Connections, Cultural Understanding Drive Anti-smoking Outreach Effort

Muscle w LogosIn partnership with Asian Americans for Equality (AAFE), experts from the Section on Tobacco, Alcohol, and Drug Use in NYU Langone Medical Center’s Department of Population Health are implementing a community navigator model to reach smokers and link them to smoking cessation resources.  Despite the availability of safe and effective treatment for tobacco dependence, only a small proportion of smokers who try to quit each year use cessation therapies. This is particularly true among low-income adults and for non-English language speakers, contributing to growing disparities in smoking prevalence. 

Through its work and its history of smoking cessation outreach, AAFE has learned some invaluable lessons.  We sat down for a Q&A session with Flora Ferng, Director of Community Outreach, and Ken Ho, Program Coordinator, to hear some of their insights.

Interviewer:  Despite the overall decline in smoking city-wide, Asian men continue to have the highest smoking rates of any population in New York City and the rates continue to climb. Smoking rates in Community District 3 [which encompasses Chinatown] are the highest in the entire city. Why do you think that is true?

Flora Ferng: Smoking rates for men in China are very high--nearly 60 percent. It is very ingrained in Chinese culture. Even celebrities and elected officials smoke in public in China.  It is a very “manly” thing to smoke. And in Chinatown, it is easy to get inexpensive cigarettes on the black market.

Ken Ho:  Here, pressure is the number one reason why Chinese men smoke. Working hours.  Stress. And then even when they are married, many men live by themselves. Many men have no people they can share their feelings with. They are lonely and bored. 

Interviewer: So how do you help them to become interested in quitting smoking in the face of such powerful reasons to smoke?

Ferng:  For some other kinds of programs you can create a flyer or brochure, and that would be it.  But we realize that smoking is a very personal decision and choice. It's an addiction. So you can't give them a flyer and say, "Hey, quit smoking," and now voila, it will stop.  So first we have to reach them. For most people, it is not a high priority.

Ho:  We don’t start the conversation about smoking until we have established a relationship. If we can help relieve other pressures, we can develop trust and perhaps lessen the burdens and stress that are causing people to smoke and making it hard to quit. Most of the smokers I have met through this work have never even thought about quitting and have never tried before.

Ferng:  One strategy we have used is to link with our other programs. In this way, we can get them in the door, for example, for a program on affordable housing or Protecting your Health and Wealth and then once they are there, we talk to them about the costs and consequences of smoking.

Ho:  I was a smoker for six years so I know how hard it is. I had two family members die because of lung cancer and I have had many friends who have been affected. When I tell them my own story and share the facts, I have more confidence to convince them – and people can tell how passionate I am.

Ferng: AAFE has been committed to this issue for a long time. Now, to reach a larger group, we contact smokers and their relatives through many of our programs and we have added a smoking question to our standard intake form. We are educating all of our intake specialists to know about the smoke cessation program. People need to know there will be a service available to them.