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Facilitators and barriers to smoking cessation among minority men using the behavioral-ecological model and Behavior Change Wheel: A concept mapping study

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Listed:
  • Nihaya Daoud
  • Ye Eun Jung
  • Ahmad Sheikh Muhammad
  • Ruth Weinstein
  • Amir Qaadny
  • Faten Ghattas
  • Mohammad Khatib
  • Itamar Grotto

Abstract

Background and aim: Universal smoking cessation strategies are not always successful for minorities, among whom smoking is highly prevalent despite high intention to quit. This study identifies facilitators for smoking cessation, as perceived by minority male smokers, that can inform a culturally appropriate national plan for smoking prevention and cessation. Methods: We conducted in 2013 a three-stage study among Arab minority male current and former smokers (ages 18–64) in Israel, among whom smoking is very high: first, a Concept Mapping (CM) study with 102 and 202 participants in the brainstorming, and sorting and rating phases respectively. Second, we assigned clusters identified in the CM study to contingency levels using the Behavioral Ecological Model (BEM). Third, we classified clusters into intervention functions and policies using the Behavior Change Wheel (BCW). Findings: The CM study revealed 58 barriers and facilitators for smoking prevention and cessation that were sorted into 11 clusters by the participants. These clusters were analogous to four BEM level contingency of smoking (social, institutional, community and individual). We classified it into two main policy categories, based on the BCW: 1- restructuring the socio-political environment of smoking through affirmative government's policies towards Arab minority in Israel, and 2-developing a culturally appropriate plan for smoking cessation in Arab local authorities including: raising awareness about tobacco hazards; enforcing anti-smoking laws; strengthening community institutional action; providing smoking cessation services; considering raising prices for tobacco products, addressing psychological sources of smoking in Arab men. Conclusions: Our study revealed barriers, facilitators and contingencies of smoking prevention and cessation with two main policy action items among the Arab minority in Israel: changing the socio-political environment of smoking, and developing a culturally appropriate smoking prevention and cessation national plan. Our study framework can inform policies and culturally appropriate interventions for smoking prevention and cessation in other minorities.

Suggested Citation

  • Nihaya Daoud & Ye Eun Jung & Ahmad Sheikh Muhammad & Ruth Weinstein & Amir Qaadny & Faten Ghattas & Mohammad Khatib & Itamar Grotto, 2018. "Facilitators and barriers to smoking cessation among minority men using the behavioral-ecological model and Behavior Change Wheel: A concept mapping study," PLOS ONE, Public Library of Science, vol. 13(10), pages 1-26, October.
    • Handle: RePEc:plo:pone00:0204657
    DOI: 10.1371/journal.pone.0204657
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    References listed on IDEAS

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    1. Nihaya Daoud & Varda Soskolne & Jennifer S. Mindell & Marilyn A. Roth & Orly Manor, 2018. "Ethnic inequalities in health between Arabs and Jews in Israel: the relative contribution of individual-level factors and the living environment," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 63(3), pages 313-323, April.
    2. repec:cdl:ctcres:qt8nw5p0zt is not listed on IDEAS
    3. Sorensen, G. & Barbeau, E. & Hunt, M.K. & Emmons, K., 2004. "Reducing Social Disparities in Tobacco Use: A Social-Contextual Model for Reducing Tobacco Use among Blue-Collar Workers," American Journal of Public Health, American Public Health Association, vol. 94(2), pages 230-239.
    4. Barnett, Ross & Moon, Graham & Kearns, Robin, 2004. "Social inequality and ethnic differences in smoking in New Zealand," Social Science & Medicine, Elsevier, vol. 59(1), pages 129-143, July.
    5. Fagan, P. & Augustson, E. & Backinger, C.L. & O'Connell, M.E. & Vollinger Jr., R.E. & Kaufman, A. & Gibson, J.T., 2007. "Quit attempts and intention to quit cigarette smoking among young adults in the United States," American Journal of Public Health, American Public Health Association, vol. 97(8), pages 1412-1420.
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