American Indian/Alaska Native Smokers' Utilization of a Statewide Tobacco Quitline: Engagement and Q
Tuesday, January 19, 2021
Posted by: Natalia Gromov
Lienemann BA, Cummins SE,
Tedeschi GJ, Wong S, Zhu SH.
American Indian/Alaska
Native Smokers' Utilization of a Statewide Tobacco Quitline: Engagement and
Quitting Behaviors From 2008 to 2018.
Nicotine Tob Res. 2021 Jan 7;23(1):219-226. doi: 10.1093/ntr/ntz205. PMID:
31711234.
Introduction.
The objective of this study was to examine access, engagement, and quitting
behaviors of American Indian/Alaska Native (AIAN) callers to the California
Smokers' Helpline. Telephone counseling is the primary function of the
quitline. The overarching theoretical framework for California's quitline is
social cognitive theory, although it also utilizes motivational interviewing
and cognitive-behavioral strategies.
Aims and methods. AIAN
(n = 16 089) and White (n = 173 425) California quitline callers from 2009 to
2018 were compared on their characteristics, engagement, and quitting
behaviors. Quitline callers responded to a telephone survey at intake. A random
selection was called for evaluation 7 months later (White n = 8194, AIAN n =
764). Data from the 2009 to 2017 California Health Interview Survey (CHIS) were
used as a reference point for AIANs (AIAN n = 1373).
Results.
The quitline and CHIS had similar proportions of AIANs (4.6% vs. 4.3%,
respectively). AIAN smokers were more likely than White smokers to report
physical (53.6% vs. 44.9%) and mental (65.7% vs. 57.8%) health conditions at
intake. AIANs were more likely to participate in counseling than White callers
(67.1% vs. 65.7%). Among those who received counseling, AIANs had greater odds
than White smokers of making a quit attempt (adjusted odds ratio = 1.39 [1.06,
1.81]) and similar odds of quitting for 180 days (adjusted odds ratio = 0.95
[0.69, 1.31]).
Conclusions.
Rates of access, engagement, and quitting suggest that individualized quitline
counseling was as effective with AIANs as it was with White smokers. Increasing
efforts to refer AIANs to existing state quitlines can help more smokers quit.
Implications.
This study showed that AIAN smokers were well represented among California
quitline callers, even without a targeted campaign. It also found that AIAN
smokers engaged in quitline services and were as able to quit as their White
counterparts were, even after adjusting for other baseline characteristics. One
implication is that public health programs can promote quitlines using
broad-based campaigns knowing that they will still motivate AIAN smokers to
seek help. Another implication is that a standard, individualized counseling
protocol delivered by culturally competent quitline staff can effectively help
AIAN smokers to quit.
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