Delivering the Science and the Art of Health Promotion

Robert F. Allen
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Commentaries

Anita Fernander
Ken Resnicow
K. Viswanath
Eliseo J. Pérez-Stable

Cigarette Smoking Interventions Among Diverse Populations

Kenneth E. Warner

Disparities in Smoking Are Complicated and Consequential.  What to Do About Them?

Eliseo J. Pérez-Stable
Neal L. Benowitz

Do Biological Differences Help Explain Tobacco-Related Disparities?

Lisa Sanderson Cox
Kolawole Okuyemi
Won S. Choi
Jasjit S. Ahluwalia

A Review of Tobacco Use Treatments in U.S. Ethnic Minority Populations
This article provides a review of published studies examining tobacco treatment interventions among ethnic and minority populations in the United States.  Literature searches were used to identify smoking cessation interventions involving racial/ethnic minority populations. Studies (1) targeted one or more ethnic minority group or consisted of at least 10% of study participants from ethnic minority groups and (2) reported abstinence outcomes. Individuals from racial and ethnic minority populations are interested in stopping smoking and willing to participate in treatment research. Variations in the content of treatment intervention and study design produced a range of abstinence outcomes across studies. Additional research is needed for all groups, including African-American smokers, and special attention is warranted for Latino, Native American, and Asian groups given the paucity of published studies. Further attention to level of individual smoking, variability in smoking patterns, and use of other tobacco products is needed, given known variation within and among racial and ethnic groups.

Chad D. Morris
Mandy G. May
Karen Devine
Shawn Smith
Tamara DeHay
John Mahalik

Multiple Perspectives on Tobacco Use Among Youth and Young Adults with Mental Health Disorders and Addictions
Youth and young adults with mental health disorders and addictions are at a high risk of becoming nicotine dependent, and at least half will die of tobacco-related diseases. Qualitative key informant interviews with health care professionals and youth focus groups were conducted using semistructured questioning regarding barriers and facilitators to tobacco interventions. Survey data were also collected from 230 smokers aged 13 to 17 years and young adults aged 18 to 25 years at three community mental health centers. Five thematic categories were identified in both the adult key informant interviews and the focus groups with youth: 1) motivation to quit, 2) cessation treatment needs, 3) social influence, 4) barriers to treatment, and 5) tobacco-free policy. Youth and young adult survey respondents who smoked were often motivated to quit, few had used proven tobacco cessation aids, but there was interest in access to nicotine replacement therapy. Merged qualitative and quantitative findings support past literature regarding youth in the general population, but also expand upon our knowledge of issues specific to youth and young adults with mental health disorders and addictions.

Articles

Donna M. Vallone
Jeff Niederdeppe
Amanda Kalaydjian   Richardson
Pallavi Patwardhan
Raymond Niaura
Jennifer Cullin

A National Mass Media Smoking Cessation Campaign: Effects by Race/Ethnicity and Education
This study assessed the effectiveness of a large-scale, national smoking cessation media campaign, the EX campaign, across racial/ethnic and educational subgroups.  The baseline survey was conducted on 5616 current smokers, 18 to 49 years, and 4067 (73% follow-up response rate) were resurveyed at the 6-month follow-up. Awareness of EX increased favorable cessation-related cognitions among Hispanics and quit attempts among non-Hispanic blacks and increased favorable cessation-related cognition and quit attempts among smokers with less than a high school education. These results suggest that the EX campaign may be effective in promoting cessation-related cognition and behaviors among minority and disadvantaged smokers.

Shu-Hong Zhu
Phillip Gardiner
Sharon Cummins
Christopher Anderson
Shiushing Wong
David Cowling
Anthony Gamst

Quitline Utilization Rates of African-American and White Smokers: The California Experience
This study compared the usage rate of the California tobacco quitline by African-American smokers with that of white smokers.  In four out of five periods of comparison, African-American smokers had a higher annual usage rate than white smokers. The odds ratios ranged from 1.44 to 2.40 (p<0.05). In the 1996 comparison, the odds ratio was .90(p <.05). Within the context of California’s comprehensive tobacco control program, which includes a strong media campaign, African-American smokers were significantly more likely to call the state quitline than white smokers. Promoting the quitline as part of antismoking media campaigns can help reduce disparity in cessation service use. 

Emily K. Burns
Elizabeth Ann Deaton
Arnold H. Levinson

Rates and Reasons: Disparities in Low Intentions to Use a State Smoking Cessation Quitline
This study examined population-level rates and reasons for low intentions to call the quitline using the 2008 Colorado Adult Tobacco Attitudes and Behavior Survey. Overall, 45.6% of smokers intend never to call the quitline. In multivariate analysis, Latinos (odds ratio, 2.5; 95% confidence intervals, 1.4, 4.7), gays/lesbians/bisexuals (odds ratio, 5.2; 95% confidence intervals, 2.4, 11.4),  and those with no insurance compared to Medicaid (odds ratio, 3.8; 95% confidence intervals, 1.1, 13.0) were most likely to intend never to call the quitline. Perceiving no need for assistance (34.8%) was the most common reason for not calling.  A majority of smokers have no or weak intentions of ever calling the quitline, with variation by subgroup, which can inform targeted media campaigns to increase quitline reach.

Joanne D’Silva
Barbara A. Schillo
Nathan R. Sandman
Theresa L. Leonard
Raymond G. Boyle

Evaluation of a Tailored Approach for Tobacco Dependence Treatment for American Indians
This study evaluated a tailored approach for tobacco dependence treatment for American Indians. Sixty-three percent of participants completed the program. The 90-day follow-up response rate was 47%. Of those who completed, 47% reported abstinence at the 90-day follow-up. Continuing smokers had cut their daily smoking by half from 17 to eight cigarettes, 88% reported an increase in self-efficacy for their next quit, and 44% planned to quit within 30 days. Evidence-based tobacco dependence treatment programs tailored to be culturally specific have the potential to significantly affect the burden of tobacco-related disparities among American Indians.

Elisa K. Tong
Hao Tang
Moon S. Chen Jr
Stephen J. McPhee
 

Provider Smoking Cessation Advice Among California Asian American Smokers
This study examined provider advice to quit smoking for Asian-American smokers and described factors that may affect the provision of such advice.  Current smokers from the California Tobacco Use Surveys for Chinese Americans, Korean Americans, and Vietnamese Americans  were assessed.  Less than one- third (30.5%) of smokers in our study reported both seeing a provider (50.8%) and then receiving advice to quit (60.1%).  Factors associated with provider visits included being female, being 45 years or older, having health insurance, and being Vietnamese.  Among smokers who saw a provider, factors associated with provider advice to quit included having health insurance and being a daily smoker. Asian-American smokers reported low proportions of provider advice to quit in the past year, largely because only one-half of smokers saw a provider. Providers who see such smokers may need greater awareness that several effective cessation treatments do not require health insurance and that intermittent smokers need advice to quit.

Patricia A. Cluss
Michele D. Levine
Douglas Landsittel

The Pittsburgh STOP Program: Disseminating an Evidence-Informed Intervention for Low-Income Pregnant Smokers
This study described the intervention model and factors associated with quitting from the Pittsburgh STOP Program, an evidence-informed dissemination intervention for low socioeconomic status pregnant smokers. An evidence-informed intervention for community pregnant women was delivered individually in a single-group pre-post evaluation design to 856 pregnant women. More than 11% of smokers quit; 48% of pre-enrollment spontaneous quitters remained abstinent. Factors significantly associated with quitting included race, mother’s age, nicotine dependence, and number of sessions attended.  Low-income pregnant smokers engaged in an evidence-informed cessation program tailored for this group, with quit rates that compare favorably with controlled research results.

Lourdes A.
  Baezconde- Garbanati
Kimberly Weich-Reushé
Lilia Espinoza
Cecilia Portugal
Rosa Barahona
James Garbanati
Faatima Seedat
Jennifer B. Unger

Secondhand Smoke Exposure Among Hispanic/Latinos Living in Multiunit Housing:  Exploring Barriers to New Policies
Hispanic/Latino residents of multiunit housing have reported high levels of exposure to secondhand smoke and little ability to protect themselves and their families from it.  Respondents expressed positive attitudes toward adopting antismoking policies in multiunit housing, but they also feared retaliation by smokers. The cultural values of familismo, respeto, simpatia and personalismo influenced their motivation to protect their families from secondhand smoke as well as their reluctance to ask their neighbors to refrain from smoking. Nonsmokers were more likely to favor complete indoor and outdoor smoking bans in multiunit housing, whereas smokers were more likely to favor separate smoking areas. The Regale Salud advocacy/policy intervention, implemented to reduce secondhand smoke exposure, prompted the passage of seven voluntary policies in apartment complexes in Southern California to prevent smoking in multiunit housing.

Belinda Borrelli
Rashelle B. Hayes
Kristin Gregor
Christina S. Lee
Elizabeth L. McQuaid

Differences in Smoking Behavior and Attitudes Among Puerto Rican, Dominican, and Non-Latino White Caregivers of Children With Asthma
This study examined differences in smoking attitudes and behavior among Dominican, Puerto-Rican, and non-Latino white caregivers who smoke and have a child with asthma. Compared with Dominicans, Puerto Ricans were more acculturated, more nicotine dependent, less motivated and confident to quit, and identified more pros of smoking. Compared with non-Latino whites, Puerto Ricans were less likely to be employed, smoked fewer cigarettes per day, had lower education, greater depressed mood, greater pros and cons of smoking, less social support,  and higher child asthma morbidity. Compared with non-Latino whites, Dominicans were less nicotine dependent, more confident to quit, less likely to live with a smoker, reported greater cons of smoking and greater stress, and were more likely to have a household smoking ban.  Puerto Ricans appeared to have more factors associated with risk of smoking treatment failure; Dominicans appeared to have more protective factors. 

Brittany M. Brothers
Belinda Borrelli

Motivating Latino Smokers to Quit: Does Type of Social Support Matter?
This study examined which types of social support were effective for quitting smoking among Latino smokers and whether social support buffered the effects of depressed mood on smoking cessation. Thirty percent of those with a partner quit smoking vs. 14.3% without a partner;  43.5% of those with high perceived positive partner support quit smoking vs. 17.4% of those with low levels.  There was a significant interaction between whether or not a smoker had a partner and depressed mood on quitting: Among those not partnered, quit rates were higher among those with low levels of depressed mood (37%) than those with high levels of depressed mood (9%; odds ratio, 1.147; 95% confidence intervals, 1.031-1.276; p < .02). This study is the first to examine multiple sources of support for smoking cessation in Latino smokers; partner support and the presence of a significant other were associated with quitting smoking.

Michael C. Zinser
Fred C. Pampel
Estevan Flores

Distinct Beliefs, Attitudes, and Experiences of Latino Smokers: Relevance for Cessation Interventions
This study examined the extent to which Latino smokers are using effective interventions for smoking cessation, with particular focus on nicotine replacement therapy.  Related aims were to explore cultural, attitudinal, knowledge, and socioeconomic variables associated with treatment use.   Colorado Latinos reported using nicotine replacement therapy substantially less often than did non-Latino whites residing in the state.  This and other differences in the study were more pronounced in Latinos characterized as of low acculturation on the basis of a language preference variable.  They appeared to be motivated to quit but endorsed attitudes and beliefs antithetical to nicotine replacement therapy use.  Health care access was lower among Latinos, and this was related to lower reports of lifetime nicotine replacement therapy use.  Results suggested that use of effective cessation interventions among Latinos may be enhanced by education about nicotine addiction and nicotine replacement therapy. 

American Journal of Health Promotion |  248-682-0707