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Measurement of Tobacco Use among South Asians in the U.S.

Principal Investigator: Cristine Delnevo

Funding Mechanism: National Institutes of Health- Grant

ID number: 1 R21 CA164913-01A1

Award Date: 9/11/2012

Institution: University of Medicine and Dentistry of New Jersey School of Public Health

Although immigrants from South Asia (including India, Pakistan, Bangladesh, Sri Lanka, Nepal, and the Maldives) comprise the second largest Asian group in the U.S. and one of the fastest growing immigrant groups, existing studies of tobacco use in South Asian immigrants are limited. Such studies tend to be geographically restricted or focused only on “western” cigarette smoking, despite the fact that South Asian tobacco consumption is characterized by significant use of strong native tobacco products – such as bidis (small brown hand-rolled cigarettes) and gutkha and paan masala (two types of chew tobacco) – that are readily available in ethnic enclaves in the U.S. Furthermore, South Asians are almost always aggregated into a broad “Asian” category, potentially masking subgroup differences. Studies conducted in the United Kingdom suggest that immigrant South Asians have high rates of tobacco use and continue use of their native tobacco products. Furthermore, given the health risks of tobacco use and the explosive growth of South Asians in the U.S., methodological research is warranted to assess inaccuracies in measuring tobacco use in this population. The goal of this study is to improve tobacco surveillance methodologies and generate a better understanding of indigenous tobacco use among South Asian immigrants in order to inform tobacco control efforts. Study aims are: (1) to understand tobacco use behaviors in this population by conducting eight focus groups (8-12 participants each); (2) to develop, refine and pre-test a survey instrument (including standard tobacco use survey questions and new questions about indigenous products) to assess the prevalence of tobacco products used by South Asian immigrants; (3) to implement a population-based split sample randomized survey of 150 South Asian immigrants that compares standard tobacco use measures and new questions developed to measure indigenous tobacco product use; and (4) to explore the feasibility of a respondent-driven sampling (RDS) approach (a “snowball sampling” methodology in which survey participants recruit their peers), in which investigators will attempt to reach an additional 450 South Asian immigrants through the original 150 participants. The findings from this study will lay the groundwork for a future investigation into the epidemiology of health behavior risks (including tobacco use) among South Asians residing in the U.S.

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