Smokeless tobacco use is prevalent among South Asian immigrants, particularly in the forms of gutka and tambaku paan. In this paper, we examined (a) gutka and tambaku paan initiation and use patterns among South Asian immigrants, and (b) perceptions related to quitting and tobacco control. Six focus groups were conducted with 39 South Asian adult gutka/tambaku paan users, in three different South Asian languages (Gujarati, Bengali, and Urdu). Participants reported easy availability of gutka and tambaku paan in neighborhood stores, and noted several factors that promoted initiation (including social networks, perceived benefits, and curiosity). Due to awareness of low social acceptance of gutka and tambaku paan in the US, some participants discussed changing patterns of use following immigration. Finally, participants proposed roles of various agencies (e.g., doctors’/dentists’ role, government-led initiatives) for tobacco control in South Asian immigrant communities. This research provides implications for improving tobacco control efforts in the United States, particularly for South Asian immigrants.

Background South Asian (SA) taxi drivers potentially possess a double epidemiologic risk for cardiovascular disease (CVD) due to their ethnicity and occupation. This study investigates SA taxi drivers’ knowledge, attitudes, beliefs about general health, CVD and approaches to reduce CVD risk. Method Five focus groups were conducted with 31 SA taxi drivers in the participants’ primary language (Bengali, Hindi, Urdu or Punjabi). Audio-recordings of the sessions were transcribed, translated and entered into ATLAS.ti 6.2 for coding and analysis. Results SA drivers in an urban setting perceive themselves to be at high risk for CVD because of high work-related stress, physical inactivity, poor diet and poor health care access. Participants attributed their occupation to increasing risk for heart disease; none believed that being SA increased their risk. Discussion Interventions to lower CVD risk among SA taxi drivers should be multi-level and involve the individual drivers and the taxi industry.

Differences between the two cases are discussed. Issues of gender identity should be considered in the assessment of male patients presenting with anorexia nervosa.

Gutka and tambaku paan (smokeless tobacco products used by South Asian immigrants) are carcinogenic to humans (and perceived as such), yet, one-fourth of South Asian immigrants report current use. This study examined disengagement beliefs that perpetuate gutka/tambaku paan use among South Asians despite awareness of health risks. Six focus groups were conducted with immigrant South Asian adult gutka/tambaku paan users, in Gujarati, Bengali and Urdu languages in New York, USA. Participants included 39 South Asian adults residing in the New York City Metropolitan area, current (a minimum of weekly gutka or tambaku paan use in the last 12 months) or former (regular use prior to past 12 months) gutka or tambaku paan users and self-reported spoken fluency in Gujarati, Urdu or Bengali languages. Participants identified many health risks associated with gutka/tambaku paan use including locked jaw, high blood pressure and cancer. Five themes of disengagement beliefs emerged: (a) skepticism about the gutka/tambaku paan–cancer link, (b) perceived invulnerability to harm, (c) compensatory beliefs, (d) faith-based rationalization and (e) acknowledgment of addiction. To promote smokeless tobacco cessation among South Asians, interventions to counter disengagement beliefs and heighten the discomfort between the dissonant cognitions represent a promising area warranting further attention.

Background Exposure to fine particulate matter (PM2.5) and black carbon (BC) have been linked to negative health risks, but exposure among professional taxi drivers is unknown. This study measured drivers' knowledge, attitudes, and beliefs (KAB) about air pollution compared to direct measures of exposures. Methods Roadside and in-vehicle levels of PM2.5 and BC were continuously measured over a single shift and compared to central site monitoring. Participants completed an air pollution KAB questionnaire. Results Taxicab PM2.5 and BC concentrations were elevated compared to central monitoring. Average PM2.5 concentrations per 15-minute interval were 4 - 49 μg/m3; 1-minute peaks measured up to 452 μg/m3. BC levels were also elevated; reaching > 10 μg/m3. 56 of 100 drivers surveyed believed they were more exposed than non-drivers; 81 believed air pollution causes health problems. Conclusions Air pollution exposure among drivers likely exceeds EPA recommendations. Future studies should focus on reducing exposures and increasing awareness among taxi drivers.