Ramadan represents ‘untapped opportunity’ to encourage smoking cessation among Muslim men

Religiously tailored text messages intended to decrease smoking during Ramadan were “feasible and acceptable” among Muslim men in Minnesota, results of a single-arm observational study showed.

According to researchers, Muslim communities have a high smoking prevalence. The prevalence among Muslim men in the United States is 62.8%, whereas the prevalence of smoking among all men in the country stands around 15%.

Rebekah Pratt, PhD, an assistant professor of family medicine and community health at the University of Minnesota Medical School, told Healio Primary Care that once a year, there is an “untapped opportunity” to “support smokers in their efforts to stop” — the holy month of Ramadan, which for many Muslims “is a time when smokers are motivated to quit.”

Pratt and colleagues recruited 50 adult Somali Muslim male immigrants for their intervention. Somali women, who have a much lower prevalence of smoking because of stigma, were not included in the study, the researchers said. To develop the text messages, the researchers worked with an imam and consulted Smokefree.gov, which offers a “free library of evidence-based text messages for smoking cessation,” Pratt said.

Examples of religiously tailored texts included:

• “Smoking is forbidden among faithful Muslims.”
• “As Muslims we must protect the health and safety of all life, our own and others that are around us.”

Examples of texts from Smokefree.gov included:

• “You may feel strange when you quit; this is withdrawal. You are addicted to nicotine and your body is used to smoking. These feelings will go away.”
• “There is NO such thing as safe tobacco. Cigars, pipes, hookah and dip carry many of the same health risks as cigarettes, like addiction.”

One message from each category was sent daily to the participants 1 week before Ramadan and continued throughout the holy month.

According to the researchers, participants significantly reduced the number of cigarettes they reported smoking per day — from 12.4 at baseline to 5.8 at week 16.

Seven participants reported quitting at week 16, and five of those participants completed carbon monoxide testing that confirmed their abstinence, the researchers said.

From baseline to 16 weeks, participants experienced a significant improvement in total scores on the Patient Health Questionnaire, which screened for anxiety and depression. Researchers said they received “overwhelmingly positive” feedback from participants regarding the intervention.

“We plan to do more research on the intervention to continue refining it,” Pratt said. “It is our hope that in the future, physicians could draw on this as an additional resource they could use in encouraging smoking cessation.”