culture, diversity, ethnicity and tobacco use · 2011-05-17 · culture often we use ethnicity and...

Culture, Diversity, Ethnicity and Tobacco UseMaryland Center for Quitting Use and Initiation of TobaccoMDQUIT.ORG

What is Culture?The confluence of genetic, familial, social, political, and historical influences that can shape

how individuals view themselves and their world,process experiences, and communicate and interact with others.

There are multiple subcultures in which individuals live (diversity within and across individuals)Individual participation/identification in a culture vary in how integrated into life and perspectiveCultural influences are not always conscious or explicit

CultureOften we use ethnicity and race as a measure of culture and diversityHowever, this is problematic since we can overlook diversity within an ethnic or cultural subgroup and overlook the dynamic nature of culture so we really develop cultural stereotypesActually each of us lives embedded in our own unique and often shared cultureCulture represents our lives in context and how that context affects our experiences and our views, beliefs and values

Cultural Competence

Understanding that there is often a gap between what we believe and how we see an issue and how someone in another cultural context sees the issueThe challenge is to create a shared narrative or view that both sides can understandCreating shared realities is the only way to create cultural competence

Our Goal TodayTo learn about how smoking, nicotine and various approaches to prevention and treatment of tobacco use can be better understood among subgroups of our population in MarylandTo explore ways

To create a shared view of the problem and the solution To acknowledge and develop a respect for cultural considerations of the various groups of individuals we want to reach with tobacco prevention and cessation messages.

Comparing Maryland Smoking Prevalence with Quitline Callers by Race & Ethnicity

Prevalence 2006 data and Quitline UseJan 1, 2007 through Dec 31, 2007

Data Sources: Free & Clear® Quarterly Reports 2007; 2006 Maryland Adult Tobacco Survey; Free & Clear® Maryland Quitline Year 2 Evaluation Report, Prepared by SSI, Inc.

Tobacco Use Prevalence, Quitline Use, and Satisfaction

Examination of the # of calls to Maryland Quitline (1-800-QUITNOW) for a full year

January 1, 2007 through December 31, 2007Examination of the prevalence of tobacco use in Maryland

Data derived from the 2006 Maryland Adult Tobacco Survey (MATS)

SSI, Inc. evaluated a sub-sample of callers to the MD Quitline & assessed their satisfaction with QL services

SSI, Inc = Social Solutions International, Inc.

Maryland Statewide Race & Ethnicity

0.6

1.2

3.6

39.1

53.7

1.7

0.0 10.0 20.0 30.0 40.0 50.0 60.0

Asian

Am. Indian

Other

White

Black

Hispanic

Rac

ial &

Eth

nic

Gro

ups

Percent of Callers (N= 5,982)

5.4

23.6

18.7

18.7

17.0

13.8

0.0 5.0 10.0 15.0 20.0 25.0 30.0

Asian

Am. Indian

Other

White

Black

Hispanic

Rac

ial &

Eth

nic

Gro

ups

Percent using tobacco

2007 Quitline Tobacco Users by Race & Ethnicity

2006 Prevalence of Tobacco Use by Race & Ethnicity

Source: 2006 Maryland Adult Tobacco SurveySource: 2007 Free & Clear® Quarterly Reports

Baltimore Region



Anne Arundel, Baltimore, Carroll, Harford, Howard, and Baltimore City

Source: 2007 Free & Clear® Quarterly Reports Source: 2006 Maryland Adult Tobacco Survey

9.5

25.7

23.1

20.0

21.3

18.6

0 5 10 15 20 25 30

Asian

Am. Indian

Other

White

Black

Hispanic

Rac

ial &

Eth

nic

Gro

ups


0.5

1.2

2.9

38.1

55.6

1.9

0.0 10.0 20.0 30.0 40.0 50.0 60.0

Asian

Am. Indian

Other

White

Black

Hispanic

Rac

ial &

Eth

nic

Gro

up

Percent of Callers (N=4,308)

Baltimore City2007 Quitline Tobacco Users

by Race & Ethnicity Baltimore City


Baltimore City

0.2

1.1

2.6

23.3

71.3

1.6

0 10 20 30 40 50 60 70 80

Asian

Am. Indian

Other

White

Black

Hispanic

Rac

ial &

Eth

nic

Gro

ups



17.8

32.0

33.6

18.7

23.7

25.8

0 10 20 30 40

Asian

Am. Indian

Other

White

Black

Hispanic

Rac

ial &

Eth

nic

Gro

ups


Baltimore County2007 Quitline Tobacco Users

by Race & Ethnicity Baltimore County

2006 Prevalence of Tobacco Use by Race & Ethnicity Baltimore County


14.9

29.6

21.5

19.9

14.7

0 5 10 15 20 25 30

Asian

Am. Indian

Other

White

Black

Hispanic

Rac

ial &

Eth

nic

Gro

ups


0.9

1.3

3.3

57.7

34.8

2.3

0 10 20 30 40 50 60 70

Asian

Am. Indian

Other

White

Black

Hispanic

Rac

ial &

Eth

nic

Gro

ups


Counties Bordering Baltimore City & Co.

1.1

1.6

3.5

73.2

18.6

2.4

0 10 20 30 40 50 60 70 80

Asian

Am. Indian

Other

White

Black

Hispanic

Rac

ial &

Eth

nic

Gro

ups

Percent of Callers (N=547)


Bordering Counties


Anne Arundel, Carroll, Harford, and Howard Counties


9.7

28.3

6.6

19.3

15.3

18.5

0 5 10 15 20 25 30

Asian

Am. Indian

Other

White

Black

Hispanic

Rac

ial &

Eth

nic

Gro

ups


Suburban Washington Region

1.1

0.5

7.2

21

67.2

4.7

0 10 20 30 40 50 60 70 80

Asian

Am. Indian

Other

White

Black

Hispanic

Rac

ial &

Eth

nic

Gro

ups




Frederick, Montgomery, and Prince George’s Counties


2.2

6.9

15.3

14.3

13.1

9.7

0 5 10 15 20 25 30

Asian

Am. Indian

Other

White

Black

Hispanic

Rac

ial &

Eth

nic

Gro

ups


Southern Maryland Region



Calvert, Charles, and St Mary’s Counties

0.8

3.1

2.3

50.4

41.1

1.6

0 10 20 30 40 50 60

Asian

Am. Indian

Other

White

Black

Hispanic

Rac

ial &

Eth

nic

Gro

ups


20.4

10.3

21.9

0.0 5.0 10.0 15.0 20.0 25.0

Asian

Am. Indian

Other

White

Black

Hispanic

Rac

ial &

Eth

nic

Gro

ups



Lower Eastern Shore Region



Dorchester, Somerset, Wicomico, and Worcester Counties

2.3

2.8

2.3

65.5

24.9

3.4

0 10 20 30 40 50 60 70

Asian

Am. Indian

Other

White

Black

Hispanic

Rac

ial &

Eth

nic

Gro

ups


22.6

20.7

19.9

18.5 19.0 19.5 20.0 20.5 21.0 21.5 22.0 22.5 23.0

Asian

Am. Indian

Other

White

Black

Hispanic

Rac

ial &

Eth

nic

Gro

ups



Upper Eastern Shore Region



Caroline, Cecil, Kent, Queen Anne’s, and Talbot Counties

0

1.5

2.7

83.5

11.9

1.9

0 10 20 30 40 50 60 70 80 90

Asian

Am. Indian

Other

White

Black

Hispanic

Rac

ial &

Eth

nic

Gro

ups


21.7

24.5

28.3

0.0 5.0 10.0 15.0 20.0 25.0 30.0

Asian

Am. Indian

Other

White

Black

Hispanic

Rac

ial &

Eth

nic

Gro

ups



Western Maryland Region



Allegany, Garrett, and Washington Counties

0

1

3.1

81.4

14.4

4.2

0 10 20 30 40 50 60 70 80 90

Asian

Am. Indian

Other

White

Black

Hispanic

Rac

ial &

Eth

nic

Gro

ups


20.1

23.4

21.9

18.0 19.0 20.0 21.0 22.0 23.0 24.0

Asian

Am. Indian

Other

White

Black

Hispanic

Rac

ial &

Eth

nic

Gro

ups



5.6

39.7

54.8

2.2

22.5

28.6

31.6

17.3

6.7

64.0

29.3

5.7

0 20 40 60 80

Other

White

Black

Hispanic% of MD Population% of Smokers% of QL Callers

Quitline Reach in MD by Race & Ethnicity

Reach Effect Hispanic 0.13 Black 1.73 White 1.39 Other 0.25

Source: Free & Clear® Maryland Quitline Year 2 Evaluation Report, Prepared by SSI, Inc.

QL EvaluationRespondents were 285 tobacco users 18-85 (M = 46.1 ± 11.9) years of age60.1% were female51.2% were Black or African American8.1% were Hispanic40.3% graduated from high school and 45.2% reported some post-high school educationAlmost all (98.6%) were cigarette smokersOver 2/3 (75.7%) reported smoking for 20 or more years3/4 (74.9%) reported smoking a pack a day or lessApproximately 3/4 enrolled in the multi-call program and 1/4 enrolled in the one-call program

Quitline SatisfactionEvaluation Sample: 285 tobacco users who received Quitline services between Jan 1

and Sep 28, 2007.Question: "Overall, how satisfied were you with the quitline?”

Results:Satisfaction was consistent across race, age, gender, education

level.Overall satisfied with services (“very”, “mostly”, or “somewhat”):

89.8% of Whites or Caucasians91.6% of Blacks or African Americans surveyed100% of Hispanics surveyed

Source: Free & Clear® Maryland Quitline Year 2 Evaluation Report, Prepared by SSI, Inc.

Underage Tobacco Use

Source: 2006 Maryland Youth Tobacco Survey (MYTS)

Statewide Rates of Current (past month) Tobacco Use among Underage Youth (2006 MYTS)

16.7

34.5

22.7

13.3

18.2

12.8

0 5 10 15 20 25 30 35 40

White

Native Hawaiian / PacificIslander

Alaskan Native /American Indian

Asian

Hispanic / Latino

Black / African-American

Percent Using Tobacco

Statewide Current (past month) Tobacco Use by School Status

24.6

38.0

35.4

18.5

24.5

15.6

5.5

22.3

11.7

4.6

8.2

8.6

0 5 10 15 20 25 30 35 40

White

Native Hawaiian / PacificIslander

Alaskan Native /American Indian

Asian

Hispanic / Latino

Black / African-American


High School Middle School1.8

2.9

4.0

3.0

1.7

4.5

Transition rate

Underage Tobacco Use by Individual Grades

32.4

21.6

23.0

25.5

13.2

5.8

3.0

31.9

22.7

24.5

22.3

13.2

7.8

6.0

17.3

14.6

15.7

15.0

11.7

9.3

5.8

34.2

28.1

22.4

16.0

9.4

5.0

2.4

0.0 10.0 20.0 30.0 40.0

12th

11th

10th

9th

8th

7th

6th

Gra

de


WhiteBlack / African-AmericanHispanic / LatinoOther

Conclusions

We need to evaluate our reach into communities that have different cultural experiences We are reaching some groups with targeted approachesHopefully in dialogue with our speakers and our local health professionals we can become more effective in engaging all our subgroups by listening to their needs and addressing their concerns

MDQUIT Resource Center for Tobacco Use Prevention and Cessation

Dr. Carlo DiClemente, DirectorDr. Janine Delahanty, Associate DirectorFrancoise Jean-Louis, Administrative AssistantCenter Specialists

Miranda GarayPreston GreeneMeredith HolmgrenDebra Malfi (On Internship)Onna VanOrden

Undergraduate Research AssistantsHabits Lab Graduate Research Assistants

culture, diversity, ethnicity and tobacco use · 2011-05-17 · culture often we use ethnicity and...

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