Report: Smoking cessation programs not reaching local Southeast Asians


A first-of-its-kind qualitative report on tobacco use in Minnesota’s Southeast Asian communities was recently released by the Diverse Racial Ethnic Groups and Nations (DREGAN) project.

The report, titled Tobacco Use in Minnesota: Perspectives from Cambodian, Hmong, Laotian, and Vietnamese Communities, is unique for three reasons:
• No one in Minnesota has conducted qualitative interviews of this depth on tobacco use with these communities.
• From start to finish this project involved members of these communities.
• These reports give the health community new insights on how best to work with these communities, which are explicitly targeted by the tobacco industry, to develop culturally appropriate approaches for reducing tobacco use in these communities.

In addition to gaining insight, the purpose of this groundbreaking research was to help reduce tobacco-related health disparities and improve tobacco prevention and cessation programs. Some key findings from the report include:

* Immigrants and refugees from Southeast Asian countries face culture shock in adjusting to American views on smoking and come to Minnesota with little knowledge of tobacco’s harms.
* Women and adolescents from these cultures are at particular risk for starting to smoke as they adjust to life in America.
* Effective stop-smoking assistance for smokers from non-Western cultures should focus on building trust with a counselor and maintaining privacy.
* Community institutions, such as Southeast Asian mutual assistance associations, can be allies in efforts to reduce the harm of tobacco.
Trained bilingual and bicultural interviewers met with 60 Southeast Asian Minnesotans to discuss their understanding of tobacco use in their communities and to identify social and cultural barriers to smoking prevention and cessation.

Many interesting stories were gathered as a result. For instance, due to public restrictions in the United States, immigrant smokers must transition from smoking as a prestigious and social activity to smoking as stigmatizing and isolating. This is a difficult transition for many people, as noted by one Cambodian man in his fifties, in the United States for 21 years. “Through my knowledge, when I was a single youth, if you didn’t know how to smoke or drink, you were not a man. So if we wanted to join a group, a meeting, we needed to know how to smoke and drink, you see.”

A Hmong man in his thirties, in the United States for 12 years, also shared, “When you ask for help, [people] will label you as a bad person, as a person who has a low life. So it’s not easy for people to come forward. It takes courage.”

“The findings help explain why mainstream strategies to reduce tobacco use aren’t as successful in some communities,” explained Steven Foldes, Ph.D., director of research and evaluation at Blue Cross and Blue Shield of Minnesota (Blue Cross). “Armed with this knowledge, we can now develop successful strategies based on the cultural values of each community.”

Barbara Schillo, Ph.D., director of research programs at the Minnesota Partnership for Action Against Tobacco (MPAAT), agrees. “It is important to have a better understanding about how Southeast Asian Minnesotans view tobacco use if we want to help all Minnesotans avoid the harms of tobacco.”

The DREGAN project is already applying report findings by working with community members to integrate key smoking prevention and cessation messages into major Southeast Asian activities such as annual health fairs and New Year celebrations. Partnering with churches to train individuals who want to reduce tobacco use in minority communities has also occurred. Communities are urged to continue conversations and use the findings to build awareness and momentum so positive health benefits can be achieved.

“The fact that Southeast Asian participants were involved as equal partners helps to create more effective and acceptable programs for these communities and also helps those of us who serve and represent these populations,” said Dr. Sara Velasco, site medical director at HealthEast Salud Integral in St. Paul.
DREGAN is a collaborative project working with Minnesota’s minority communities to reduce the harm caused by tobacco.

Partners include the Asian Pacific Tobacco-Free Coalition of Minnesota (APT-FCM), Blue Cross, Comunidades Latinas Unidas En Servicio (CLUES), MPAAT and Southeast Asian Refugee Community Home (SEARCH). Along with the Southeast Asian report, DREGAN released another report about tobacco use in Latino communities.

Copies of the report can be downloaded from any of the partner Web sites, including, or www.clues. org.