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Designing tobacco control in the Dominican Republic: Understand the culture first

Ann M Dozier, RN, PhD1, Deborah Ossip-Klein, PhD1, Nancy Chin, PhD1, Scott McIntosh, PhD1, Sergio Diaz, MD2, Timothy D. Dye, PhD1, Susan Fisher, PhD1, Essie Sierra, MPH1, Zahira Quiqones, MD2, and Latoya Armstrong1. (1) Department of Community and Preventive Medicine, University of Rochester, 601 Elmwood Avenue -- Box 644, Rochester, NY 14642, 585-273-2592, ann_dozier@urmc.rochester.edu, (2) Pontificia Universidad Católica Madre y Maestra, Autopista Duarte -- Apartado Postal 822, Santiago, Dominican Republic

Background: Among Latin American Countries, the Dominican Republic (DR) ranked 1st or 12th in smoking rates. Tobacco use increased nearly 4-fold in 30 years, with tobacco-related morbidity and mortality concomitantly rising. Published research on DR tobacco use, attitudes/beliefs is limited as are their tobacco control and intervention programs. Methods: To guide such program development a Rapid Assessment Procedure provided a current snapshot of the DR smoking culture. During a 2-week period (2003) six communities were targeted (2 urban, 2 peri-urban, 2 rural) for 2-3 days each. Two interdisciplinary teams (mixed gender and nationalities) conducted participant observations and interviews.

Results: Over 150 individuals across the communities representing key leaders and the general community participated. Smokers, quitters and never-smokers were included. Intercommunity differences were identified. Communities’ perceive that “everyone smokes”. This was not substantiated. Never smokers ‘thank god’ that they did not have this habit/custom or vice/addiction. The former is a lifestyle while the latter is a problem. Smoking and coffee drinking are inextricably linked. Older individuals and rural residents are perceived to smoke more. Community knowledge about the affects of smoking is limited to the package warning (it hurts one’s health). Tobacco advertising is ubiquitous. Cigarettes are universally available (singles or packs (10/20)). Smokers are price sensitive. While passive smoking effects are not well known, smokers are respectful of non-smokers and children.

Conclusions: Key attitudinal and community level information was obtained to structure tobacco control and cessation programs that reflect the unique culture and increase the likelihood of acceptance.

Learning Objectives:

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

International Tobacco Poster Session

The 132nd Annual Meeting (November 6-10, 2004) of APHA