title: Tobacco use and cessation among Somalis in Minnesota.
abstract: BACKGROUND
  Somalis compose the largest African refugee group living in the U.S., with more than 10,330 primary arrivals in fiscal year 2006 alone. Half of all Somalis in the U.S. live in Minnesota. Although tobacco use is a considerable problem among Somalis, especially among men, little research has examined factors affecting tobacco use and cessation.
  
  
  METHODS
  A sequential exploratory design informed the overall study methodology. Key informant interviews (n=20) and focus group discussions (13 groups; n=91) were conducted with Somali adults and youth in the fall of 2006 and the summer of 2007, respectively. Participants were asked about tobacco-use prevalence, prevention, and cessation, and the marketing of tobacco.
  
  
  RESULTS
  Perceived prevalence of tobacco use by Somalis is high at 50%. The main reason for initiating tobacco use was the influence of friends or peer pressure and included other social factors. Prevention and cessation messages suggested by participants include medical advice, education on the negative health effects of tobacco use, religion, and the support of family and friends. Barriers to cessation include lack of insurance coverage, lack of knowledge on where to find assistance, and lack of cessation support groups. Severe social stigma for Somali female smokers poses specific challenges to prevention and intervention efforts. Water-pipe smoking is perceived to be prevalent, particularly among female youth.
  
  
  CONCLUSIONS
  Somalis view tobacco use as an important issue in their community. Religious and social support and demographically targeted approaches should be key factors in creating effective prevention and cessation programs and must address water-pipe smoking.
authors.affiliation: Minnesota International Health Volunteers, Minneapolis, Minnesota 55404, USA.
authors.forename: Kristin K W
authors.initials: KK
authors.lastname: Giuliani
authors.forename: Osman A
authors.initials: OA
authors.lastname: Mire
authors.forename: Safiya
authors.initials: S
authors.lastname: Jama
authors.forename: Diana K
authors.initials: DK
authors.lastname: Dubois
authors.forename: Douglas
authors.initials: D
authors.lastname: Pryce
authors.forename: Saeed
authors.initials: S
authors.lastname: Fahia
authors.forename: Laura C
authors.initials: LC
authors.lastname: Ehrlich
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D017144:Focus Groups; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation / Q000379:methods; D012998:Somalia / Q000208:ethnology; D014505:Urban Population; D055815:Young Adult