Assessing factors influencing smoking and smoking cessation within Chinese communities in the Greater Vancouver Area: A qualitative exploratory study
Noah Tregobov 1, 2, 3,   Iraj Poureslami 1, 2,   Jessica Shum 1, 2,   Niloufar Aran 1, 2,   Austin McMillan 3,   J. Mark FitzGerald 1, 2  
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Division of Respiratory Medicine, Centre for Heart and Lung Health, Vancouver Coastal Health Research Institute, Vancouver General Hospital, University of British Columbia, Vancouver, Canada
Gordon and Leslie Diamond Health Care Centre, Vancouver General Hospital, University of British Columbia Hospital, Vancouver, Canada
Faculty of Health Sciences, Queen’s University, Kingston, Canada
J. Mark FitzGerald   

Division of Respiratory Medicine, Centre for Heart and Lung Health, Vancouver Coastal Health Research Institute, Vancouver General Hospital, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada
Submission date: 2020-05-04
Final revision date: 2020-08-14
Acceptance date: 2020-08-21
Publication date: 2020-10-07
Tob. Prev. Cessation 2020;6(October):57
The prevalence of smoking is high within Chinese-Canadian communities and there is a lack of culturally and linguistically appropriate smoking cessation resources and services. We aimed to ascertain factors affecting smoking and smoking cessation from the perspectives of current smokers and key informants.

As part of a multistage mixed-methods study taking place from January 2013 to June 2014, a qualitative exploratory study design was conducted applying a community-based participatory research approach. Focus groups and interviews were conducted with adult (aged ≥19 years) Chinese-Canadian current smokers (≥5 cigarettes per day for the past 30 days) and interviews were held with key informants in Vancouver, Canada. A constant comparison method was applied to code data, and an inductive approach was used to identify emergent themes.

In all, 35 smokers from the target communities (11 female, 24 male) participated in 4 focus group sessions and 17 key informants (14 female, 3 male) were individually interviewed. Internal and external factors influencing smoking onset, continuation, and cessation from the perspectives of smokers and key informants were identified. Male smokers thought that the most influential factor influencing smoking initiation was social pressure, while female smokers thought that it was stress. Female smokers reported refraining from seeking cessation assistance due to a perceived negative image of female smokers within the community. Both key informants and participants indicated that involving friends and family in the quitting process may help to motivate smokers.

Smokers from Chinese-Canadian communities may benefit from linguistically appropriate and culturally relevant smoking cessation interventions that consider prevailing attitudes, perceptions, and beliefs. The knowledge gained may inform the development of future smoking cessation programs and resources for the target community, while our approach may be applicable to other ethnocultural or immigrant communities.

We sincerely thank all participants and key informants for helping to advance our understanding, and community organizations for participant recruitment.
The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported.
The work was supported by the Vancouver Foundation, a non-government funding agency in British Columbia, Canada (Proposal number: UNR12- 0714).
Each author has made substantial contributions to acquiring the data, and helping to write, edit, and prepare the manuscript. IP and JMF worked to design the study and NT and JS conducted the majority of qualitative data analysis. All authors approve of the submitted version and agree to be accountable for their own contributions.
Not commissioned; externally peer reviewed.
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