Muslim-American Muslim-American Culture and Tobacco Culture and Tobacco

Use Use

ByByDarlene Liberti, RN Darlene Liberti, RN

�لموألكوم �لموألكومأ أ(Assalaamu Alaykum)(Assalaamu Alaykum)

IntroductionIntroduction

Muslims considered “Arab” or “Middle Eastern”Muslims considered “Arab” or “Middle Eastern” Emigrate from many Arabic-speaking countries Emigrate from many Arabic-speaking countries Muslims believe in Islam Muslims believe in Islam (Ahmed, 2004)

Diverse Arab heritage Diverse Arab heritage Largest number reside in northeast USLargest number reside in northeast US 40% have bachelor’s degree or higher40% have bachelor’s degree or higher

(De la Cruz & Brittingham, 2003).

Cultural ConsiderationsCultural Considerations

Speak Arabic at home, understand Speak Arabic at home, understand EnglishEnglish

Men dominateMen dominate Same sex providerSame sex provider Nurses are helpers not professionalsNurses are helpers not professionals Ramadan: a time for fastingRamadan: a time for fasting Pray 5 times per dayPray 5 times per day(Amhad, 2004)

HeritageHeritage Marriage is sacredMarriage is sacred Strong family bondsStrong family bonds Many do not believe in Western medicineMany do not believe in Western medicine Divine intervention (“In Sha Allah”)Divine intervention (“In Sha Allah”) Younger generation care for older Younger generation care for older

generationgeneration Left hand is uncleanLeft hand is unclean(Amhad, 2004)

Three Domains of Muslim Culture

Spirituality

High Risk Behaviors

Family Roles and Organization

(Yosef 2008)

Spirituality Muslims believe in one God, Allah Beliefs are written in the Koran Daily practices include prayer Human body is to be cherished Ramadan strengthens

relationship with God Pilgrimage to Mecca once

in lifetime(Yosef 2008)

Muslim Spirituality 5 “Pillars of Islam” include:

• The profession of faith

• Daily prayers

• Fasting during Ramadan

• Giving alms to the poor, Zakat

• A pilgrimage to Mecca once a lifetime

(Yosef, 2001)

Family Roles and Organization Patriarchal, man is head of

household Extension of families with

marriage bonds Men are responsible for

financial support of family Women are equal; role is to

raise children Women are not discouraged

from working(Hodge, 2005)

High Risk Behaviors

High rate of smoking Overeating and lack of exercise Not obtaining healthcare Little data on HIV/AIDS; related to modesty(Hodge, 2005)

Three Health Problems Identified in the Muslim Population

Tobacco use Diabetes Less frequent

female health screening(Jaber, Brown, Hammad, Zhu & Herman, 2003)

Tobacco Use

Cardiovascular risk factors of Arab Americans

Study particularly looked at smoking history

Results showed higher smoking rate Results showed lower rate of quitting

smoking(Weglicki, Templin, Rice, Jamil & Hammad, 2008)

Water-Pipe Use

Also called hookah, narghile, sheesha Popular in Middle East and North Africa 100 million daily users Smoking promotes feeling of relaxation Promotes conservation Social interaction(Baker & Rice, 2008)

Epidemiological Data on Global Epidemiological Data on Global SmokingSmoking

4 million tobacco related deaths per year and 4 million tobacco related deaths per year and will double by 2020.will double by 2020.

Every 8 seconds, someone dies from tobacco Every 8 seconds, someone dies from tobacco useuse

Smoking has increased in most developing Smoking has increased in most developing nationsnations

Smoking has decreased in U.S. the last three Smoking has decreased in U.S. the last three decadesdecades

Every minute 10 million cigarettes are soldEvery minute 10 million cigarettes are sold(CDC, 2008)(CDC, 2008)

Epidemiological Data on Global Epidemiological Data on Global SmokingSmoking

Highest rate of smoking worldwide: Highest rate of smoking worldwide: Western Pacific Region Western Pacific Region

80,000 - 100,000 children start 80,000 - 100,000 children start smoking every daysmoking every day

Among young teens: 1 in 5 smoke Among young teens: 1 in 5 smoke worldwideworldwide

50% of adolescents who start 50% of adolescents who start smoking go on to smoke as adultssmoking go on to smoke as adults

Epidemiological Data for Epidemiological Data for Middle- East and SmokingMiddle- East and Smoking

According to WHO in 2000, Yemen is in the top 10 countries According to WHO in 2000, Yemen is in the top 10 countries worldwide for tobacco useworldwide for tobacco use

Other Middle Eastern Countries with highest percentage of Other Middle Eastern Countries with highest percentage of tobacco consumption among men is as follows: Tunisia tobacco consumption among men is as follows: Tunisia (69%), Djibouti (57.5), Iraq and Syria (50%), Jordan (48%) (69%), Djibouti (57.5), Iraq and Syria (50%), Jordan (48%) and Lebanon (46%).and Lebanon (46%).

Highest female tobacco consumption: Lebanon (35%) Highest female tobacco consumption: Lebanon (35%) followed by Jordan (10%)followed by Jordan (10%)

Lowest percentage: Oman (15.5%), UnitedLowest percentage: Oman (15.5%), United

Arab Emirates (18.3%) and Saudi Arabia Arab Emirates (18.3%) and Saudi Arabia

at (22%) for men at (22%) for men (WHO, 2009)(WHO, 2009)

Cultural Factors about Smoking Cultural Factors about Smoking in Muslim Societyin Muslim Society

Male dominated society and demonstrates power.Male dominated society and demonstrates power. Social interactionSocial interaction StressStress Traditions such as usage of water-pipes. Traditions such as usage of water-pipes. Water -pipes believed to be less harmful than Water -pipes believed to be less harmful than

cigarettes.cigarettes. Saudi Arabia and OmanSaudi Arabia and Oman

have banned smoking in have banned smoking in

public places. public places.

Healthy People 2010-2020 Healthy People 2010-2020 Initiatives on SmokingInitiatives on Smoking

National Health Objectives in order to improve National Health Objectives in order to improve health of society.health of society.

Tobacco Use is major focus area for health Tobacco Use is major focus area for health initiative and focus goal for program.initiative and focus goal for program.

Smoking is one of the leading cause of health Smoking is one of the leading cause of health indicators in United Statesindicators in United States

23.1% of males and 18.3% of females smoke in 23.1% of males and 18.3% of females smoke in United StatesUnited States

Consequences of Smoking

• Cigarette smoking causes many cancers

• Second hand smoke• Risk increases with exposure to

cigarette smoke• Benefits of smoking cessation• Suffering increased with lung cancer

Negative Media Ads

Advertising geared towards adolescents

Marketing aimed at increasing sales $1.06 billion spent on promoting

cigarettes Quit Smoking Ads(Sussman, 2001)

ReferencesReferencesAhmad, N.M. (2004, April). Arab-American culture and healthcare. Retrieved March

28, 2010 from http://www.case.edu/med/epidbio/mphp439/Arab-Americans.htmDe la Cruz, P., & Brittingham, A. (2003). The Arab population: 2000 census. U.S.

Department of Commerce, Economics and Statistics Administration. Retrieved March 28, 2010 from https://ask.census.gov/cgi-bin/askcensus.cfg

Dobbins, M., DeCorby, K., Manske, S. & Goldblatt, E. Effective practices for school-based tobacco use prevention. Preventive Medicine. 46(4) (2008), p.p.289-297.

Glynn, T. J.,& Manley, M.W. (1989). How to kelp your patients stop smoking: A national cancer institute manual for physicians. US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Cancer Institute. Bethesda

(MD): NIH Publication No. 89-3064,1989.Grossman, M., Coate, D., Lewitt M. & Shakotko A. (1983). Economic and other

factors in youth smoking. National Science Foundation. Washington (DC)

ReferencesReferences

Hodge, D.R. (2005).Social work and the house of Islam: orienting practitioners to the beliefs and values of Muslims in the US. Social Work. 50(2) pp162-173.

Project Towards No Tobacco Use, retrieved on March 31, 2010 from

www.minorityhealth.hhs.gov/npa/.../ProjectTowards NoTobaccoUse.pdf

Rice, v., Weglicki, L, Templin, T., Jamil, H., Hammand, A. Intervention effects on tobacco use in Arab and non-Arab American adolescents. Addictive Behaviors. 35 (1) (2010), p.p. 46-48.

Sussman, S. School-based tobacco use prevention and cessation: where are we going? American Journal of Health Behavior. 25 (3) (2001), p.p. 191-199

Walker, M.S. (2006). Depressive symptoms after lung cancer surgery: Their relationship to coping style and social support. Psycho-Oncology 15: 684-693

Weglicki, L.S., Templin, T.N., Rice, V., Jamil, H., & Hammad, A. Comparison of cigarette and water-pipe smoking by arab and non-arab american youth. 2008. Retrieved on April 2, 2010 from www.ncbi.nlm.nih.gov › Journal List › NIHPA Author Manuscripts

ReferencesReferences

Yosef, A. Culturally sensitive care of the Muslim patient. Journal of Transcultural Nursing.12(3)(2001),pp.228-233.

Yosef, A. Health beliefs, practices and priorities for health care of Arab Muslims in the United States. Journal of Transcultural Nursing. 19(3)(2008), pp. 284-291.