Assessing Tongan attitudes and beliefs about smoking to reduce tobacco use in the community

An estimated 13,000 Tongans live in San Mateo County, California. Observational evidence led community leaders to question whether a high smoking rate among local Tongans may be among the major health risks for the community. The San Mateo County Health System and local non-profit Taulama for Tongans set out to systematically assess the smoking rate among the population with the hope of gaining insights that would lead to an intervention to limit smoking as a health risk factor. A 47-question survey was developed to assess tobacco use, exposure to secondhand smoke, and community perceptions of tobacco use. The survey was translated into Tongan and distributed by community members through church and social networks.

In total, 194 surveys were completed by adult Tongans. Thirty-two percent of respondents reported smoking, as compared to an 11% overall County smoking rate, with a high number of respondents also reporting that their friends and family members smoke. Survey results showed high community comprehension of the harms of tobacco use, certain cultural limits on smoking, as well as strong community support for smoke-free policies. The process also highlighted some limitations of surveying a population who may be less familiar with survey research. These data were paired with cultural understandings to develop a preliminary social marketing campaign for the Tongan community. A smoke-free event policy campaign and development of a culturally-appropriate educational material serve as the first steps in combating the effects of tobacco among the Tongan community in San Mateo County.