Date of Graduation

2018

Document Type

Dissertation

Degree Type

PhD

College

School of Public Health

Department

Pharmaceutical Systems and Policy

Committee Chair

Kimberly Kelly

Committee Member

Fadi Alkhateeb

Committee Member

Kevin Larkin

Committee Member

Michael Newton

Committee Member

Usha Sambamoorthi

Abstract

Muslims in the United States (US) exhibit higher rates of tobacco use in comparison with rest of the US population. As a result, US Muslims might be at a higher risk for negative health consequences of tobacco use such as lung cancer. Investigating factors that are associated with tobacco use, number of smoking cessation attempts, and interest in lung screening in adult US Muslims can facilitate future efforts aimed at improving health outcomes, essentially through reducing tobacco use rates and promoting preventive lung screening in this population. Therefore, the current dissertation aimed to investigate the association of Social Cognitive Theory factors with 1) tobacco use, 2) number of serious smoking cessation attempts, and 3) interest in lung screening in a sample of adult Muslims in the US. Data were collected from November 2016 through March 2017 from a convenience sample of adult (≥ 18 years) US Muslims. The study included a cross-sectional online survey. Participants with a personal history of lung cancer were excluded. Associations between Social Cognitive Theory factors and tobacco use, number of serious smoking cessation attempts as well as interest in lung screening were investigated with univariate analyses followed by regression analyses. For aim 1, eligible participants (n=271) from 30 states completed the survey; 52.8% reported current tobacco use. In terms of personal factors, individuals were less likely to report current tobacco use if they 1) perceived more personal consequences for tobacco use on health, and 2) reported greater confidence regarding ability to abstain from tobacco use. In terms of environmental factors, individuals whose family members did not use tobacco were less likely to report current tobacco use. Interaction between sex and attitudes indicated that among individuals with negative views about tobacco use, women were less likely to report current use compared to men. For aim 2, eligible participants (n=132) from 23 states completed the survey; 47.0% seriously attempted to quit smoking at least once over the past 12 months, half of which reported attempting to quit without any assistance. Smokers reported more serious smoking cessation attempts if they 1) had more knowledge about the consequences of smoking cessation, 2) had more positive attitude regarding quitting, and 3) reported greater religiosity. Additionally, smokers reported fewer serious smoking cessation attempts if they 1) were employed, 2) affiliated with Sunnah sect, 3) reported better self-assessed health, 4) reported higher perceived value for quitting, and 5) indicated that using tobacco was not allowed inside the home. For aim 3, eligible participants (n=271) from 30 states completed the survey; 59.9% expressed an interest in being screened for lung cancer. Individuals were more likely to express an interest in lung cancer screening if they had 1) more positive views about lung screening, 2) higher perceived value of screening, and 3) greater self-efficacy with regard to ability to undergo lung screening. Personal views and confidence in one’s ability to take an action can be essential factors in tobacco use-related behavior and interest in lung screening among US Muslims. Additionally, religiosity can play an influential role in promoting tobacco cessation in US Muslim smokers. Overall, this dissertation can be a seminal work for future interventions aimed at reducing tobacco use and its health burden, especially lung cancer, in this unique segment of the US population.

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