Trusted Group is Shifting Hmong Cultural Practices around Tobacco Use

Hmong American Partnership envisions a healthier, commercial tobacco-free community 

Hmong American Partnership (HAP) has been serving the Southeast Asian community in St. Paul since 1990. From youth programs to health and wellness to workforce development and more, HAP is an active and valued partner in the community.

HAP’s initiatives aimed at commercial tobacco prevention and cessation services are a vital part of their work. The Hmong Tobacco-Free Program has two main components, according to Pa Xiong Vang, Tobacco Prevention Coordinator for HAP. First, prevention of commercial tobacco and nicotine use by youth, and second, outreach to organizations and businesses in the community to encourage tobacco-free policies and refer community members to quitting resources. Both efforts are grounded in an understanding of Hmong culture and social norms around smoking and other tobacco and nicotine use.

HAP is supported in these efforts as one of eleven recipients of a Tobacco-Free Communities (TFC) grant from the Minnesota Department of Health, a program to reduce smoking, prevent youth commercial tobacco use, and address tobacco-related disparities in Minnesota. The TFC grant program is part of a growing movement to promote community-driven tobacco prevention and control activities and strategies.

Community members are informing HAP’s tobacco prevention strategies

To better understand how and why tobacco is used by community members, and what works for staying commercial tobacco free, HAP is conducting a community assessment through focus groups, in-depth interviews, and surveys. HAP’s advisory council leads this community assessment design and outreach. The Community Advisory Council is a diverse team of community members with backgrounds in public health, medicine, and mental health, with youth, adult, and elder representatives.

Community-level research like that being done by HAP often provides a richer, more complex picture of health issues, especially when working to understand something like how tobacco is used within a specific group. For example, tobacco use data usually counts all Asian and Pacific Islander communities as one, yet HAP’s community research may reveal observable differences between Hmong and other Asian cultures. Vang believes that commercial tobacco use in the Hmong community is probably higher than the 8.3% rate reported for all Asian adults in Minnesota (compared to 15.2% of the general population). HAP’s research will help to investigate such questions, and to tailor programs to respond to the differences and specific needs of the Hmong community and Hmong culture.

Partnering with area schools, and engaging young people in HAP’s Pathways to Success youth program, Vang is seeing changes in the use of commercial tobacco and nicotine products. It isn’t just cigarettes, cigars, pipes, or chewing tobacco anymore. Use of nicotine-delivery devices like hookah, e-cigarettes like JUUL, and other vaping products are on the rise. “Cigarettes are the main choice in the Hmong community, but e-cigarettes are something new we’re seeing, mostly among youth,” continued Vang. As a result, HAP has incorporated e-cigarette information into its tobacco education work with young people. “We want youth to know that these tobacco products are just as harmful.”

Working with adult community members, HAP has learned that many who want to quit using tobacco are seeking support groups, phone counseling, and other personalized help, in addition to getting other quitting help like using nicotine replacement therapies. The family-centered nature of Hmong society offers one way for community members to personally support one another. “We’re really looking at how do we adapt and create” what meets the community’s needs, observed Vang.   

Finding creative ways to shift cultural practices

At Hmong weddings and funerals, Vang says, cigarettes have traditionally been given out and used, mainly among Hmong men. “It’s considered a cultural and social norm, and if you don’t use it then you’re not honoring your traditions. We don’t really talk about it. It goes into gender and masculinity—and also touches on having your Hmong identity, and then your American identity, too.”

Part of HAP’s work is guiding people to shift cultural norms like these. “I’ve seen families who still use cultural practices, but they don’t use cigarettes; they use dollar bills, and roll them up in the shape of cigarettes”, said Vang. “It’s a cultural shift, and we want to support movement toward alternative healthy behaviors.”

HAP is also working with community partners to encourage policies for tobacco-free grounds at worksites, restaurants and retailers, and nonprofit organizations in the community. “If they don't have a tobacco-free policy on site already and are interested in one, we help them with an action plan,” said Vang.

Increasing future impact by building on community assets, strengths

Looking ahead, HAP will continue to build on Hmong cultural strengths to reach more people and create lasting change.

Throughout the year, events like Hmong New Year, community resource fairs, dance, music and food festivals, soccer tournaments, and health fairs all provide opportunities for celebrating Hmong culture—and engaging community members around tobacco. “The Hmong Health Care Professional Coalition does a great job of running a health fair with on-site health screenings,” helping provide services and health information to people who may not come to a clinic, but do come out for these community events, said Vang.

Traditional media and social media are also useful for outreach to the Hmong community. “We have YouTube channels that are only in Hmong, which we see families using, and the older generation listens to Hmong radio.” HAP will be sharing culturally informed messages when they use these platforms for tobacco and nicotine prevention, and to encourage people to quit.   

“Through the Tobacco-Free Communities grant, we at Hmong American Partnership strive through to a tobacco-free generation and support culturally appropriate and sensitive services and tobacco cessation for the Hmong community,” said Vang.

Learn more about Hmong American Partnership at www.hmong.org.

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More stories about community grantees

The Tobacco-Free Communities Grant Program funds local community grants and technical assistance and training grants that aim to reduce and prevent youth tobacco use and address tobacco-related disparities in Minnesota by promoting community-driven tobacco prevention and control activities and strategies.