Abdillahi Kahin, pictured on Aug. 22, 2025, of Wellshare International, works toward reducing tobacco use in the Somali community.
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When Hassan Mohamed, a tobacco use prevention coordinator with African Immigrants Community Services of Minneapolis, talks with Somali youth about the hazards of tobacco, he finds himself facing two main adversaries: vaping and hookahs.
Hassan, who has been on the job for six months, and his team hear of those tobacco delivery systems’ popularity during their visits to schools and community centers.
“A lot of youth [vape] nowadays — high schoolers, college students — and actually fall for advertising for different flavors,” he said. “The Somali community are also doing what’s called hookah, which is a different kind of smoking.”
According to the most recent Minnesota Youth Tobacco survey by the state Department of Health, the rate of teens who took their first hit of a nicotine vape or e-cigarette in 2023 nearly doubled, to 30%, since 2017. About one in 10 teens reported using vapes and e-cigarettes regularly, with 80% of those teens reporting being dependent on them.
The good news from the report is that 65% of teen tobacco users had tried to quit, compared to 54% of teens in the 2017 survey.
The Commercial Tobacco-Free Communities Grant Program, using Minnesota Department of Health funding, provides money to local groups for programming aimed at preventing and reducing youth tobacco use.
African Immigrants Community Services was among the first group of grant recipients, with funding from 2022 to 2026. Each grantee receives between $100,000 and $150,000 per year to tailor their prevention efforts to fit the needs of the communities they serve.
Hassan said there is a tendency in the Somali community to hide tobacco use, which makes it harder to intervene.
“We’re East African, so in our community, [tobacco use] is kind of taboo,” Hassan said. “For some elders, it’s OK to smoke, but the younger ones don’t want to be seen in public, so they smoke privately, or they prefer electronic vapes.”
Hassan Mohamed, pictured on Aug. 20, 2025, has worked to reduce tobacco use in the Somali community.
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Throughout his work, some trends Hassan and his team have seen include older Somali men using cigarettes as their tobacco delivery method of choice, while vapes and e-cigarettes are prevalent among younger Somalis. Trends in hookah use, however, are less about age and have more to do with gender, he said.
“Hookah is used by a lot of women,” he said.
The hazards of hookah
Researchers at the University of Minnesota are also trying to help Somali tobacco users kick the habit.
April Wilhelm, a physician, assistant professor and researcher at the university, is in the second year of a two-year research project funded by the university’s Masonic Cancer Center that is examining Somali parents’ perception of the health risks of hookah use to themselves and via secondhand smoke to other household members, particularly children. Wilhelm said the study was prompted by data from studies over the past 15 years that suggest an increase in Somali use of hookahs in their homes, and increasing exposure to secondhand smoke.
A hookah, also called a shisha, is a water pipe that heats flavored tobacco with charcoal, filters the smoke through water to cool it, then delivers the smoke to the user via a hose. It presents the same health dangers as other forms of tobacco use, medical experts say.
“We really wanted to better understand how parents think about shisha and its use in their home relative to their children,” Wilhelm said. “We also wanted to understand some of the things that would help make a healthy change when it came to having hookah in the home, and what some of the things are standing in the way that we might be able to integrate into an intervention or a program to help reduce hookah smoking in Somali family homes.”
Dr. April Wilhelm, pictured on Aug. 22, 2025, is a physician and professor at the University of Minnesota who researches tobacco use in the Somali community.
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Wilhelm partnered with WellShare International, a community health organization based in Minneapolis. WellShare’s community health workers, who are from the communities they serve, interviewed people in Somali about their tobacco use and recruited them to take part in the project’s focus groups.
Wilhelm and her team worked with six focus groups that involved 40 Somali parents, and also interviewed 10 professionals who are Somali American or work closely with the community in areas that included health care, social work, education and religion.
The biggest takeaway, she said, was a widespread lack of knowledge about the health hazards of hookah use, both for the person smoking with one and those exposed to its smoke.
“That came up over and over again, about people’s perceptions around this being less risky than other burned products related to tobacco use, combustible products,” she said. “That was just a really key message.”
Trust is key to effectively sharing information
Researchers used that information to develop an intervention program involving visits by WellShare community health workers to families that smoke hookah in their homes to raise awareness about the health risks to everyone in the family.
Abdillahi Kahin, a senior program manager with WellShare, said shared cultural knowledge and language are crucial in this process, because for many Somali families, accepting that kind of information requires a level of trust.
“When you know deeply what you are talking about, because you are from the same community, you talk about it differently than somebody from outside of the community,” Abdillahi said. “Having people from the same communities delivering that work is very crucial — it has been tested in our community health worker model, and it works.”
State officials previously encountered barriers trying to reach certain communities due to those communities’ different relationships with commercial tobacco, said Parker Smith, MDH’s communication specialist on prevention and policy efforts related to commercial tobacco.
“For example, in American Indian communities, tobacco is a sacred medicine, and so that had been a barrier in the past to implementing effective strategies,” he said. “Before doing that preventative work, we had to engage the community on sacred and traditional tobacco.”
Through the Commercial Tobacco-Free Communities Grant Program, state officials are able to partner with and fund organizations like African Immigrant Community Services and WellShare International that have closer ties to those communities and can provide culturally specific strategies for tobacco use prevention.
“That’s what we encourage our grantees to do,” Smith said. “The hope is that these strategies that we’re trying to move forward with community based organizations that are granted these funds will be able to tailor these interventions to their community in the way that works best for them within the funding parameters.”
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