Comparison of Barriers to Cessation among Arab American Smokers of Cigarettes and Waterpipe

Abstract

This cross-sectional study examined the differences in barriers to cessation and reasons for quitting smoking among dual smokers of cigarettes and waterpipe tobacco, exclusive cigarette smokers and exclusive waterpipe smokers. Participants were Arab American adults residing in Richmond, Virginia, who were recruited from Middle Eastern grocery stores, restaurants/lounges and faith and charity organizations. The study yielded several key findings: (1) Exclusive cigarette and waterpipe smokers had similar mean barriers to quitting and were more concerned about their health than dual smokers. (F(2, 150) = 5.594, p = 0.0045). This implies that barriers to smoking and health concerns could be a function of the individual who smokes rather than the modality of smoking itself. (2) Exclusive cigarette or waterpipe smokers and dual smokers may have different reasons for quitting, since they have different reasons for smoking. The proportion of smokers who endorsed smoking as a messy habit as the reason among exclusive cigarette smokers was 0.37, whereas the proportion among exclusive waterpipe smokers was 0.04 and among dual smokers 0.39. The difference in proportions is significant, χ2 (df = 2, N = 154) = 13.17, p = 0.0014. In summary, this study supports the need to further investigate dual cigarette and waterpipe smokers, as the study results indicate greater barriers to smoking cessation in this group. Recognition and understanding of these barriers among dual tobacco users would be important for any future tobacco intervention among waterpipe smokers.

Smoking Behaviors in Arab Americans: Acculturation and Health Beliefs

“…The desire to quit smoking was low, in particular among men. This finding is similar to other studies when the intention to quit cigarettes and/or water pipe smoking was also low Haddad et al, 2014).…”

“…According to Cohen (1988), the total variance of 40.6%, explained by the final model, is a large effect. The findings of being female and having lower level of nicotine addiction are predictive of higher desire to quit smoking are similar to other studies (Al-Omari & Scheibmeir, 2009; Haddad et al, 2014; Jamil et al, 2009).…”

“…Female participants had more confidence in quitting smoking and reported higher number of attempts to quit smoking than males that is similar to other studies (Al-Omari & Scheibmeir, 2009;Jamil et al, 2009). Surprisingly, females reported water pipe smoking at a significantly higher rate than males, which is different from previous studies conducted in the United States (Grekin & Ayna, 2012;Haddad et al, 2014). However, studies conducted in the Arab countries show that the prevalence of water pipe smoking among Arab women is increasing at higher rates compared with cigarette smoking (Samet & Yoon, 2010).…”

“…Reasons for quitting smoking differed greatly from other studies. In the sample, participants reported the primary reason to quit smoking was their doctor’s recommendation; in a previous study, the primary reason to quit smoking was the cost of smoking, and doctor’s recommendation was the eighth reason (Haddad et al, 2014).…”

“…In addition, there are important gender differences in smoking behaviors among Arabs. Arab males in the United States and in the Arab world have significantly higher rates of smoking cigarettes and water pipe than Arab females (Azab et al, 2010; Haddad, El Shahawy, & Ghadban, 2014). However, more recently, studies are showing an increasing rate of water pipe smoking among Arab women (Khalil et al, 2013; Mohammad, Kakah, & Mohammad, 2008; Samet & Yoon, 2010).…”