title: Description of tobacco use and cessation among Bhutanese refugees participating in a tobacco cessation program.
abstract: To compare the tobacco use, exposure, and cessation differences between Bhutanese refugee and non-Hispanic Caucasian tobacco users in a US federally qualified health center tobacco cessation program.
  
  
  
  A retrospective cohort study reviewing data from 374 patients counseled on tobacco cessation was performed. Demographic information, tobacco use history, exposure to tobacco, and type of tobacco used characterized baseline assessments. The patient record was followed forward in time to evaluate tobacco cessation outcomes as the dependent variable. Data were analyzed using odds ratios and the Mann-Whitney U-test.
  
  
  
  Data analysis included 318 patients (211 non-Hispanic Caucasian patients and 107 Bhutanese refugee patients). Bhutanese refugees demonstrated a higher likelihood of smokeless tobacco product use than the non-Hispanic Caucasian population (67.3% vs 1%, OR = 214.971, 95% CI 50.429, 916.383), and a greater odds of having household tobacco users (OR = 2.533, 95% CI 1.532, 4.186). Likewise, the non-Hispanic Caucasian population exhibited larger odds of smoking cigarettes vs the Bhutanese population (97.2% vs 26.2%, OR = 96.399, 95% CI 38.449, 241.687), had a higher odds of passive smoke exposure (OR = 12.765, 95% CI 5.36, 30.393), and higher likelihood of a past quit attempt (OR = 9.037, 95% CI 5.180, 15.765). Significant gender differences with regard to type of tobacco used were noted among Bhutanese refugees. Bhutanese refugees demonstrated significantly higher likelihood of tobacco cessation, compared with the non-Hispanic Caucasian population, at all length cutpoints, while showing no difference in number of follow-up visits or median time followed.
  
  
  
  These culture-specific findings, showing unique tobacco use characteristics and increased cessation among the Bhutanese refugee population, provide novel information helpful to professionals identifying and treating these individuals for tobacco cessation. More research is needed to confirm our results and findings.
authors.affiliation: a College of Health Professions , North Dakota State University , Fargo , ND , USA.
authors.forename: Brody
authors.identifier: 0000-0002-9181-221X
authors.initials: B
authors.lastname: Maack
authors.affiliation: b Pharmacy Service , VA Eastern Colorado Health Care System , Denver , CO , USA.
authors.forename: Robert
authors.identifier: 0000-0002-4634-8235
authors.initials: R
authors.lastname: Willborn
mesh_terms: D000328:Adult; D001631:Bhutan / Q000208:ethnology; D015331:Cohort Studies; D003431:Cross-Cultural Comparison; D005260:Female; D006293:Health Promotion / Q000379:methods / Q000458:organization & administration; D006801:Humans; D008297:Male; D015397:Program Evaluation; D012036:Refugees / Q000523:psychology / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012423:Rural Health; D062789:Tobacco Products; D064424:Tobacco Use / Q000208:ethnology / Q000517:prevention & control / Q000523:psychology; D020340:Tobacco Use Cessation / Q000208:ethnology / Q000379:methods / Q000523:psychology; D014030:Tobacco, Smokeless; D014481:United States; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data
keywords: Bhutanese; Nepal; Tobacco; cessation; community health center; pharmacist; refugee; retrospective cohort; rural health