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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., (Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.)

Background: Somalis compose the largest African refugee group in the U.S., with more than 55,000 primary arrivals since 2000. Minnesota has the largest Somali population in the U.S. Despite its size, little research has been conducted to determine the extent of tobacco use among Somali youth., Purpose: This paper reports the results from a knowledge, attitudes, and practices (KAP) survey designed to explore factors related to tobacco-use prevention, initiation, and cessation, and to reliably estimate tobacco-use prevalence among Somali youth in grades 9 through 12 in Minnesota., Methods: A KAP survey, modeled after validated state and national youth tobacco-use surveys, was adapted for Somali youth and administered to ethnically Somali youth (N = 302) from seven high schools in Minnesota in 2008. Participants were chosen through probability-proportional-to-size and multi-stage random sampling methods, and the results were analyzed in 2009., Results: Somali high school students' estimated prevalence for "ever-users" of cigarettes was 12.8%, and current use was 4.7%. This is one quarter of the reported statewide smoking prevalence for Minnesota high school students (19.1%) and half of the nationwide prevalence for blacks/African Americans (11.6%). Ever-users were more likely to have close friends or live with someone who smoked cigarettes (p < 0.01). Belief in the Islamic prohibition of tobacco affected future intention to use tobacco (p < 0.01), as did the belief that using hookah/sheisha is less risky than smoking cigarettes (p < 0.01)., Conclusions: Estimated cigarette use prevalence (4.7%) for Somali youth was substantially lower than among Minnesota high school students and also lower than perceived prevalence among Somalis. Positive peer pressure and religion appear to be protective factors in tobacco use and should be integrated into future Somali tobacco prevention and cessation programs, along with education on the risks of hookah/sheisha use., (Copyright © 2010 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.)

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.