St. Louis County hopes to put dent in Bosnian residents' smoking

~ For many, sharing cigarettes symbolizes friendship and cultural solidarity.

ST. LOUIS -- On a recent Saturday night, a St. Louis bar popular with Bosnians was heavy with cigarette smoke.

The ashtrays on the tables were filled with cigarette butts. Patrons sang, danced and clapped with cigarettes dangling from their mouths.

Bar patron Elvir Sarajlic says he has smoked up to two packs a day for 13 years and has no plans to quit.

"I like coffee, going out. Cigarettes go with that," says Sarajlic, 33, a Bosnian who moved to St. Louis in 1999. "It's my choice. It's just a habit from the old country."

The St. Louis County Health Department hopes to change such sentiments and persuade tens of thousands of Bosnians here to go tobacco-free.

About 50,000 Bosnians now live in the St. Louis area, and half of the adults are believed to be smokers. That's double the percentage of adult Missouri smokers.

Worried about long-term health costs for Bosnians, the county has hired Anto Peric, an area Bosnian, to help spread the message. Peric moved to St. Louis 11 years ago and now lives in St. Louis County.

The anti-smoking campaign will target Bosnian media outlets and their programs.

Peric said he will collect Bosnians' views on smoking and quitting, approach smokers at work sites, and invite them to join focus groups.

"I'm expecting people laughing at the idea of quitting smoking because many Bosnians are cynical after going through the war's ordeals," Peric said. Still, "there will be those who are willing to listen and educate themselves about the hazards of smoking and are interested in quitting but don't know how."

Next year, the program may expand to serve Bosnian smokers who work outside the county limits in the city of St. Louis. Participants will have access to free nicotine replacement gum and patches.

The program will ask smokers why they smoke and what it would take to quit. It will explain the dangers of secondhand smoke, and point out that it costs $1,100 a year to support a pack-a-day habit. Smokers also will see a "smoker's lung" prop that's been treated with chemicals found in cigarette smoke.

"It's our obligation to provide as much education as possible about the detrimental effect of smoking, not only on the smoker but also on family members and co-workers," said Viviane McKay, a health department education coordinator who will work with Peric. "It's adding to our health costs."

The program is being funded with a two-year, $242,000 Missouri Foundation for Health grant.

If they want to be effective, organizers will have to consider the role of smoking in Bosnian culture, said Aida Cajdric, a Bosnian doctoral candidate in clinical psychology at Saint Louis University who has interviewed Bosnian smokers for her dissertation.

For many, sharing cigarettes symbolizes friendship and cultural solidarity, she said.

"Bosnians like to socialize, and smoking is a major part of socializing," Cajdric said. "Coffee and cigarettes go together."

Zamir Jahic, 38, of south St. Louis County, smoked three packs a day until he suffered a heart attack two years ago.

Jahic believes the anti-smoking program is a good idea but questions whether it will influence middle-aged Bosnians.

"They know smoking is bad for them," he said, "but they think they cannot live without cigarettes."