Hooper MW, Carpenter KM, Salmon EE, Resnicow K.
Enhancing Tobacco Quitline Outcomes for African American Adults: An RCT of a Culturally Specific Intervention.
Am J Prev Med. 2023 Jun 9:S0749-3797(23)00253-2. doi: 10.1016/j.amepre.2023.06.005. Epub ahead of print. PMID: 37302513.

Introduction. African American adults continue to suffer disproportionately from smoking related diseases. Pragmatic interventions are needed to increase smoking cessation rates in this population. This study tested the effectiveness of a culturally specific tobacco cessation video intervention among African American enrollees in a tobacco quitline.

Study design. This was a three-arm semi-pragmatic randomized controlled trial.

Setting/participants. This study was conducted among African American adults (N=1,053) recruited from the North Carolina tobacco quitline (QuitlineNC) and data were collected between 2017-2020.

Intervention. The experimental intervention was Pathways to Freedom (PTF), a culturally specific video intervention designed to promote cessation among African American persons. Participants were randomized to receive (1) Quitline Only, (2) Quitline services plus a standard, non-tailored video intervention, or (3) quitline services plus PTF.

Main outcome measures. The primary outcome was self-reported 7-day point prevalence smoking abstinence (ppa) at 6-months. Secondary outcomes included 7-day ppa at 3-months, 24-hour ppa and 28-day continuous abstinence (at 3- and 6-months), and intervention engagement. Data analyses occurred in 2020 and 2022.

Results. At the 6-month follow-up, 7-day ppa was significantly greater in the PTF Video arm compared to Quitline Only (OR=1.5, CI: 1.11 - 2.07, p = .01). Twenty-four hour ppa was significantly greater in the PTF (versus Quitline Only) group at 3- (OR=1.49; 95% CI: 1.03-2.15) and 6-months (OR=1.58; 95% CI: 1.10-2.28). At 6-months, 28-day continuous abstinence (OR=1.60; 95% CI: 1.17-2.20) was significantly greater in the PTF Video arm compared with Quitline Only. Quitline engagement was significantly greater for both video arms compared with quitline only. Views of the PTF Video were 76% higher than views of the Standard Video.

Conclusions. Culturally specific tobacco interventions delivered via state quitlines can increase cessation rates and thus have the potential to decrease health disparities among African American adults.