Enhancing Tobacco Quitline Outcomes for African American Adults: An RCT of a Culturally Specific Int

Webb Hooper M, 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 Dec;65(6):964-972. doi: 10.1016/j.amepre.2023.06.005. Epub 2023 Jun 10. PMID: 37302513.

Introduction: This study tested the effectiveness of a culturally specific tobacco cessation video intervention among African American quitline enrollees.

Study design: This was a 3-arm semipragmatic RCT.

Setting/participants: African American adults (N=1,053) were recruited from the North Carolina tobacco quitline and data were collected between 2017 and 2020.

Intervention: Participants were randomized to receive (1) quitline services only; (2) quitline services plus a standard, general audience video intervention; or (3) quitline services plus Pathways to Freedom (PTF), a culturally specific video intervention designed to promote cessation among African American persons.

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

Results: At 6 months, 7-day point prevalence abstinence was significantly greater in the Pathways to Freedom Video arm compared with quitline-only (OR=1.5, CI=1.11, 2.07). Twenty four-hour point prevalence abstinence was significantly greater in the Pathways to Freedom (than in quitline-only) group at 3 (OR=1.49, 95% CI=1.03, 2.15) and 6 (OR=1.58, 95% CI=1.10, 2.28) months. At 6 months, 28-day continuous abstinence (OR=1.60, 95% CI=1.17, 2.20) was significantly greater in the Pathways to Freedom Video arm than in the quitline-only arm. Views of the Pathways to Freedom Video were 76% higher than views of the standard video.

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