Influences on smoking among Greek-Australians aged 50 and over: A mixed-methods study

Author: Masoud Mohammadnezhad

Mohammadnezhad, Masoud, 2014 Influences on smoking among Greek-Australians aged 50 and over: A mixed-methods study, Flinders University, School of Health Sciences

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INTRODUCTION: Cigarette smokers have a higher probability of developing several chronic health disorders. Smokers of all ages can benefit by quitting, but many Australians continue to smoke. Older Greek-Australians have the highest prevalence of cigarette use in Australia. This study assesses smoking among Greek-Australians aged 50 and over and compares predictors of smoking behaviour in this group with the predictors for older Anglo-Australians. METHODS: This investigation included three complementary studies: first, a systematic review of articles on smoking published between 1980 and 2011. The review focused on Randomized Controlled Trials (RCTs) and Quasi-RCTs in which the effects of specific behavioural interventions were examined. Papers were evaluated for inclusion and then data were extracted and interpreted. Second, snowball sampling techniques were used to identify 20 current smokers (12 males and 8 females) aged 50 or older. A qualitative study was designed to gather information on participants' perspectives and understandings regarding their reasons for smoking and their attitudes to quitting. Responses were collected via a semi-structured, face-to-face interview, conducted with the assistance of a Greek translator. The audio-taped interviews were translated and then their content was analysed. Third, a convenience sampling method was used to collect data for a cross-sectional survey of older smokers and non-smokers, including both Greek-Australians and Anglo-Australians in four subgroups: Greek-Australian Smokers (GSs), Greek-Australian non-smokers (GNSs), Anglo-Australian smokers (ASs), and Anglo-Australian non-smokers (ANSs). The data were collected over a six-month time frame from 27 October 2012 to 30 April 2013; subsequent analysis explored participants' knowledge of the health impacts of smoking and attitudes to smoking and/or quitting. Interview questions were designed to test possible differences in predictors of behaviour, knowledge, and attitudes between the four subgroups. Overall, 387 people (106 ANSs, 82 ASs, 103 GNSs, and 96 GSs) participated in this study. RESULTS: The systematic review identified some facilitators and predictors of effective smoking cessation programs targeting older smokers, and smokers with a non-English speaking background (NESB). The qualitative study results showed that older GSs had poorer knowledge about the negative health consequences of smoking as well as a more positive attitude to smoking consumption. They scored low for perceived benefits of smoking cessation and perceived risks of smoking use, while scoring high for perceived barriers to quitting. Few of the older Greek smokers expressed intention to quit, and their level of self-efficacy to embark on smoking cessation was low. Finally, comparing the results of the cross-sectional survey confirmed that GSs had poorer knowledge about the health consequences of smoking and had a more positive attitude to smoking. An integrated model (I-Model) was then developed based on four behavioural change models and theories, to illustrate the relationships of the research variables and to highlight smoking behavioural patterns among older Greek-Australians. CONCLUSION: Older Greek-Australians have been identified as a priority group for smoking cessation interventions in Australia. The new proposed I-Model can be regarded as a comprehensive tool to help health care providers and researchers develop effective strategies to promote smoking cessation for older Greek-Australians.

Keywords: Smoking,Greek-Australians,Anglo-Australians,Older people

Subject: Public Health thesis, Health Sciences thesis

Thesis type: Doctor of Philosophy
Completed: 2014
School: School of Health Sciences
Supervisor: Prof. Paul Ward