Exploring the smoking-related behaviour among South Asian ethnic minority smokers in Hong Kong : a qualitative study

Abstract

Introduction: Hong Kong is a multicultural city with many ethnic minorities, of which South Asians make up a large proportion of the population. Despite measures to curb smoking in Hong Kong, which has one of the lowest smoking rates in the world, there has been little research on smoking among South Asians. Objectives: This study aimed to explore the experiences, knowledge, attitudes and needs concerning smoking and smoking cessation among South Asian ethnic minority smokers in Hong Kong, while also addressing the possibility of developing adaptive interventions to help them quit smoking. Methods: A qualitative approach was selected as the research method for this study through the implementation of semi-structured interviews. A purposive sampling technique was used of achieving a full understanding of this particular group of people. The subjects who were invited to participate in this study are of South Asian ethnicity and are current smokers. Thematic content analysis was used to analyse the transcripts that were produced from the audio recordings of interviews with the participants. Results: A total of thirty South Asian ethnic minority smokers from India, Pakistan and Nepal participated in the semi-structured interviews. Four themes emerged from the qualitative findings, which are: T1 Smoking initiation factors, T2 Motivation to quit; T3 Barriers to quitting; T4 Barriers accessing smoking cessation support. Pressure, limited social network, the change of religious environment are the main smoking initiation factors among South Asian Ethnic Minorities in Hong Kong. The main motivations to quit smoking among them are the expense of cigarette prices and health concerns. Lack of social support and knowledge about smoking cessation and difficulty coping with withdrawal symptoms are the main barriers they face during quitting. Their unawareness of the smoking cessation services, an inability to afford the expense of clinics, and received unexpected treatment methods are the reasons they are reluctant to seek smoking cessation support again. Stricter laws, setting a higher cigarette price, and smoking cessation support target on SAEM smokers were needed. The development and evaluation of cultural and religious specific interventions are needed to address this problem. Conclusions: This study generates new knowledge about the experiences, knowledge and attitudes related to smoking and smoking cessation among South Asian ethnic minority smokers in Hong Kong. The results indicate that these smokers are a group of people that requires more attention. It is of paramount importance for healthcare professionals in Hong Kong to develop interventions that target this group. Moreover, the government authorities should improve the existing regulations on tobacco control. Implication for practice: Healthcare professionals need to develop smoking cessation interventions based on emotional support and knowledge improvement for this population. Moreover, healthcare providers need to learn about better communication with ethnic minority smokers. Healthcare professionals should spend more effort on strengthening the enforcement of smoking bans base on the existing tobacco control policies. The existing smoking cessation services need improvement to adapt more ethnics.