Text Message Support for Smoking Cessation During Ramadan: A Focus Group Study with Somali Immigrant Muslim Men

INTRODUCTION: Somali Muslim male immigrants in Minnesota have a high prevalence of smoking, estimated at 44%, compared with the average smoking rate for adults in the United States (14%). However, the literature has reported spontaneous reductions of smoking during Ramadan. This study sought to gather the views of Somali Muslim men on how faith impacts their smoking, and determine what messaging to incorporate into a tailored text messages intervention that draws on the Muslim faith beliefs and practices during Ramadan to promote smoking cessation. METHODS: 37 Somali adult male smokers were recruited from community settings to participate in one of 5 focus groups in Minneapolis and Saint Paul, Minnesota. The research study team developed a semi-structured focus group guide that explored: 1) the experience of Muslim immigrants quitting smoking during Ramadan, 2) views on text messaging interventions to reduce smoking focusing on health and faith, and 3) views on the relationship between faith and smoking. A thematic analysis was conducted. RESULTS: Participants reported reductions in smoking during Ramadan, which was mostly achieved without formal treatment (i.e., willpower). There was interest in text messaging interventions that incorporated faith and health-related messages, and that would be delivered around the time of Ramadan. Participants described concerns about the adverse health effects of smoking including the risk of chronic health issues, cancer, and death. CONCLUSION: Combining faith and health related text-based messaging, and tailoring interventions around and beyond Ramadan, may be a valuable approach to help address smoking disparities in the Somali immigrant community. IMPLICATIONS: Ramadan offers a unique window of opportunity to intervene upon smoking for Somali Muslim immigrant men, for whom rates of smoking are high. Combining faith and health related text-based messaging, and tailoring interventions around and beyond Ramadan, may be a valuable approach to help address these serious smoking disparities.