Raquel Paz Castro
- Swiss Research Institute for Public Health and Addiction at the University of Zurich, Zurich, Switzerland
| | - Michael P. Schaub
- Swiss Research Institute for Public Health and Addiction at the University of Zurich, Zurich, Switzerland
| | - Corina Salis Gross
- Swiss Research Institute for Public Health and Addiction at the University of Zurich, Zurich, Switzerland
| |
Collapse
|
4
|
Smoking Cessation in Lower Socioeconomic Groups: Adaptation and Pilot Test of a Rolling Group Intervention. BIOMED RESEARCH INTERNATIONAL 2021; 2021:8830912. [PMID: 33763486 PMCID: PMC7963897 DOI: 10.1155/2021/8830912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 01/25/2021] [Accepted: 02/16/2021] [Indexed: 11/24/2022]
Abstract
Background Socioeconomic inequalities in smoking rates persist and tend to increase, as evidence-based smoking cessation programs are insufficiently accessible and appropriate for lower socioeconomic status (SES) smokers to achieve long-term abstinence. Our study is aimed at systematically adapting and pilot testing a smoking cessation intervention for this specific target group. Methods First, we conducted a needs assessment, including a literature review and interviews with lower SES smokers and professional stakeholders. Next, we selected candidate interventions for adaptation and decided which components needed to be adopted, adapted, or newly developed. We used Intervention Mapping to select effective methods and practical strategies and to build a coherent smoking cessation program. Finally, we pilot tested the adapted intervention to assess its potential effectiveness and its acceptability for lower SES smokers. Results The core of the adapted rolling group intervention was the evidence-based combination of behavioral support and pharmacotherapy. The intervention offered both group and individual support. It was open to smokers, smokers who had quit, and quitters who had relapsed. The professional-led group meetings had a fixed structure. Themes addressed included quitting-related coping skills and health-related and poverty-related issues. Methods applied were role modeling, practical learning, reinforcement, and positive feedback. In the pilot test, half of the 22 lower SES smokers successfully quit smoking. The intervention allowed them to “quit at their own pace” and to continue despite a possible relapse. Participants appraised the opportunities for social comparison and role modeling and the encouraging atmosphere. The trainers were appreciated for their competencies and personal feedback. Conclusions Our adapted rolling group intervention for lower SES smokers was potentially effective as well as feasible, suitable, and acceptable for the target group. Further research should determine the intervention's effectiveness. Our detailed report about the adaptation process and resulting intervention may help reveal the mechanisms through which such interventions might operate effectively.
Collapse
|
5
|
Jaworski A, Green B, Kennett K, Mayol A, Rowe R. Tobacco cessation experiences and needs: perspectives from Arabic-speaking communities. J Ethn Subst Abuse 2020; 21:1010-1028. [PMID: 32990528 DOI: 10.1080/15332640.2020.1824837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Use of tobacco products is higher in Arabic-speaking communities in Australia, compared to other populations. 70 persons identifying as being from Arabic-speaking communities in Western Sydney participated in focus group discussions to explore experiences and needs relating to tobacco, alcohol and other drug treatment. Tobacco was rated as the substance of highest concern in this sample, however a pattern of change was observed. Widespread cigarette use supported by gendered norms that particularly encouraged smoking among men was shifting, with some decline in the social acceptability of cigarette smoking linked to experience of health impacts and the financial cost to families. In contrast, waterpipe tobacco smoking was described as a common and acceptable practice across age and gender cohorts, despite some participants challenging the cultural and health rationales of this practice. Preventing tobacco-related harm among younger populations was highly valued among study participants, drawing on strong support for families as key influencer of health behaviors. Cessation strategies viewed as effective among community members spoken with commonly centered upon the notion of individual willpower, and appreciated the disincentivising impacts of high taxation on cigarettes. This study prioritizes community-informed perspectives for reducing tobacco related harms amongst Arabic-speaking populations in Australia and offers direction to health promoters, public health workers and policymakers. Results indicate opportunities exist to improve tobacco control outcomes through strategies that align prevention and treatment options with relevant community beliefs and norms, and build on existing harm reduction behaviors and support seeking behaviors.
Collapse
Affiliation(s)
- Alison Jaworski
- Drug and Alcohol Multicultural Education Centre, Sydney, Australia
| | - Belinda Green
- Drug and Alcohol Multicultural Education Centre, Sydney, Australia.,NSW Health Education Centre Against Violence, North Parramatta, Australia
| | - Kate Kennett
- Centre for Population Health, Western Sydney Local Health District, Parramatta, Australia
| | - Abeny Mayol
- Drug and Alcohol Multicultural Education Centre, Sydney, Australia
| | - Rachel Rowe
- School of Public Health & Community Medicine, University of New South Wales, Sydney, Australia
| |
Collapse
|
6
|
van Wijk EC, Landais LL, Harting J. Understanding the multitude of barriers that prevent smokers in lower socioeconomic groups from accessing smoking cessation support: A literature review. Prev Med 2019; 123:143-151. [PMID: 30902700 DOI: 10.1016/j.ypmed.2019.03.029] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 02/25/2019] [Accepted: 03/16/2019] [Indexed: 10/27/2022]
Abstract
One explanation for the increasing smoking-related health inequalities is the limited access of lower socioeconomic status (SES) smokers to smoking cessation support. In order to understand this limited access - and to eventually improve accessibility - we provide a structured overview of the barriers that lower SES smokers face in the successive phases of access to cessation support. Our literature review included 43 papers on barriers of access to cessation support for lower SES smokers, published before June 2016. We used the access to health care framework to categorize the extracted barriers into (a) either the abilities of smokers or dimensions of cessation support and (b) one of the successive phases of access to support. We found that lower SES smokers encounter many barriers. They are present in all phases of access to cessation support, and different barriers may be important in each of these phases. We also found that each phase transition is hampered by barriers related to both the abilities of smokers and the dimensions of cessation support, and that these barriers tend to interact, both with each other and with the disadvantaged living conditions of lower SES smokers. In conclusion, reducing smoking-related health inequalities by improving lower SES smokers' access to smoking cessation support requires a comprehensive approach. Our structured overview of barriers may serve as a starting point for tailoring such an approach to the multitude of barriers that prevent lower SES smokers from accessing cessation support, while simultaneously taking into account their disadvantaged living conditions.
Collapse
Affiliation(s)
- Els C van Wijk
- Amsterdam UMC, University of Amsterdam, Department of Public Health, Amsterdam Public Health Research Institute, Meibergdreef 9, Amsterdam, Netherlands.
| | - Lorraine L Landais
- Amsterdam UMC, University of Amsterdam, Department of Public Health, Amsterdam Public Health Research Institute, Meibergdreef 9, Amsterdam, Netherlands
| | - Janneke Harting
- Amsterdam UMC, University of Amsterdam, Department of Public Health, Amsterdam Public Health Research Institute, Meibergdreef 9, Amsterdam, Netherlands
| |
Collapse
|
7
|
Benson FE, Nierkens V, Willemsen MC, Stronks K. Smoking cessation behavioural therapy in disadvantaged neighbourhoods: an explorative analysis of recruitment channels. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2015; 10:28. [PMID: 26227135 PMCID: PMC4521474 DOI: 10.1186/s13011-015-0024-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 07/15/2015] [Indexed: 11/10/2022]
Abstract
BACKGROUND The optimum channel(s) used to recruit smokers living in disadvantaged neighbourhoods for smoking cessation behavioural therapy (SCBT) is unknown. This paper examines the channels through which smokers participating in a free, multi-session SCBT programme heard about and were referred to this service in a disadvantaged neighbourhood, and compares participants' characteristics and attendance between channels. METHODS 109 participants, recruited from free SCBT courses in disadvantaged areas of two cities in the Netherlands, underwent repeated surveys. Participants were asked how they heard about the SCBT and who referred them. Participant characteristics were compared between five channels, including the General Practitioner (GP), a community organisation, word of mouth, another health professional, and media or self-referred. Whether the channels through which people heard about or were referred to the service predicted attendance of ≥4 sessions was investigated with logistic regression analysis. RESULTS Over a quarter of the participants had no or primary education only, and more than half belonged to ethnic minority populations. Most participants heard through a single channel. More participants heard about (49%) and were referred to (60%) the SCBT by the (GP) than by any other channel. Factors influencing quit success, including psychosocial factors and nicotine dependence, did not differ significantly between channel through which participants heard about the SCBT. No channel significantly predicted attendance. CONCLUSION The GP was the single most important source to both hear about and be referred to smoking cessation behavioural therapy in a disadvantaged neighbourhood. A majority of participants of low socioeconomic or ethnic minority status heard about the programme through this channel. Neither the channel through which participants heard about or were referred to the therapy influenced attendance. As such, concentrating on the channel which makes use of the existing infrastructure and which is highest yielding, the GP, would be an appropriate strategy if recruitment resources were scarce.
Collapse
Affiliation(s)
- Fiona E Benson
- Department of Public Health, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - Vera Nierkens
- Department of Public Health and Primary Care, LUMC, Hippocratespad 21, 2333 RC, Leiden, The Netherlands.
| | - Marc C Willemsen
- Department of Health Promotion, CAPHRI School for Public Health and Primary Care, Maastricht University, Minderbroedersberg 4-6, 6211 LK, Maastricht, The Netherlands.
| | - Karien Stronks
- Department of Public Health, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| |
Collapse
|
8
|
Urban M, Burghuber OC, Dereci C, Aydogan M, Selimovic E, Catic S, Funk GC. Tobacco addiction and smoking cessation in Austrian migrants: a cross-sectional study. BMJ Open 2015; 5:e006510. [PMID: 26044757 PMCID: PMC4458634 DOI: 10.1136/bmjopen-2014-006510] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2014] [Revised: 04/21/2015] [Accepted: 04/23/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Recent observations revealed substantial differences in smoking behaviour according to individuals' migration background. However, smoking cessation strategies are rarely tailored on the basis of a migration background. We aimed to determine whether smoking behaviour and preferences for smoking cessation programmes differ between Austrian migrant smokers and Austrian smokers without a migration background. STUDY DESIGN Cross-sectional study. SETTING Recruitment and interview were performed at public places in Vienna, Austria. PARTICIPANTS The 420 smokers included: 140 Bosnian, 140 Turkish migrant smokers of the first or second generation, as well as 140 Austrian smokers without a migration background. METHODS We cross-sectionally assessed determinants of smoking behaviour and smoking cessation of every participant with a standardised questionnaire. PRIMARY OUTCOME MEASURE The Fagerström Test for Nicotine Dependence. SECONDARY OUTCOME MEASURES Determinants of smoking behaviour, willingness to quit smoking and smoking cessation. RESULTS Nicotine addiction expressed via the Fagerström score was significantly higher in smokers with a migration background versus those without (Bosnian migrant smokers 4.7 ± 2.5, Turkish migrant smokers 4.0 ± 2.0, Austrian smokers without a migration background 3.4 ± 2.3, p<0.0001). Bosnian and Turkish migrant smokers described a greater willingness to quit, but have had more previous cessation trials than Austrian smokers without a migration background, indicating an increased demand for cessation strategies in these study groups. They also participated in counselling programmes less often than Austrian smokers without a migration background. Finally, we found significant differences in preferences regarding smoking cessation programmes (ie, preferred location, service offered in another language besides German, and group rather than single counselling). CONCLUSIONS We found significant differences in addictive behaviour and cessation patterns between smokers with and without a migration background. Our results indicate a strong demand for adjusting cessation programmes to the cultural background.
Collapse
Affiliation(s)
- Matthias Urban
- Department of Respiratory and Critical Care Medicine, Otto Wagner Hospital, Vienna, Austria
| | - Otto Chris Burghuber
- Department of Respiratory and Critical Care Medicine, Otto Wagner Hospital, Vienna, Austria
| | | | | | | | | | - Georg-Christian Funk
- Department of Respiratory and Critical Care Medicine, Otto Wagner Hospital, Vienna, Austria
| |
Collapse
|
9
|
Mou J, Fellmeth G, Griffiths S, Dawes M, Cheng J. Tobacco smoking among migrant factory workers in Shenzhen, China. Nicotine Tob Res 2012; 15:69-76. [PMID: 22492086 DOI: 10.1093/ntr/nts085] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND While several studies of smoking behaviors in rural-to-urban Chinese migrants exist, none to our knowledge have focused on factory workers, estimated to represent between 10% and 20% of China's total rural-to-urban migratory population. This paper assesses factors associated with smoking behavior among rural-to-urban migrant factory workers in Shenzhen, China. METHODS A cross-sectional survey of migrant workers from 44 randomly selected factories in Shenzhen, China. Participants were migrant factory workers aged 16-59 years and holding nonlocal household registration. The main outcome measures were demographic, migration-related, and behavioral factors associated with smoking status. RESULTS Four thousand and eighty-eight completed questionnaires were obtained (response rate 95.5%). Overall smoking prevalence (including occasional, daily, and heavy daily smoking) was 19.1%. The prevalence of daily smoking (including heavy daily smoking) was higher in men (27.3%) than women (0.7%). These rates are significantly lower than national smoking rates (59.5% in men, 3.7% in women) and rates found in a similar study. A high-risk group of men who smoke heavily and consume alcohol frequently was identified. Longer working hours and less rest were associated with higher rates of smoking. Frequent Internet use and lack of insurance were associated with lifetime smoking. Gender-adjusted models showed that poorer mental health and an accumulated working time in Shenzhen of 2-3 years increased female workers' likelihood of smoking. CONCLUSIONS Migrant factory workers in Shenzhen had lower rates of smoking than other population groups in China. The identification of risk factors for heavy smoking may help to effectively target health promotion interventions.
Collapse
Affiliation(s)
- Jin Mou
- Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | | | | | | | | |
Collapse
|