Culturally informed smoking cessation strategies for Native Hawaiians.

We examined the perceived supports and barriers and the smoking cessation strategies used by Native Hawaiian former and current smokers for the purpose of developing a culturally informed smoking cessation program. Ten focus groups with a total of 52 Native Hawaiian men and women were convened in a rural community in Hawai'i. Thematic analysis of focus group transcriptions resulted in the identification of 11 strategies and 23 supports for and 13 barriers to smoking cessation that were categorized into social, psychological, physical, political, economic, behavioral, and spiritual factors. Native Hawaiian former smokers (compared with current smokers who had tried to quit) found social, psychological, and physical factors helpful in supporting smoking cessation and remaining smoke free. They also reported having used more behavioral and religious/spiritual strategies to quit smoking compared with current smokers. The stories of former smokers also spoke to the importance of family and their religion/spirituality in quitting. Consistent with the findings from other studies, multiple factors were implicated in smoking behavior, suggesting that a multicomponent strategy may be beneficial for addressing the social, psychological, and physical factors related to smoking that we observed in our sample of Native Hawaiians. We also recognize that religion/spirituality is an integral part of Native Hawaiian culture and that church-based support of smoking cessation may help those Native Hawaiians for whom religion/spirituality is an important source of inspiration and guidance.