Tina Bexson reports for the Guardian: ‘Taste of Tradition’ – Quitting smoking within the UK’s Asian communities

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For Asian men, smoking is second nature and a sign of belonging – but some areas in the UK are more committed than others in providing help for them to quit.

TINA BEXSON reports for the Guardian newspaper

Rufon Uddin is trying to give up smoking. He is finding it very difficult.

One of the biggest obstacles is being out with his friends in Newcastle upon Tyne’s West End where they all live and work. It is also hard because smoking is very much part of being a Bangladeshi man. It’s viewed with a strong sense of social acceptance, social bonding, and tradition.

“It’s very hard when they are all smoking and you are not, you feel apart as though you are missing out,” he says. “It’s also often the only real time when you can smoke properly because once our people get married, we wont smoke at home in front of the wife because she doesn’t like it.”

Nor can he smoke in front of anyone older than him because it is customary for Bangladeshis to never smoke in front of elders. “It’s a respect thing in Bangladeshi society,” Rufon explains. “I don’t smoke in front of my parents, even though my father smokes, and they know I smoke. And if I pass group of lads in their twenties who are smoking they will hide their cigarettes or put them out until I’ve gone past, out of respect for me. But I see lots of white people when they get to 16 smoking in front of their parents with their parents even buying cigarettes for them.”

But he can smoke at work. “95% of us work in an Indian takeaway or restaurant,” he says, “and there are many more opportunities to smoke at work than there are for white people whose day is usually more structured. As long as we go outside we can have a cigarette whenever we need.”

Although he recognises that giving up is ultimately up to the individual, he would like to join a local smoking cessation programme run by Newcastle and Tyne Primary Care Trust (PCT) to give him a head start. But it is only geared towards the white population and fails to acknowledge the different cultural concerns and problems facing smokers from his culture.

This is surprising because according to a survey by the Department of Health smoking is much more common amongst Bangladeshi men (44%) than among white men (27 %). For Bangladeshi men aged 50-74, the rate is a staggering 56%. This has serious health consequences. For example cardiovascular disease (angina, heart attack, stroke, high blood pressure and diabetes) is 60-70% higher amongst Bangladeshi and Pakistani men, than the general population.

These significant differences between whites and South Asian men and women mark a drastic need for culturally sensitive interventions in Newcastle, outlines research recently published in the British Medical Journal (BMJ) from the School of Population and Health Sciences at the University of Newcastle.

Places such as Bradford, Birmingham and Tower Hamlets in London, are already running both successful and advanced interventions such as the campaigns that take place during Ramadam. And since the Department of Health launched the NHS Asian tobacco education campaign in August, local smoking cessation services run by PCTs are increasing in other South Asian communities throughout the UK.

So why not in Newcastle upon Tyne?

Judy Loggie, the manager of smoking cessation services at Newcastle and Tynside PCT, who has only recently took up her post, admits that they should be doing more. “We should be doing all this stuff, but we’re not. We did have Asian smoking cessation workers working on and off for two years, but it wasn’t a programme, it was just how we had responded to Asian needs so far. It’s not enough, and we need to do some more.”

Martin White, Senior Lecturer in Public Health at the University of Newcastle, conducted the BMJ research. He was struck by how “many white middle class professionals within health care will view South Asians as a singular population with the idea that they can develop a ‘one size fits all’ approach to interventions for them.”

“But it’s fundamentally wrong,” he adds. “For example, it doesn’t make sense that what should work for young male Bangladeshis who work anti social hours in the restaurant trade should work for elders sitting at home all day. They are almost different cultural groups.”

Since its almost expected for the elders to smoke, Shazan Uddin, a bilingual community health worker and cardiac rehab nurse for the Westgate Heartbeat project in Newcastle, says that it takes a major health crisis for many of them to give up.

Many of his clients are elderly South Asians with coronary heart disease and diabetes. “Usually they’ve either had a heart attack or are going to have heart bypass surgery before they give up,” he says.

Targeting those who aren’t suffering any ill health effects and who don’t want to give up is very difficult. “They say they’ve smoked all their life and don’t think its doing them any harm, it helps them relax. They’ve always got a way of justifying why they smoke and don’t want to give up”.

The situation isn’t helped by the acute lack of awareness of the serious health risks linked by smoking. DoH figures show that only 27% of Pakistanis and Bangladeshis associate smoking with heart disease.

Religion has little influence because despite tobacco being seen as Haram (not good says God) it is not specifically banned by their Islamic faith as alcohol is. Nor do their wives have much impact. “Their wives do put pressure on them but they say that they as men are the decision makers in Asian families,” says Shazan.

“Up until now there has been very little information available in Bengali advising them on the damage smoking causes and on how to give up. But they need more information but they don’t want any more of those leaflets, most of them don’t like reading anyway.” Because of these reasons, Shazan believes that any culturally sensitive smoking cessation programme would have to include structured group sessions.

Jamal Sarwar, 35, was one of the Bangladeshi advisors working for the PCT. Now he works as a community interpreter in the day and in an Indian restaurant in the evening. He is also a light smoker.

“It is absolutely necessary we have a proper smoking cessation programme in place. When I was working as a smoking cessation advisor we found that we needed a central place where clients could go and see a doctor, a nurse and where they could get advice, nicotine replacement therapy, counselling and join a group. But we did not have that.”

However Martin White acknowledges that there is the possibility of a programme being seen as “intrusive and patronising with people preaching to the Asian community”. “But on the other hand there are many people in the community who do want to give up.”

Jamal agrees. “They would welcome a Bangladeshi smoking cessation programme. There is nothing at the moment and leaving it purely up to will power is very hard. If the programme is geared towards my community then I don’t think it can be patronising at all.”

“Also the elders would only be happy on a programme with their own age group and taken by an adviser of their own age group. The same goes for the younger men who have different pressures and influences such as Indian films where the hero is always smoking. Our people need to feel the comfort of their own people.”

If he ever joined a smoking cessation programme Rufon would want the advisor to understand the pressures of working in an Indian takeaway or restaurant, and know what goes on in his community. “A person from a different culture wouldn’t,” he says, “but a Bangladeshi man would.”

Martin White argues that any future culturally sensitive programme in Newcastle must take on board the differences within the communities themselves if they are going to reach their target population and be effective. “UK investment is urgently needed in culturally sensitive smoking cessation interventions for South Asians that involve the government and national and local health agencies, particularly primary care trusts.” These requirements should be underlined by the Race Relations (Amendment) Act 2000, he adds, which obliges public authorities, including the NHS, to promote racial equality in access to services.

SIDE BAR :

TOWER HAMLETS PCT TOBACCO CESSATION PROGRAMMES FOR SOUTH ASIANS:

Tower Hamlets PCT funds a project serving the Bangladeshi community partnered by Queen Mary University of London and a community organisation, Social Action for Health. It offers a ‘culturally competent service’ that tries to meet the needs of the local community by using bilingual gender specific male and female advisors who are aware of the socio-cultural context of tobacco use and the impact this has on tobacco cessation for the Bangladeshi community.

Although smoking is acceptable amongst Bangladeshi men, in women it is regarded as taboo, and disrespectful. Only 4% of the women smoke. They prefer to chew tobacco in a mixture called Paan especially those aged over 55 and of whom its estimated that 56% chew. Chewing is just as harmful, contributing to coronary heart disease, and cancer of the mouth. “But we don’t want to take anything away from them, it’s traditional within their culture,” says Tobacco Cessation Advisor Shamsia Begum. “They’d have seen their grandparents do it. So our message is ‘enjoy your paan and leave out the tobacco’.”

The advisors try and distinguish what the main causes for the addiction are. For women, its often being in a different country without the freedom they are used to. Smoking is frequently linked to stress.

“So we try and divert the men to an alternative to cigarettes to relieve stress, such as exercise or a hobby,” Shamsia explains. “ It may also be appropriate to refer them on to another service too.”

All materials, including advice pamphlets, contact details and questionnaires, are printed in both English and Bengali.  An advisory group made up of smoking cessation advisors and community members meets quarterly to discuss and advise on new developments.

“We work on a locality basis,” says Ray Croucher, Professor of Community Oral Health at Queen Mary University of London, and the project’s joint manager. “We don’t wait for people to contact us – we recruit from the community by being present at, for example, a local food co-op and English language classes.”

Once clients have entered the Tower Hamlets programme they receive one to one counselling, nicotine replacement therapy and weekly advice.  “Then we continue to make contact in the community or, if they’d prefer, provide domiciliary visits. Our success rate is around 62%, compared to the national average of 48-50%.”

The approach is “holistic”, he continues, “and sometimes offers guidance on housing and benefits issues or facilitates access to dental care. Through liaison with environmental health officers we’ve also developed a Code of Practice for Retailers – traditional tobacco products imported from South Asia often have inadequate labelling about the health impacts of tobacco use.”

TAIL END

‘Understanding Influences on Smoking in Bangladeshi and Pakistani Adults: A Community Based, Qualitative Study’, by the School of Population and Health Sciences at University of Newcastle, Newcastle upon Tyne, is available at http://bmj.com/cgi/content/full/326/7396/962

ENDS

 

 

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BIGGIE & TUPAC Review and interview with Director Nick Broomfield by TINA BEXSON For HOTDOG magazine

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BIGGIE & TUPAC

Review and interview with Director Nick Broomfield by TINA BEXSON For HOTDOG magazine

The increasingly fearless director tirelessly tracks the lives and unsolved murders of the two rap stars and former friends, Tupac Shaker, and Biggie Smalls in a roller coaster ride of gang violence and rap rivalry, punctuated by Broomfield’s suitably subtle and deadpan narration. We’re in typical Broomfield territory. There’s the usual varied collection of idiosyncratic characters on the receiving end of his surprisingly effective fumbled questioning; the new insights including Biggie’s middle-class upbringing belying his Gangsta image, and Tupac acting out a scene from Scarface at a Harlem acting school. There’s also the incidental humour. Then there are the conspiracy theories, a la ‘Kurt and Courtney’. But here’s the difference: These conspiracy theories are so extreme and entangled that you wonder how the hell Broomfield coped with such an investigative challenge.

The assumed motivation for both killings – that they arose from the beef between West Coasts Death Row records, Tupac’s label, and East’s Bad Boy records, Biggie’s label – is swiftly dismissed. Instead the feud is widely rumoured to have been fuelled by the formers CEO, Gangsta Kingpin Suge Knight, to distract from his alleged scheme to murder Tupac, whom he owed millions in unpaid royalties. The subsequent shooting of Biggie six months later was seen to serve the same purpose – to divert further attention. Best of all, there’s the ongoing tale of police corruption, specifically voiced by ex-LAPD detective Russell Poole, that begs further questions in this convoluted exploration. Were some LAPD officers moonlighting as security for Knight and ‘signed up’ members of the related Bloods Gang? Did Knight also hire them to kill Tupac after the 1996 Tyson fight in Las Vegas? And to kill Biggie six months later after a Vibe magazine party? Then there’s the FBI. Why were they keeping Biggie under surveillance at the time of his murder, and why didn’t they intervene on that dark fateful night? It’s gripping stuff, though frustrating. You’re desperate to see justice done, or at least see some of the lose ends tied up. But this is ‘real life’, and there are no happy endings. Talking of endings, one of the final shots featuring a reference to the life expectancy of Snoop Dogg on Suge Knight’s Death Row website, is both disturbing and hilarious.

Interview with Nick Broomfield by Tina Bexson:

As a big fan of Biggie & Tupac’s music, “especially Biggie’s”, Nick Broomfield was intrigued by the murders from the off. “But”, he says, “I only decided I wanted to do the story when it became political, when it seemed members of the LAPD were involved, and the FBI might well be too.

“It was a mean task, and involved over 14 weeks of shooting. They even hired a private detective to get more information on the ‘Bookkeeper’ who took care of Death Row Records Dodgy books.”

“Then we got several breaks that had not been revealed before”, adds Broomfield, “like stuff that Kevin Hacky, Tupac’s bodyguard came up with, and what we got out of the Bookkeeper when we interviewed him in prison. It was very much an investigative piece, and I felt more of a responsibility to get it right instead of fiddling around as much as I have done in some of my other films.”

It never becomes crystal clear who can be held accountable for the slayings, but the film does ask questions about the involvement of Death Row Records and of specific characters like David Mack, Rafael Perez (both dirty cops), and Amir Muhammad. It also asks why the LAPD haven’t followed up the leads.

“The level of corruption in the police department is worse than it’s ever been”, Broomfield reveals, “But we’re hoping the film will add to the clamour for more of an investigation.”

He also believes the paranoia about black power in America is an ongoing concern.

“Biggie and Tupac were seen as politically wild. They had a lot of support and were taken very seriously. This was seen as being far more important to the FBI than the injustice of the murders.”

But despite the gravity of the subject matter, ‘Biggie & Tupac’ is splattered with humour which the director says, came mostly from the characters involved with the Hip Hop scene.

“People like Hacky, were so absurd. And you can’t believe how extreme it all is, and that makes it funnier.”

Visiting Suge Knight in a maximum secure prison (where he was being held on unrelated charges) is likened to being funny “like a horror show”. The cameraman was slightly overcome by the sight of hundreds of overly muscular men in the outside gym, and the resulting footage is rather wobbly.

“If you film in a combat zone, whether it’s a prison or whatever, some people manage to stay cool and go with what’s happening. Others end up like a deer in the headlights and don’t hear what you are saying to them. You feel horribly cruel because the more they fold, the more you have to give them new instructions, and it just gets worse and worse.”

“It was recommended this guy because I was told he’d filmed in a prison before. But on the drive up there, I discovered the filming he’d done was not only in an empty prison, it was for a soap opera.”

Although it was “a freaky film to make”, Broomfield was more frightened before the shoot.

“It’s then you think, ‘well what are the chances of something happening to me’. But I’m delighted to still be here, and delighted its finished. I couldn’t sleep for months because I didn’t think I could make it work. But now I can go out and have dinner without being completely crazed and obsessed.”

Broomfield explained that he won’t be getting into something as big straight away as his next big project is a feature film, tentatively called ‘Indecent Exposure’.

“It’s about the head of Colombia Pictures who blew his brains out in 1995. He was an embezzler through and through, somebody who pretended to be one thing but was something else. He was a difficult character to unravel.”

Viewers will look forward to the unravelling.

TAIL END:

“Labyrinth”, a book by the Rolling Stone journalist, Randall Sullivan, which traces the murders will be published in the States on April 2nd. It is available on Amazon.

 

Ends (TB)

Photographs from World-wide Photowalk day 2017, ( طريق آل البيت Photowalk), Cairo

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Turkish coffee and empty chairs on al Ashraf St, el Khalifa, Cairo

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Gas for domestic use is still transported by horse and cart in many areas of Cairo

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Baladi bread fresh from the oven

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Al Ashraf Street, Al Khalifa

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Baladi bread bakery

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Mashrabiya, a type of Oriel window, overlooking Sharia Khayamiya

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Koshary, an Egyptian dish originally made in the 19th century, made of ricemacaroni and lentils mixed together, topped with a spiced tomato sauce, and garlic vinegar; garnished with chickpeas and crispy fried onions.

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The dried crispy snacks that accompany Koshary

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The Street of The Tentmakers of Chareh El-Khiamiah ), Islamic Cairo 

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Ibn Tulun Mosque

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The Street of The Tentmakers of Chareh El-Khiamiah ), Islamic Cairo 

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Mohamed Ali Sabil

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The Street of The Tentmakers of Chareh El-Khiamiah ), Islamic Cairo 

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Northern end of Al Khayama, Islamic Cairo

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Northern end of Al Khayama, Islamic Cairo

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Ibn Tulun Mosque

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La Sayeda Nafeesah Mosque, Cairo

Tina Bexson interviews Dutch cinematographer, Robby Müller

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Since the Seventies Dutch cinematographer Robby Müller has steadily established himself as a creative risk taker, collaborating with the likes of Wim Wenders, Jim Jarmusch, Lars Von Trier, on films such as Paris Texas, Down by Law, Ghost Dog: The Way of the Samurai, and Breaking the Waves; and most recently with Michael Winterbottom on 24 Hour Party People. Not bad for a man who says that he decided to become a cinematographer as a way of getting out of the Army.

Here he gives us a rare insight into his technique and why he favours black and white:

What was it like working on 24 hour party people?

“Michael (Winterbottom) had asked me twice before to work with him but I was busy on other films. Then we met up and he interested me in the story of Factory Records and the Hacienda. I was especially keen to work in this rougher and fresher style he had in mind. Shooting a film can be very mechanical, it’s all slate, camera, action, cut, then you prepare, and repeat the whole process over and over. You lose momentum, but Michael wanted all the shots improvised and we managed to keep the pace going. I got into the history behind the story too, and Manchester, but not the rain. ”

You’ve often said you like to create situations where ‘happy accidents can happen’. Why?

“These can end up helping the way the director wants to tell his story. Like in Breaking the Waves. We were very much operational with the cameras for the sex in the toilet scene, and worried we had fucked it up, but the result ending up being just what Lars Von Trier wanted, it bought about the sense of drama he was after without that polished look.”

So what is Lars Von Trier like to work with?

“Lars has a very clear idea of what he does and doesn’t want. Like on Dancing in the Dark he had us use 100 DV cameras to film the musical scenes, we all had the freedom to move 360 degrees, and all those camera shots were perfectly in synch with each other so we could easily cut between them, it was very magic. So was Björk, I liked her very much, she was a very professional woman, and a good actress.”

You also collaborated extensively with Jim Jarmusch on many of his films, what was your most memorable experience?

“There are many. I liked working on Down by Law (with Tom Waits, John Lurie, and Roberto Benigni) where I felt it was important to be shooting in black and white. Colour should only be used if it supports the story otherwise its just exotic background wrapping, giving superfluous information. Its like a poem, you leave out what you don’t need. And because we shot in such an exotic location (New Orleans), it would have been a completely different film if it was in colour, making the audience look at the landscape and the surroundings rather than the people. Jarmusch was very receptive to this way of thinking.”

What’s distinctive about the way Wim Wenders works?

“He often barely had a script or a storyboard, and would nearly always shoot in buildings already occupied by people, never studios. So I was always working with natural light and more intimate surroundings but I like that sense of realism so if there’s not enough I would open up the lens rather than add extra lighting.”

“I also like to work chronologically as he does, without any rigid time scales imposed so you can work in more of an organic way. You can bring in new people too, you can get a feel of the film and develop it as you go along.”

What advice do you have for young filmmakers and cinematographers?

“Don’t rely on new technology, its only a tool, a means to an end, don’t let it make you lose sight of where you are going. Don’t over do it, keep things simple.”

“Don’t have a second agenda, be honest, keep the integrity, at least to yourself, and always ask yourself why you are doing a certain project, do you really like it, do you know where you stand? I try to do this on all the films I work on. But of course there were certain times when me and my gaffer have asked ourselves ‘what on earth are we doing here?’”

“Oh, and always ask the director why you are shooting in colour (if you are) then at least you know what you’re working with and you’re not just a zombie following rules.

What film has particularly inspired you?

“Fellini’s 8 ½. It was beautifully shot in black and white.”

Robby Müller’s credits include:

Coffee and Cigarettes

24 Hour Party People

Dancer in the Dark

Ghost Dog: The Way of the Samurai (1999)

Buena Vista Social Club

Breaking the Waves

Beyond the Clouds

Dead Man

Mad Dog and Glory

Until the End of the World

Mystery Train

Barfly

Down by Law

To Live and Die in L.A.

Paris Texas

Repo Man

Kings of the Road (1976)

Alice in the Cities (1974)

Goalkeeper’s Fear of the Penalty Kick (1971)

© Tina Bexson