Tobacco Use Among Arab American Youth
Condition: Tobacco Use Disorder
MeSH terms: Tobacco Use Disorder
Study type: Observational

Summary: 
      Michigan has the 10th highest smoking rate in the nation. Smoking rates are also very high in
      the Middle East and in Arab American families. The purpose of this study is to learn about
      tobacco use in Michigan Arab American youth ages 14 to 18. The study will evaluate why some
      young people start smoking and others do not. The study will also test an educational program
      designed to encourage young people to either quit tobacco use or to avoid it.
    

Detailed description: 
      Cigarette smoking is the chief avoidable cause of death and disease in Michigan, the United
      States, and the world. In 1996, 25.9% of the Michigan adult population smoked cigarettes;
      Michigan has the 10th highest smoking rate in the nation. When the indirect costs of lost
      income due to smoking-related illnesses and premature death are added to the cost of medical
      care, tobacco use costs Michigan citizens more than $2.6 billion per year (Michigan
      Department of Community Health (MDCH), 1996). Contributing to tobacco use statistics in
      Michigan is a rapidly growing Arab American immigrant population. Studies have shown
      cigarette smoking rates in Middle-Eastern adolescents range from 33% to 58%. This study will
      examine cultural, personal, social, and environmental forces operating in Arab American
      youths at risk for habitual tobacco use. The study will also test the effects of a smoking
      cessation/prevention intervention on smoking behavior.

      The settings for this study are the Arab Community Center for Economic and Social Services
      (ACCESS) Teen Health Center, which services almost 2,500 youth visits each year, and local
      high schools with a significant population of Arab American youth. The majority of the people
      served by the clinic are poor, under-educated, live in extended families of 3 to 5 adults,
      are immigrants, and speak Arabic as a first language. A total of 4,000 adolescents over 14
      years old will be asked to provide information on demographic and cultural variables,
      self-esteem, stress, family and peer tobacco use, intention to use tobacco, history of
      tobacco use, initial stage of change, and perceived health.

      Youths with the highest risk for tobacco use will be randomly assigned to either a Modified
      Project Toward No Tobacco Use (Project TNT) intervention or a wait list control group.
      Project TNT, the precursor to the Arab American-specific modified Project TNT, was designed
      to target the primary causes of tobacco use among adolescents and has been shown to be
      effective in diverse cultural groups. The modified Project TNT consists of weekly 40-minute
      sessions with a health educator over 4 weeks. Bilingual health educators will deliver the
      intervention in a small group (four to six adolescents) or classroom context. Follow-up data
      will be collected at 3, 6, and 12 months after the program is completed. Youth assigned to
      the wait list control group will participate in the modified Project TNT after the Month 6
      follow-up data is collected from the first group.
    

Intervention name(s): Modified Project Toward No Tobacco Use
Intervention type(s): Behavioral
Observational model: Other
Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        2300 + school-based Arab American adolescents (14-18 years) were recruited for
        participation in this study of tobacco use.

        1700 students provided detailed health and tobacco use histories. 616 students were
        assigned by classroom to a smoking cessation intervention or to a class on health.
      
Keywords: Youth; Adolescents; Smoking cessation; Smoking prevention; Risk factors; Arab Americans