Pathways to Tobacco Control Policy Change: A Systems Approach to Engaging Asian American, Native Hawaiian and Pacific Islander Communities

Background: Despite the success of tobacco control policies in decreasing tobacco prevalence in the U.S., Asian American, Native Hawaiian and Pacific Islander (AANHPI) subgroups still exhibit a high prevalence of tobacco use and few communities have been actively engaged in tobacco control policy change. Utilizing a community based participatory research approach, the “Community-led Policies and Leadership to Eliminate Asian American and Pacific Islander Tobacco Disparities (ComPLEAT)” project aims to assess and develop AANHPI communities’ readiness for change and leadership capacity for implementing a 4-Prong Policy Change model.

Objective:  To describe perspectives about pathways to successful policy change across two communities, Cambodians in Long Beach and NHPI in San Diego

Methods: Key informant interviews were conducted among 21 Cambodian and NHPI community leaders and advocates in 2014.  Community partners were trained to use an interview guide developed in collaboration with project staff, and led the recruitment and selection of interview participants.  The interview, conducted in English,  transcriptions were analyzed for themes and discussed among project staff, scientific consultants,  and community partners.

Results: Results suggested three themes including 1) Policy Change (i.e., policy experience ranges for both communities and there is a strong need for an investment in culturally tailored communication), 2) Intergenerational Dynamics (i.e. refugee and migration experiences contribute to acculturation, which can be seen as a loss and a gain), and 3) Threats (i.e. cultural trauma can create barriers and also creates the need to talk about fear and cultural resilience).

Discussion: Cambodian and NHPI communities have community and culturally specific concerns that are important to consider for developing strategies for tobacco policy change.  Engaging community partners in all phases of the key informant interview process was critical to capturing perspectives of the community on sensitive issues, while also building the leadership capacity of community partners.