Smoking Cessation Interventions in Indigenous North Americans: A Meta-Narrative Systematic Review.
Thursday, January 19, 2023
Posted by: Natalia Gromov
Rusk
AM, Kanj AN, Murad MH, Hassett LC, Kennedy CC.
Smoking Cessation
Interventions in Indigenous North Americans: A Meta-Narrative Systematic
Review.
Nicotine Tob Res. 2023 Jan 1;25(1):3-11. doi: 10.1093/ntr/ntac181. PMID:
35869642; PMCID: PMC9717368.
Introduction: Indigenous
North Americans have the highest cigarette smoking prevalence among all racial
and ethnic groups in the United States. We seek to identify effective
components of smoking cessation interventions in Indigenous people in the
United States associated with favorable cessation outcomes.
Methods: A
review of literature studying smoking cessation interventions in Indigenous
North Americans (American Indians and Alaska Natives) from January 2010 through
August 2021 was completed. The primary objective of this study was to identify
components of interventions associated with positive smoking cessation outcomes
in Indigenous people. The studies identified were synthesized in a
meta-narrative approach.
Results: Ten
studies out of 608 titles were included (6 randomized trials, 2 single-arm
studies, 1 cohort study, and 1 prospective observational study). Five
categories of smoking cessation interventions were identified; phone or
web-based tools, culturally-tailored interventions, the inclusion of Indigenous
study personnel, pharmaceutical cessation aids, and behavioral health
interventions. Phone and web tools, cultural tailoring, and inclusion of
Indigenous personnel conditions inconsistently influenced smoking cessation.
Pharmaceutical aids were viewed favorably among participants. Individualized
behavioral counseling sessions were effective at promoting smoking cessation,
as was input from local communities in the planning and implementation phases
of study.
Conclusion: A
successful smoking cessation intervention in Indigenous North Americans
includes Tribal or community input in intervention design and implementation;
should provide individualized counseling sessions for participants, and offer
access to validated smoking cessation tools including pharmacotherapy.
Implications: This
study identifies a paucity of smoking interventions utilizing standard of care
interventions in Indigenous North Americans. Standard of care interventions
including individualized cessation counseling and pharmacotherapy were
effective at promoting cessation. The use of novel culturally tailored
cessation interventions was not more effective than existing evidence-based
care with the exception of including Tribal and local community input in
intervention implementation. Future smoking cessation interventions in
Indigenous North Americans should prioritize the use of standard of care
cessation interventions.
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