Cigarettes and the Somali diaspora: tobacco use among Somali adults in Minnesota.

Background: Since the onset of the Somali civil war in 1991, more than 1 million Somalis have been displaced from Somalia. Minnesota has the largest Somali population in the U.S. Informal tobacco prevalence estimates among Somali populations in the U.S. and the United Kingdom range from 13% to 37%, respectively. Little research has been conducted to determine the extent of Somali tobacco use. Purpose: This paper reports the results from a knowledge, attitudes, and practices (KAP) survey conducted and analyzed in 2009 that explores tobacco use and estimates prevalence among Somali adults aged >= 18 years in Minnesota. Methods: Modeled after validated state and national tobacco use surveys, the survey was adapted for Somalis and administered to ethnically Somali adults (N=392) from 25 neighborhood clusters, in Minnesota. Participants were chosen through probability proportional to size and multistage random sampling methods. Results: Estimated prevalence for cigarette use among Somalis was 24% (44% among men, 4% among women). Ever users were significantly more likely to be men, have attended college, and have friends who used cigarettes (p<0.0001). Belief in Islamic prohibition of tobacco was protective and affected current use and future intention to use tobacco (p<0.0001). The majority of Somali smokers were unwilling to use current cessation programs. Conclusions: Estimated cigarette use prevalence was lower than perceived prevalence (37%). Contrary to typical results, greater smoking prevalence was found among Somalis with higher education levels. Positive peer pressure and religion are protective factors from tobacco use and should be integrated into prevention and cessation programs. (Am J Prev Med 2012;43(5S3):S205-S213) (C) 2012 American Journal of Preventive Medicine