Characteristics and prevalence of tobacco use among Somali youth in Minnesota

Background: In 2008, the Minnesota Department of Health reported a state-wide smoking prevalence of 19.1% among high school students, indicating that tobacco use continues to be a problem among teenagers. Somalis compose the largest African refugee group in the U.S., with more than 55,000 primary arrivals since fiscal year 2000. Minnesota has the largest Somali population in the U.S. and, despite its size, little research has been conducted to determine the extent of tobacco use among Somali youth.

Methods: A knowledge, attitudes and practices (KAP) survey, modeled after validated state and national youth tobacco use surveys was adapted for Somali youth and administered to ethnically Somali youth (n=302) from seven (7) high schools in Minnesota in 2008. Participants were chosen through probability proportional to size and multistage random sampling methods.

Results: Estimated prevalence for ‘ever users' of cigarettes was 12.8% and current use was 4.7%, which is one quarter of the reported state-wide smoking prevalence for Minnesota high school students. Ever users were more likely to have friends who used cigarettes, chewing tobacco or hookah and to believe that tobacco use makes young people ‘look cool' than never users (p<0.01). Belief in Islamic prohibition of tobacco affected future intention to use tobacco (p<0.01).

Conclusions: Estimated cigarette use prevalence (4.7%) for Somali youth was substantially lower than perceived prevalence. Positive peer pressure and religion are protective factors in tobacco use and should be integrated into any future prevention and cessation programs.