Creating a Culturally-Specific South Asian Tobacco Module

Background/Context South Asians are the second-largest Asian subgroup and fastest growing minority population in the United States. Despite large disparities in preventable diseases among this community, lack of disaggregated and culturally-appropriate data preclude the creation of targeted intervention strategies. Large cardiovascular and site-specific cancer disparities exist among South Asian Americans. Population-based research in the U.S. has concluded that tobacco does not contribute to excess burden of these diseases; these studies did not inquire about indigenous tobacco products commonly used by South Asians. Local surveys including culturally-specific tobacco demonstrate higher rates of tobacco, resulting in more consistent associations with tobacco-related disparities. These studies used dramatically different survey instruments, thus not allowing comparability. Methods This abstract will present qualitative methods used to ascertain tobacco products commonly-used by South Asian Americans, modes of ingestion, and culturally-defined “units of use”. Focus groups—separated by key demographic variables—were conducted in three distinct ethnic enclaves, inquiring about cultural contexts of tobacco use. This data was used to create culturally-specific survey items, which were cognitively-tested by community members; these were subsequently integrated into state-level validated adult tobacco instruments. Findings/Implications Initial findings indicate distinct patterns of use not accurately captured by existing and/or validated tobacco surveys. Analyses suggest high total use rates, and lack of accurate knowledge influencing use of indigenous products. Religion, socioeconomic status, birthplace, and time in U.S. seem to be determinants of use. Population-based implementation of the module will facilitate more accurate reflections of tobacco use among South Asians, enabling implementation of targeted programs.