Immigration can lead to environmental, social, and economic disruptions in families. Immigrant families who arrive in the United States from Africa and the Middle East also experience these changes which can result in residency in low-income areas with experiences of health disparities. The separation of the family unit due to inability of some family members to obtain entry visas to the US and the expectation of integration into a new culture also pose challenges to members. There is also the possibility of disruptions in leadership structure due to a sudden attempt at replacing the extended family structure prevalent in many African and Middle Eastern cultures with the American nuclear family arrangement. We therefore sought to determine the role of the family in combustible tobacco product use among Immigrants from Africa and the Middle East who currently live in the Greater Salt Lake City area. We hypothesized by the use of the social learning theory of modeling, positive or negative reinforcement, and the experiential learning theory of experience that families play a role in the initiation, maintenance and cessation of smoking among immigrant youth.