Testing the feasibility and acceptability of a religiously-tailored text messaging intervention to reduce smoking among Somali Muslim men during Ramadan

Nicotine Tob Res. 2020 Dec 5:ntaa260. doi: 10.1093/ntr/ntaa260. Online ahead of print.


INTRODUCTION: The prevalence of smoking among Somali Muslim male immigrants residing in Minnesota is estimated at 44%, however smoking reduction is common during the month of Ramadan. This study evaluated the feasibility and impact of a religiously-tailored text message intervention delivered during Ramadan to encourage smoking reduction among Somali Muslim men who smoke.

METHODS: 50 Somali men were recruited. Participants received two text messages per day starting one week prior to and throughout the month of Ramadan. Approximately half were religiously-tailored and half were about the risks of smoking and benefits of quitting. Smoking behavior was assessed at baseline, and at weeks 4 (end of Ramadan), 8, and 16. Outcomes included feasibility, acceptability, and preliminary impact of the text message intervention on smoking reduction and bio-verified abstinence.

RESULTS: The average age was 41 years. Average time to first cigarette was 1.8 hours at baseline, and 46% of participants smoked menthol cigarettes. Eighteen of 50 participants selected English and 32 selected Somali text messages. Subjects significantly reduced self-reported cigarettes per day (CPD) from 12.4 CPD at baseline to 5.8 CPD at Week 16 (p<0.001). Seven subjects reported quitting at week 16, five completed CO testing, confirming self-reported abstinence. The majority of participants found the cultural and religious references encouraging at the end of the week 16 survey.

CONCLUSIONS: Religiously-tailored text messages to decrease smoking are feasible and acceptable to Somali Muslim men who smoke during Ramadan. This intervention for addressing smoking disparities is worthy of further study.

IMPLICATIONS: Recruitment of Somali Muslim men who smoke is feasible and supports the idea that further studies targeting smoking during Ramadan are practical. Ramadan presents a window of opportunity upon which to build smoking cessation interventions for smokers who identify as Muslim. These preliminary findings suggest that text messaging is a feasible and acceptable intervention strategy, and that religious tailoring was well received. Such an approach may offer potential for addressing smoking disparities among Somali Muslim male smokers.

PMID:33277991 | DOI:10.1093/ntr/ntaa260