Cultural Connections Help Somalis Become Tobacco-Free

African Immigrants Community Services supports refugees to overcome stress, and spread the word on commercial tobacco’s harms

Many East African immigrants who live in Minnesota have experienced trauma or stress associated with the decades-long civil war in Somalia and the challenges of resettling in a new country. These unique stressors may be related to this community’s higher rates of commercial tobacco use. It is estimated that 24 percent of East Africans in Minnesota smoke cigarettes or hookah, compared to 13.8 percent of Minnesota’s overall population (see Cigarettes and the Somali Diaspora: Tobacco Use among Somali Adults in Minnesota and MATS Fact Sheet by ClearWay Minnesota).  

African Immigrants Community Services (AICS), a nonprofit organization in Minneapolis that serves refugees and immigrants, is working to lower commercial tobacco use in the community by encouraging women and youth to educate others about the harms of commercial tobacco use and nicotine addiction, especially hookah use.

AICS is supported in their efforts as one of eleven recipients of a Tobacco-Free Communities (TFC) grant from the Minnesota Department of Health. TFC is a program to reduce smoking, prevent youth commercial tobacco use, and address tobacco-related disparities in Minnesota. The Tobacco-Free Communities Grant Program is part of a growing movement to promote community-driven tobacco prevention and control activities and strategies.

Community conversations address the need for more education

“We held focus groups with women, and interviews with youth, and found there are a lot of misperceptions about hookah and shisha,” said Sarah Ali, the former Tobacco-Free Communities Coordinator at AICS. Some people aren’t aware that flavored tobacco and shisha, a form of tobacco, contain significant levels of nicotine and that water pipes like hookahsdo not filter out harmful chemicals. “Smoking hookah is a way of socializing,” both for groups of women and when young people are together, observed Ali. “It’s a way of connecting, and coping with stress, but it becomes a constant thing and creates more problems with addiction down the road.”

“By working with women and youth as peer educators in the community, we’re getting them involved so they can inform others about the harms of tobacco” and addiction to nicotine. “The women’s program is important because they support each other well,” noted Ali, while “at home they’re so busy supporting other people.” The twice-weekly community education group for Somali women meets at the Brian Coyle Center in Minneapolis’s West Bank neighborhood and focuses on tobacco prevention, health and wellness, and community activities.

Earlier this year, AICS organized a community event to introduce and celebrate the launch of a new social media campaign addressing tobacco use, including unveiling the logo and materials for the project, which were created through community input. This community event was attended by more than two hundred children, youth and adults, and visitors learned about nicotine addiction and the harm smoking does to a person’s physical health. Another community event this fall concentrated on the dangers of youth vaping. Parents were able to view different devices used for vaping and learned how to talk with their children about the health impact of vaping. Participants contributed comments and pledged to continue the conversation in their homes and with their circle of family and friends.

War in Somalia has fueled immigration, created trauma, and increased tobacco risk

Many immigrants from East Africa have come to Minnesota as refugees fleeing war. Experiences of trauma and stress, such as the events of war, are associated with increased tobacco use. Rates of cigarette smoking among trauma-exposed individuals are nearly double the rates of non-trauma-exposed individuals, and these smokers tend to smoke more heavily and have higher levels of nicotine dependence (Trauma Exposure and Cigarette Smoking, National Institutes of Health). 

In addition, when refugees arrive they face all the challenges that come with leaving their lives, resources, and occupations behind and relocating to an unfamiliar country: language barriers, finding employment, housing, and health care, and settling in a new community—not to mention encountering Minnesota winters. Reducing the stress—and the increased risk of commercial tobacco use that goes with—is a core focus of AICS’s work.

“We help them with all the forms and paper work, help them find housing and a job so they can gradually become self-sufficient,” said Mustafa Hassan, Executive Director of AICS. “They may be providing food and clothing for a large family—eight, nine, even 14 people. All these things can be very stressful.”

Balancing these stress factors, Minnesota’s East African community is supported by cultural values of care and connectedness. “We are a tight-knit community that holds faith and values very strong,” said Ali. “There is really a huge community asset of interdependence that supports tobacco cessation efforts,” echoed Hassan. “It’s really helping.”

Community leaders are eager to support education and outreach

AICS has reached out to community leaders for help educating the community. “The imams have been very open to addressing issues in the Friday sermons, and creating a trust situation where people can talk openly,” said Hassan. “Imams are able to give the information from a religious, cultural, and health perspective. They can say hookah and tobacco are bad for your health, bad for your kids, bad for the community. And it’s costly; if you have lung cancer you can’t support your family.”

Ali agreed that working with the mosques has been very important. “Mosques are really able to get the word out. Several were on board right away, and held events with us so we could do tobacco education.”

Collaborative efforts of TFC grantees are building a better future for all

Hassan is optimistic about the future. “The Tobacco-free Communities grant is really helpful for our community,” he said, “for those who are coming to this country with the custom of smoking, and also those, particularly women, who are picking it up here. We’re bringing people together at every step of the process of education, and providing resources for cessation.” Hassan also sees beyond the East African community to all the communities served by the Tobacco-Free Communities grants. “I am really encouraged. We can get this done by collective action—from the top levels of government and policymakers to people like us on the ground working together. We are really happy to be a part of that.”

Learn more about African Immigrant Community Services at www.aicsmn.org.

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More stories about community grantees

The Tobacco-Free Communities Grant Program funds local community grants and technical assistance and training grants that aim to reduce and prevent youth tobacco use and address tobacco-related disparities in Minnesota by promoting community-driven tobacco prevention and control activities and strategies.

Learn more about the Tobacco-Free Communities Grant Program and read grantee stories featuring their work throughout Minnesota communities.