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Abstract：
OBJECTIVE: Head and neck cancer (HNC) constitutes a substantial portion of the cancer burden worldwide, with over 550,000 new cases and over 300,000 deaths annually, with disproportionately high mortality rates in the developing countries. The large majority of HNCs are caused by tobacco use, and synergistic effects of tobacco and alcohol use. Using the Common-Sense Model (CSM) as a framework, this qualitative study sought to understand South Asian HNC survivors\' cognitive and emotional representations of their cancer; and to assess if these representations differ by smokeless tobacco (SLT) vs. smoked tobacco use.
METHODS: In-depth semi-structured interviews, conducted with South Asian HNC survivors (N = 15, 80% participants were immigrants, while 20% came to the United States for treatment) to identify key themes and issues related to HNC experience and SLT vs. smoked tobacco use.
RESULTS: The results of the study provide a deeper understanding of South Asian HNC survivor experiences with receiving a HNC diagnosis, delays in seeking treatment and related medical care, disagreement regarding smoked tobacco/SLT history as potential causes of cancer, strategies to cure the cancer or prevent recurrence, enduring physical and psycho-social consequences of treatment, and emotional impact of the cancer experience. Three key implications emerged: (a) the utility of narratives as a method of eliciting HNC survivor experience to understand patient experiences and concerns; (b) the potential for public health practitioners to harness patients\' voices and the power of storytelling for developing campaigns about public awareness of SLT use, providing information and support to SLT users, and encouraging SLT quitting resources; and (c) the importance of providing clear, personalized and culturally sensitive education regarding the risks of SLT use.
CONCLUSIONS: This study underscores the significance of offering tailored tobacco cessation services to South Asian HNC survivors, and to help inform supportive models of care for others.
METHODS: In-depth semi-structured interviews, conducted with South Asian HNC survivors (N = 15, 80% participants were immigrants, while 20% came to the United States for treatment) to identify key themes and issues related to HNC experience and SLT vs. smoked tobacco use.
RESULTS: The results of the study provide a deeper understanding of South Asian HNC survivor experiences with receiving a HNC diagnosis, delays in seeking treatment and related medical care, disagreement regarding smoked tobacco/SLT history as potential causes of cancer, strategies to cure the cancer or prevent recurrence, enduring physical and psycho-social consequences of treatment, and emotional impact of the cancer experience. Three key implications emerged: (a) the utility of narratives as a method of eliciting HNC survivor experience to understand patient experiences and concerns; (b) the potential for public health practitioners to harness patients\' voices and the power of storytelling for developing campaigns about public awareness of SLT use, providing information and support to SLT users, and encouraging SLT quitting resources; and (c) the importance of providing clear, personalized and culturally sensitive education regarding the risks of SLT use.
CONCLUSIONS: This study underscores the significance of offering tailored tobacco cessation services to South Asian HNC survivors, and to help inform supportive models of care for others.
摘要：
目的：头颈癌（HNC）占全球癌症负担的很大一部分，每年新增病例超过55万例,死亡人数超过30万人,发展中国家的死亡率过高。绝大多数HNC是由烟草使用引起的，以及烟草和酒精使用的协同效应。使用常识模型(CSM)作为框架，这项定性研究试图了解南亚HNC幸存者对其癌症的认知和情感表征；并评估这些表征是否因无烟烟草（SLT）与烟熏烟草的使用。
方法：深入半结构化访谈，与南亚HNC幸存者进行(N=15，80%的参与者是移民，而20%的人来到美国接受治疗)，以确定与HNC经验和SLTvs.烟熏烟草的使用。
结果：研究结果为南亚HNC幸存者接受HNC诊断提供了更深入的了解，寻求治疗和相关医疗服务的延误，关于吸烟/SLT历史是癌症的潜在原因的分歧，治愈癌症或预防复发的策略，持久的身体和心理社会后果的治疗，和癌症经历的情感影响。出现了三个关键含义：（a）叙事的实用性，作为引起HNC幸存者经验的一种方法，以了解患者的经历和关注；（b）公共卫生从业人员利用患者的声音的潜力和讲故事的力量，以开展有关SLT使用公众意识的运动，向SLT用户提供信息和支持，并鼓励SLT放弃资源；和(C)提供明确的重要性，关于SLT使用风险的个性化和文化敏感教育。
结论：这项研究强调了为南亚HNC幸存者提供量身定制的戒烟服务的重要性，并帮助告知对他人的支持模式。
方法：深入半结构化访谈，与南亚HNC幸存者进行(N=15，80%的参与者是移民，而20%的人来到美国接受治疗)，以确定与HNC经验和SLTvs.烟熏烟草的使用。
结果：研究结果为南亚HNC幸存者接受HNC诊断提供了更深入的了解，寻求治疗和相关医疗服务的延误，关于吸烟/SLT历史是癌症的潜在原因的分歧，治愈癌症或预防复发的策略，持久的身体和心理社会后果的治疗，和癌症经历的情感影响。出现了三个关键含义：（a）叙事的实用性，作为引起HNC幸存者经验的一种方法，以了解患者的经历和关注；（b）公共卫生从业人员利用患者的声音的潜力和讲故事的力量，以开展有关SLT使用公众意识的运动，向SLT用户提供信息和支持，并鼓励SLT放弃资源；和(C)提供明确的重要性，关于SLT使用风险的个性化和文化敏感教育。
结论：这项研究强调了为南亚HNC幸存者提供量身定制的戒烟服务的重要性，并帮助告知对他人的支持模式。
