Culturally Specific Interventions Can Increase Tobacco Cessation Among Black/African American Quitline Enrollees

Tobacco quitlines offer evidence-based services that help individuals quit tobacco use. They are shown to be effective with great potential to serve populations experiencing health disparities, because they remove key access barriers (e.g., cost, lack of health insurance, transportation).

Even so, the lack of available culturally competent care in quitline services may contribute to racial disparities in tobacco cessation. Previous studies show that Black/African American adults who smoke show interest in quitline services and report high motivation to quit, but they experience less success with these services compared to other groups—highlighting the need for culturally specific tobacco interventions developed for this population.

A newly published randomized controlled trial that tested the effectiveness of a culturally specific tobacco intervention among Black/African American adults enrolled in a state quitline found increased smoking cessation compared to interventions developed for the general population. In this study, researchers tested the effectiveness of the “Pathways to Freedom” (PTF) intervention, a culturally specific, 60-minute video that combines theory, evidence, and cultural assets to promote tobacco cessation among Black/African American adults who wish to quit.

Participants enrolled in the study were recruited from callers to QuitlineNC—the tobacco quitline for North Carolina residents—who self-identified as Black/African American and were currently smoking and willing to quit. Participants were assigned randomly to one of three groups:

• Quitline services only, which comprised four tobacco cessation coaching calls, interactive online support, and at least 2 weeks of nicotine replacement therapy
• Quitline services plus a standard (general population) tobacco cessation video
• Quitline services plus the PTF tobacco cessation video

In all three groups, participants received an initial counseling call from a study-trained coach as part of quitline services. Participants could also contact the quitline for support between coach-initiated counseling calls. In the standard video and PTF video groups, coaches guided participants to video sections on topics that came up during counseling calls.

To determine the effectiveness of the intervention, the researchers assessed participants for frequency and number of cigarettes smoked at the time of study enrollment. The researchers then followed up with participants at 3- and 6-months post-enrollment to determine smoking abstinence. In addition, participants were asked to complete surveys to report how long they had abstained from smoking.

The PTF video plus quitline services intervention increased coaching engagement more than quitline services only, and increased smoking abstinence more than the other two interventions (i.e., quitline services only and quitline services plus standard tobacco cessation video): 24-hour smoking abstinence was greater at 3 months, and 7-day smoking abstinence and 28-day continuous abstinence were greater at 6 months. The PTF video also received 76% more online views than the standard video, indicating higher acceptability by participants.

The researchers concluded that culturally specific tobacco interventions delivered through state quitlines can increase smoking cessation among Black/African American adults, and that the PTF video intervention has the potential to reduce tobacco-associated disparities that disproportionately burden this population. The PTF video is currently being disseminated through 47 (of 50) state tobacco quitlines.

Citation

Hooper, M.W., Carpenter, K.M., Salmon, E.E., & Resnicow, K. (2023). Enhancing tobacco quitline outcomes for African American adults: An RCT of a culturally specific intervention. American Journal of Preventive Medicine, 1-9. https://doi.org/10.1016/j.amepre.2023.06.005

Page created Sept. 6, 2023