Smoking cessation patterns and predictors among adult Californians of Korean descent

Acculturation, Depression, and Smoking Cessation: a trajectory pattern recognition approach

BACKGROUND

Korean Americans are known for a high smoking prevalence within the Asian American population. This study examined the effects of acculturation and depression on Korean Americans' smoking cessation and abstinence.

METHODS

This is a secondary data analysis of a smoking cessation study that implemented eight weekly individualized counseling sessions of a culturally adapted cessation intervention for the treatment arm and a standard cognitive behavioral therapy for the comparison arm. Both arms also received nicotine patches for 8 weeks. A newly developed non-parametric trajectory pattern recognition model (MI-Fuzzy) was used to identify cognitive and behavioral response patterns to a smoking cessation intervention among 97 Korean American smokers (81 men and 16 women).

RESULTS

Three distinctive response patterns were revealed: (a) Culturally Adapted (CA), since all identified members received the culturally adapted intervention; (b) More Bicultural (MB), for having higher scores of bicultural acculturation; and (c) Less Bicultural (LB), for having lower scores of bicultural acculturation. The CA smokers were those from the treatment arm, while MB and LB groups were from the comparison arm. The LB group differed in depression from the CA and MB groups and no difference was found between the CA and MB groups. Although depression did not directly affect 12-month prolonged abstinence, the LB group was most depressed and achieved the lowest rate of abstinence (LB: 1.03%; MB: 5.15%; CA: 21.65%).

CONCLUSION

A culturally adaptive intervention should target Korean American smokers with a high level of depression and a low level of biculturalism to assist in their smoking cessation.

TRIAL REGISTRATION

NCT01091363. Registered 21 March 2010.

The Relationship Between Cultural Competence Education and Increasing Diversity in Nursing Schools and Practice Settings

This article attempted to examine the relationship between cultural competence education and increasing diversity in nursing schools and practice settings. In addition to the review of the literature, a panel of experts was interviewed regarding institutional practices in response to the challenge of increasing diversity and cultural competence education. Evidence of positive outcomes of cultural competent care and impact of race and ethnic concordance between patients and providers are presented. The challenge of increasing underrepresented minorities in health care professions remains elusive. An ecological analysis is recommended to address the social and cultural barriers that transcend the micro system of the school and the macro system of the society. The challenge of increasing diversity and realizing outcomes of cultural competence education requires social and comprehensive remedies to level life inequities that perpetuate a history of disadvantages in some groups.

Transitions in Smokers' Social Networks After Quit Attempts: A Latent Transition Analysis

INTRODUCTION

Smokers' social networks vary in size, composition, and amount of exposure to smoking. The extent to which smokers' social networks change after a quit attempt is unknown, as is the relation between quitting success and later network changes.

METHODS

Unique types of social networks for 691 smokers enrolled in a smoking-cessation trial were identified based on network size, new network members, members' smoking habits, within network smoking, smoking buddies, and romantic partners' smoking. Latent transition analysis was used to identify the network classes and to predict transitions in class membership across 3 years from biochemically assessed smoking abstinence.

RESULTS

Five network classes were identified: Immersed (large network, extensive smoking exposure including smoking buddies), Low Smoking Exposure (large network, minimal smoking exposure), Smoking Partner (small network, smoking exposure primarily from partner), Isolated (small network, minimal smoking exposure), and Distant Smoking Exposure (small network, considerable nonpartner smoking exposure). Abstinence at years 1 and 2 was associated with shifts in participants' social networks to less contact with smokers and larger networks in years 2 and 3.

CONCLUSIONS

In the years following a smoking-cessation attempt, smokers' social networks changed, and abstinence status predicted these changes. Networks defined by high levels of exposure to smokers were especially associated with continued smoking. Abstinence, however, predicted transitions to larger social networks comprising less smoking exposure. These results support treatments that aim to reduce exposure to smoking cues and smokers, including partners who smoke.

IMPLICATIONS

Prior research has shown that social network features predict the likelihood of subsequent smoking cessation. The current research illustrates how successful quitting predicts social network change over 3 years following a quit attempt. Specifically, abstinence predicts transitions to networks that are larger and afford less exposure to smokers. This suggests that quitting smoking may expand a person's social milieu rather than narrow it. This effect, plus reduced exposure to smokers, may help sustain abstinence.

Korean American Women's Experiences with Smoking and Factors Associated with Their Quit Intentions

This study explored Korean American women's experiences with smoking and tested the theory of planned behavior to identify factors associated with their intentions to quit smoking. It employed a mixed-methods research design, using qualitative and quantitative data. Participants were recruited via a combination of random (N = 49) and convenience (N = 45) sampling techniques. Women in this study initiated smoking at age of 23 on average, and nearly half smoked at indoor houses. They initiated smoking out of curiosity about the effect and belief that smoking would relieve their stress. Reasons for continued smoking were (a) to avoid nicotine withdrawal symptoms, (b) to cope with life stressors, including acculturative stress, and (c) to fulfill one's destiny as a lifetime smoker. Many attempted to quit due to health issues and pregnancy. Fear of disclosure and limited English proficiency were found to be major barriers to seeking help for quitting. Past-year quit attempt(s), attitudes toward quitting, and perceived family norm favoring quitting explained 25% of the variance in intentions to quit smoking (F [3,90] = 11.58, P < 0.001). Findings suggest that gender- and culture-specific intervention strategies are needed to assist Korean American women in smoking cessation.

Investigating group contingencies to promote brief abstinence from cigarette smoking

In contingency management (CM), monetary incentives are contingent on evidence of drug abstinence. Typically, incentives (e.g., "vouchers" exchangeable for goods or services) are contingent on individual performance. We programmed vouchers contingent on group performance to investigate whether these contingencies would promote brief abstinence from cigarette smoking. Thirty-two participants were divided into small teams (n = 3 per team). During three 5-day within-subject experimental conditions, participants submitted video recordings of breath carbon monoxide (CO) measures twice daily via Motiv8 Systems, an Internet-based remote monitoring application. During the interdependent contingency condition, participants earned vouchers each time they and their teammates submitted breath CO samples indicative of abstinence (i.e., negative samples). During the independent contingency condition, participants earned vouchers each time they submitted negative samples, regardless of their teammates' performance. During the no vouchers condition, no monetary incentives were contingent on abstinence. In addition, half of the participants (n = 16) could communicate with their teammates through an online peer support forum. Although forum access did not appear to promote smoking abstinence, monetary incentives did promote brief abstinence. Significantly more negative samples were submitted when vouchers were contingent on individual performance (56%) or team performance (53%) relative to when no vouchers were available (35%; F = 6.9, p = .002). The results show that interdependent contingencies can promote brief abstinence from cigarette smoking. Moreover, the results suggest that these contingencies may help lower treatment costs and promote social support.

Investigating the myth of the "model minority": a participatory community health assessment of Chinese and Vietnamese adults

Despite the persistent belief that Asians are the "model minority" there is accumulating evidence of health concerns within Asian subgroups. In this study, we implemented a cross-sectional participatory community health assessment in an urban city in Massachusetts, to understand differences and similarities in demographics, health and healthcare access in Chinese and Vietnamese adults. We gathered qualitative data from community stakeholders to inform the development of a community health assessment tool. The tool elicited information on healthcare access, health status, behavioral health and chronic disease history and treatment. Healthcare access issues and poor health status, particularly among Chinese participants and mental health symptomotology in both groups were areas of concern. These findings revealed important health concerns in two Asian ethnic groups. Studies are needed to better understand these concerns and inform programs and policies to improve health outcomes in these Asian ethnic groups.

Smoking trajectories among Koreans in Seoul and California: exemplifying a common error in age parameterization

Immigration to a nation with a stronger anti-smoking environment has been hypothesized to make smoking less common. However, little is known about how environments influence risk of smoking across the lifecourse. Research suggested a linear decline in smoking over the lifecourse but these associations, in fact, might not be linear. This study assessed the possible nonlinear associations between age and smoking and examined how these associations differed by environment through comparing Koreans in Seoul, South Korea and Korean Americans in California, United States. Data were drawn from population based telephone surveys of Korean adults in Seoul (N=500) and California (N=2,830) from 2001-2002. Locally weighted scatterplot smoothing (lowess) was used to approximate the association between age and smoking with multivariable spline logistic regressions, including adjustment for confounds used to draw population inferences. Smoking differed across the lifecourse between Korean and Korean American men. The association between age and smoking peaked around 35 years among Korean and Korean American men. From 18 to 35 the probability of smoking was 57% higher (95%CI, 40 to 71) among Korean men versus 8% (95%CI, 3 to 19) higher among Korean American men. A similar difference in age after 35, from 40 to 57 years of age, was associated with a 2% (95%CI, 0 to 10) and 20% (95%CI, 16 to 25) lower probability of smoking among Korean and Korean American men. A nonlinear pattern was also observed among Korean American women. Social role transitions provide plausible explanations for the decline in smoking after 35. Investigators should be mindful of nonlinearities in age when attempting to understand tobacco use.

Internet-based group contingency management to promote abstinence from cigarette smoking: a feasibility study

BACKGROUND

In contingency management (CM) interventions, monetary consequences are contingent on evidence of drug abstinence. Typically, these consequences are contingent on individual performance. Consequences contingent on group performance may promote social support (e.g., praise).

METHODS

Thus, to combine social support with the monetary incentives of CM, we integrated independent and interdependent group contingencies of reinforcement into an Internet-based intervention to promote smoking abstinence. Breath carbon monoxide (CO) measures were compared between treatment conditions and a baseline control condition. Thirteen participants were divided into 5 groups or "teams" (n=2-3 per team). Each participant submitted video recordings of CO measurement twice daily via the Internet. Teammates could monitor each other's progress and communicate with one another through an online peer support forum. During a 4-day tapering condition, vouchers exchangeable for goods were contingent on gradual reductions in breath CO. During a 10-day abstinence induction condition, vouchers were contingent on abstinence (CO≤4ppm). In both treatment conditions, concurrent independent and interdependent group contingencies were arranged (i.e., a mixed contingency arrangement).

RESULTS

Less than 1% of CO samples submitted during baseline were≤4ppm, compared to 57% submitted during abstinence induction. Sixty-five percent of participants' comments on the online peer support forum were rated as positive by independent observers. Participants rated the intervention favorably on a treatment acceptability questionnaire.

CONCLUSION

The results suggest that the intervention is feasible and acceptable for promoting abstinence from cigarette smoking.

Smoking on both sides of the pacific: home smoking restrictions and secondhand smoke exposure among Korean adults and children in Seoul and California

INTRODUCTION

This study, informed by ecological frameworks, compared the prevalence, predictors, and association of home smoking restrictions with secondhand smoke exposure (SHSe) between Koreans in Seoul, South Korea, and Korean Americans in California, United States.

METHODS

A cross-sectional survey was drawn from telephone interviews with Korean adults in Seoul (N = 500) and California (N = 2,830) during 2001-02. Multivariable regressions were used for analyses.

RESULTS

Koreans, compared with Korean Americans, had significantly fewer complete home smoking bans, 19% (95% CI: 16-23) versus 66% (95% CI: 64-68), and were more likely to not have a home smoking restriction, 64% (95% CI: 60-69) versus 5% (95% CI: 4-6). Home smoking restrictions were associated with lower home SHSe; however, the impact was consistently larger among Korean Americans. Households with more SHSe sources were less likely to have the strongest home smoking restrictions, where the difference in complete bans among Korean Americans versus Koreans was largely among those at low risk of SHSe, 82% (95% CI: 76-86) versus 36% (95% CI: 17-57), while high-risk Korean American and Koreans had similar low probabilities, 10% (95% CI: 7-13) versus 7% (95% CI: 3-13).

CONCLUSIONS

Consistent with ecological frameworks, exposure to California's antismoking policy and culture was associated with stronger home smoking restrictions and improved effectiveness. Interventions tailored to Korean and Korean American SHSe profiles are needed. Behavioral interventions specifically for high-risk Korean Americans and stronger policy controls for Koreans may be effective at rapidly expanding home smoking restrictions.

It's others, not the police: smoking, reprimand, and fines among adults of Korean descent in California

OBJECTIVE

This study assesses the association of immediate social and legal reprimand and current smoking status among Californians of Korean descent.

DESIGN

Data were drawn from a population-based probability sample using a telephone survey conducted by bilingual, professional interviewers (N = 2085). About 85.0% of eligible respondents completed interviews and 86.3% of participants preferred to be interviewed in Korean.

MAIN OUTCOME MEASURE

Smoking status was measured using Centers for Disease Control and Prevention criteria, ever smoked 100 cigarettes and currently smoke every day or some days.

RESULTS AND CONCLUSION

Reports of immediate criticism by others in several settings was associated with nonsmoking, but likelihood of immediate legal penalties was unrelated. Participants were far less likely to expect legal than social sanction. Results were replicated after controlling for reinforcers of smoking and ecologically relevant variables including models of smoking, primary group social support for smoking, acculturation, sex, acculturation by sex (male) interaction, age, and education. It may be efficacious to target public health interventions encouraging appropriate social sanctions of smoking in public among persons of Korean descent, and to encourage strict enforcement of legal penalties for smoking in public places.

Use of a smokers' quitline by Asian language speakers: results from 15 years of operation in California

OBJECTIVES

We examined state quitline utilization by smokers who called Chinese-, Vietnamese-, or Korean-language lines, and compared their usage rates to those of Asians and Whites calling the English-language line.

METHODS

Using data from 15 years (1993-2008) of operation of the California quitline (which included data on 22 061 callers to Chinese, Korean, and Vietnamese lines) and from multiple California Health Interview Surveys, we computed the call rates for Whites, English-speaking Asians, and the 3 Asian-language groups. We also examined callers' demographics and where they heard about the quitline.

RESULTS

Asian smokers who spoke English were significantly less likely than English-speaking White smokers to call the quitline (odds ratios range from 0.36 to 0.62). Smokers speaking 1 of the 3 Asian languages were no less likely than White smokers to call (odds ratios range from 0.82 to 3.25). More than 80% of those calling the Asian-language lines reported hearing about the quitline through mass media.

CONCLUSIONS

Contrary to general expectation, smokers speaking Asian languages were just as likely to call the quitline as English-speaking White smokers. State quitlines should consider adding Asian-language lines to help address disparities in access to cessation services.

Gender modifies the relationship between social networks and smoking among adults in Seoul, South Korea

OBJECTIVE

To evaluate the interaction of gender with social network mechanisms and smoking behaviors in Seoul, South Korea, where smoking is common among men but not women.

METHODS

During 2002, telephone surveys were completed with 500 adults drawn from a probability sample in Seoul. Respondents described their smoking status, smoking rate (number of cigarettes smoked per day) and social networks by assessing who discouraged or encouraged smoking (smoking support) or smoked (smoking models). Multivariable regressions were used for analyses.

RESULTS

Women encountered significantly less smoking support than men, 88% (95% confidence interval [95% CI], 85-91) versus 70% (95% CI 66-73) net discouragement of smoking in their network. A difference in smoking support from 25 to 75% net discouragement was associated with a 27% (95% CI 9-49) lower probability of smoking among women, significantly stronger (z = 3.18, p < 0.01) than among men who had a 19% (95% CI 8-27) lower probability of smoking. A similar difference in smoking support was associated with male smokers smoking 6.38 (95% CI 0.86-12.30) fewer cigarettes per day, or 2,329 (95% CI 314-4,490) fewer cigarettes per year. The later association could not be observed among women due to the small proportion of female smokers. Smoking models were not significantly associated with any smoking behaviors across genders.

CONCLUSIONS

Social network mechanisms were differentially associated with the high smoking prevalence among men and low prevalence among women and should be targeted by interventions tailored to these differences.

Parent quit attempts after counseling to reduce children's secondhand smoke exposure and promote cessation: main and moderating relationships

INTRODUCTION

This study explored predictors of smoking quit attempts in a sample of low-income smoking mothers who participated in a randomized trial of a 6-month, 14-session counseling intervention to decrease their children's secondhand smoke exposure (SHSe) and eliminate smoking.

METHODS

Measures were taken at baseline and at 3, 6, 12, and 18 months on 150 mothers who exposed their children (aged <4 years) to > or = 10 cigarettes/week in the home. Reported 7-day quits were verified by saliva cotinine or urine anabasine and anatabine levels.

RESULTS

There were few quits longer than 6 months. Mothers in the counseling group reported more 24-hr quits (p = .019) and more 7-day quits (p = .029) than controls. Multivariate modeling revealed that having quit for at least 24 hr in the year prior to baseline and the number of alternative cessation methods ever tried were predictive of the longest quit attempt during the 18-month study. Mothers in the counseling group who at baseline felt SHSe posed a health risk for their children or who at baseline had more permissive home smoking policies had longer quit attempts.

DISCUSSION

Results confirm that attempts to quit smoking predict additional quit attempts. This suggests that practice may be necessary for many people to quit smoking permanently. Findings of interaction analyses suggest that participant factors may alter the effects of treatment procedures. Failure to account for or employ such factors in the analysis or design of community trials could confound the results of intervention trials.

The effect of smoke-free homes on adult smoking behavior: a review

INTRODUCTION

Smoke-free homes are known to reduce exposure to harmful secondhand smoke. Recent studies suggest that they may also positively affect smoking behavior among smokers themselves.

METHODS

We review the literature on the effect of smoke-free homes on adult smoking behavior. The literature search included database (PubMed) and manual searches of related articles and reference lists for English-language studies published from 1 January 1990 to 16 November 2008.

RESULTS

We identified 16 cross-sectional and 7 longitudinal studies of the population-level association of smoke-free homes with adult smoking behavior. Additional studies provided population estimates of trends in and correlates of smoke-free homes. Prevalence of smoke-free homes varies but has been increasing over time in the countries studied and was greater among smokers who were younger, of higher income or educational attainment, smoked fewer cigarettes per day, or lived with a nonsmoking adult or child. Both longitudinal and cross-sectional studies showed that smokers who had or who newly implemented a smoke-free home were significantly more likely to make a quit attempt and to be abstinent, after controlling for confounding factors. In longitudinal studies, those who continued to smoke had a modest, but significant, decrease in cigarette consumption at follow-up.

DISCUSSION

There is strong and consistent population-level evidence that a smoke-free home is associated with increased smoking cessation and decreased cigarette consumption in adult smokers. As they not only reduce exposure to secondhand smoke but also increase cessation rates, promotion of smoke-free homes should be a key element in tobacco control programs.

Where there's smoke, there's fire: high prevalence of smoking among some sub-populations and recommendations for intervention

In Australia, the prevalence of smoking is higher among certain sub-populations compared to the general population. These sub-populations include Aboriginal and Torres Strait Islander people, people from culturally and linguistically diverse backgrounds, as well as people with mental and substance use disorders and prisoners. The aims of this paper are to: describe the high prevalence of smoking among these particular sub-populations and harms associated with smoking; explore possible reasons for such high prevalence of smoking; review the evidence regarding the efficacy of existing smoking cessation interventions; and make recommendations for smoking interventions and further research among these groups. In addition to low socio-economic status, limited education and other factors, there are social, systems and psychobiological features associated with the high prevalence of smoking in these sub-groups. General population-based approaches to reducing smoking prevalence have been pursued for decades with great success and should be continued with further developments that aim specifically to affect Aboriginal and Torres Strait Islander people and some cultural groups. However, increasing attention, more specific targeting and flexible goals and interventions are also required for these and other distinct sub-populations with high smoking prevalence. Recommendations include: more funding and increased resources to examine the most appropriate education and treatment strategies to promote smoking cessation among people from Aboriginal and Torres Strait Islander and some culturally and linguistically diverse backgrounds; larger and better-designed studies evaluating smoking cessation/reduction interventions among distinct sub-groups; and system-wide interventions requiring strong leadership among clients and staff within mental health, drug and alcohol and prison settings.

Correlates of smoking cessation among Filipino immigrant men

A survey on tobacco use among 318 Filipino immigrant men aged 40–75 years was conducted in Los Angeles, California. Those who reported more English language use with their family, friends and neighbors (OR = 1.31) and who lived in households with complete smoking prohibition (OR = 3.82) were more likely to be successful in quitting smoking. Those who endorsed more positive beliefs on physical and social consequences of smoking (OR = 0.69) and who had mostly smoking friends (OR = 0.37) were less likely to be successful in quitting smoking. Our findings suggest that prohibiting smoking in households, creating social networks of non-smokers, and education or counseling are important components of a smoking cessation intervention for Filipino immigrant men.

Does church participation facilitate tobacco control? A report on Korean immigrants

Background This study explores hypotheses linking church attendance to smoking prevalence, cessation, exposure to environmental tobacco smoke (ETS), and household smoking bans among Korean immigrants in California. Methods Data were drawn from telephone interviews with Korean adults (N = 2085) based on a probability sample during 2005–2006 in which 86% of those contacted completed interviews. Results Koreans who reported that they had attended church were less likely to be current smokers and to be exposed to ETS, and more likely to have quit smoking and to have a complete smoking ban than non-attenders after statistical controls for behavioral covariates. Discussion Whether or not participants reported attending church was associated with increased tobacco control practices. Public health interventions may profit by seeking to expand cooperation with religious congregations to facilitate efforts to promote healthy lifestyles among immigrant populations beyond the influences of church attendance.

Predictors of short-term smoking cessation among Korean American men

OBJECTIVES

The purpose of this study was to examine which demographic, smoking behavior, and theoretical variables of theory of planned behavior would predict smoking cessation attempts among Korean American men.

DESIGN

This is a longitudinal study and data collection was conducted at baseline and 1-month follow-up.

SAMPLE

At baseline, 118 Korean adult male smokers were recruited into the study and of these, 93 participated at follow-up.

MEASURES

Study questionnaires consisted of demographic data, smoking behavior, and theoretical variables.

ANALYSIS

A multiple regression analysis was performed to identify correlates of behavioral intentions to quit smoking at baseline and binary logistic regression analysis for predictors of actual quitting behavior at follow-up.

RESULTS

Among smoking behavior variables, past-year quit attempts and average number of cigarettes smoked per day explained 15% of the variance in behavioral intentions to quit smoking ( p<.0001). Two theoretical variables attitudes and perceived family social norms increased the explanatory power by 22% ( p<.0001) with an overall of 37%. Religion and perceived family social norms had about 32% predictive power over actual quitting behavior ( p<.0001).

CONCLUSIONS

Any smoking cessation programs planned for Korean American men consider encouraging family members to affirm antismoking messages to this ethnic subgroup.

Influence of American acculturation on cigarette smoking behaviors among Asian American subpopulations in California

Using combined data from the population-based 2001 and 2003 California Health Interview Surveys, we examined ethnic and gender-specific smoking behaviors and the effect of three acculturation indicators on cigarette smoking behavior and quitting status among 8,192 Chinese, Filipino, South Asian, Japanese, Korean, and Vietnamese American men and women. After adjustment for potential confounders, current smoking prevalence was higher and the quit rate was lower for Korean, Filipino, and Vietnamese American men compared with Chinese American men. Women's current smoking prevalence was lower than men's in all six Asian American subgroups. South Asian and Korean American women reported lower quit rates than women from other ethnic subgroups. Asian American men who reported using only English at home had lower current smoking prevalence and higher quit rates, except for Filipino and South Asian American men. Asian American women who reported using only English at home had higher current smoking prevalence except for Japanese women. Being a second or later generation immigrant was associated with lower smoking prevalence among all Asian American subgroups of men. Less educated men and women had higher smoking prevalence and lower quit rates. In conclusion, both current smoking prevalence and quit rates vary distinctively across gender and ethnic subgroups among Asian Americans in California. Acculturation appears to increase the risk of cigarette smoking for Asian American women. Future tobacco-control programs should target at high-risk Asian American subgroups, defined by ethnicity, acculturation status, and gender.

Fatores associados ao índice de cessação do hábito de fumar em duas diferentes populações adultas (Projetos Bambuí e Belo Horizonte)

O objetivo deste trabalho foi verificar o índice de cessação do tabagismo e os fatores associados ao mesmo. O estudo foi conduzido na Região Metropolitana de Belo Horizonte e na cidade de Bambuí, em Minas Gerais, Brasil. Participaram, respectivamente, 13.261 e 1.018 adultos (> 20 anos) selecionados aleatoriamente entre os residentes das áreas de estudo. O índice de cessação do tabagismo foi igual a 40,6% (IC95%: 39,1-42,3) na Região Metropolitana de Belo Horizonte e 38,8% (IC95%: 34,4-43,1) em Bambuí. Na Região Metropolitana de Belo Horizonte, associações independentes e positivas com esse índice foram observadas para idade (> 40 anos), escolaridade (4-7 e > 8 anos de estudo), número de condições crônicas (> 2) e número de consultas médicas no último ano (1-3 e > 4); associação negativa foi observada para estado civil (não casados). Em Bambuí, foi observada associação independente e positiva com idade (> 40 anos) e negativa com número de hospitalizações no último ano (> 2). A heterogeneidade dos fatores associados à interrupção do tabagismo dificulta a identificação de grupos vulneráveis, visando estratégias de prevenção. São necessários novos estudos para um melhor entendimento dessa heterogeneidade.

A brief smoking cessation intervention for Chinese and Korean American smokers

OBJECTIVE

This study evaluated changes in smoking-related beliefs and behavior following a brief, culturally adapted smoking cessation intervention for Chinese and Korean smokers.

METHOD

From May 2002 to March 2003, 66 smokers residing in or around southeastern Pennsylvania were randomly assigned to a theory-based smoking cessation intervention or general health counseling. Participants completed assessments of perceived risks of smoking, pros and cons of quitting, quitting self-efficacy, and distress at baseline and follow-up time points. Sessions were conducted in the participant's native language (Korean, Cantonese, or Mandarin). Both groups received nicotine replacement therapy.

RESULTS

Overall, 38% of participants reported quitting smoking at 3-month follow-up. Quit rates were higher (52.6% among Chinese, 60.0% among Korean) in the intervention condition compared to the control condition (23.5% among Chinese, 40.0% among Korean) at 1-month, but not 3-month, follow-up. There was a main effect of treatment condition for self-efficacy with intervention participants reporting significantly higher levels of self-efficacy compared to control participants. Further, a treatment x time interaction was observed for cons of quitting, reflecting fewer cons in the intervention group than the control group at 1-month and 3-month follow-up.

CONCLUSION

A culturally adapted intervention for Chinese and Korean Americans can be effective in changing specific smoking-related cognitions and behavior. This study represents a promising first step toward advancing our understanding of the associations between smoking-related cognitions and behavior among Asian American smokers.