Facilitators and barriers to smoking cessation among minority men using the behavioral-ecological model and Behavior Change Wheel: A concept mapping study.

Nihaya Daoud,Ruth Weinstein,Mohammad Khatib,Ahmad Sheikh Muhammad,Faten Ghattas,Amir Qaadny,Itamar Grotto,Ye Eun Jung,Lion Shahab

doi:10.1371/journal.pone.0204657

Nihaya Daoud, Ruth Weinstein + Show 7 more

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https://doi.org/10.1371/journal.pone.0204657

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Abstract

Background and aimUniversal smoking cessation strategies are not always successful for minorities, among whom smoking is highly prevalent despite high intention to quit. This study identifies facilitators for smoking cessation, as perceived by minority male smokers, that can inform a culturally appropriate national plan for smoking prevention and cessation.MethodsWe conducted in 2013 a three-stage study among Arab minority male current and former smokers (ages 18–64) in Israel, among whom smoking is very high: first, a Concept Mapping (CM) study with 102 and 202 participants in the brainstorming, and sorting and rating phases respectively. Second, we assigned clusters identified in the CM study to contingency levels using the Behavioral Ecological Model (BEM). Third, we classified clusters into intervention functions and policies using the Behavior Change Wheel (BCW).FindingsThe CM study revealed 58 barriers and facilitators for smoking prevention and cessation that were sorted into 11 clusters by the participants. These clusters were analogous to four BEM level contingency of smoking (social, institutional, community and individual). We classified it into two main policy categories, based on the BCW: 1- restructuring the socio-political environment of smoking through affirmative government's policies towards Arab minority in Israel, and 2-developing a culturally appropriate plan for smoking cessation in Arab local authorities including: raising awareness about tobacco hazards; enforcing anti-smoking laws; strengthening community institutional action; providing smoking cessation services; considering raising prices for tobacco products, addressing psychological sources of smoking in Arab men.ConclusionsOur study revealed barriers, facilitators and contingencies of smoking prevention and cessation with two main policy action items among the Arab minority in Israel: changing the socio-political environment of smoking, and developing a culturally appropriate smoking prevention and cessation national plan. Our study framework can inform policies and culturally appropriate interventions for smoking prevention and cessation in other minorities.

Highlights

Tobacco use is the greatest preventable cause of premature death and chronic morbidity around the world [1]
We conducted in 2013 a three-stage study among Arab minority male current and former smokers in Israel, among whom smoking is very high: first, a Concept Mapping (CM) study with 102 and 202 participants in the brainstorming, and sorting and rating phases respectively
Facilitators and contingencies of smoking prevention and cessation with two main policy action items among the Arab minority in Israel: changing the sociopolitical environment of smoking, and developing a culturally appropriate smoking prevention and cessation national plan

Summary

Introduction

Tobacco use is the greatest preventable cause of premature death and chronic morbidity around the world [1]. Minority populations display significantly lower rates of successful cessation compared to majority populations [3, 9,10,11], despite greater intention to quit than majority groups. Such higher intention has been found among Hispanic Blacks and Hispanics in the US compared to Whites [12, 13], as well as among Bangladeshi and Pakistani minority men in the UK [11]. This study identifies facilitators for smoking cessation, as perceived by minority male smokers, that can inform a culturally appropriate national plan for smoking prevention and cessation

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