Introduction
American Indians have the highest cigarette smoking prevalence of any racial/ethnic
group in the U.S. There is currently no effective empirically based smoking-cessation
program for American Indians. The purpose of this study was to determine if a culturally
tailored smoking-cessation program, All Nations Breath of Life (ANBL), is more effective
than a non-tailored cessation program among American Indian smokers.
Design
A multisite RCT was conducted from September 2009 to July 2014; analysis was conducted
in 2015.
Setting/Participants
Participants were rural or reservation-based American Indian smokers aged ≥18 years.
Intervention
Smokers were group randomized to either the culturally tailored ANBL or non-tailored
current best practices (CBP) for a total enrolled sample size of 463 (ANBL, n=243; CBP, n=220).
Main Outcome Measures
The primary outcome of interest was salivary cotinine−verified 7-day point prevalence
smoking abstinence at 6 months. Results for both responder-only and intent-to-treat
analyses for self-reported and cotinine-verified abstinence are presented.
Results
Intention-to-treat, imputing all non-responses as smokers, the self-reported point
prevalence abstinence rates at 12 weeks were 27.9% in the ANBL arm and 17.4% in the
CBP arm (p=0.028). There was a statistically significant difference in self-reported 6-month
intent-to-treat point prevalence abstinence rates between ANBL (20.1%) and CBP (12.0%)
arms (p=0.029). None of the cotinine-verified results were statistically significant.
Conclusions
The culturally tailored smoking-cessation program ANBL may or may not be an effective
program in promoting cessation at 12 weeks and 6 months. Participants in the culturally
tailored ANBL program were approximately twice as likely to quit smoking at 6 months
compared with the CBP program, using self-reported abstinence.
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Article info
Publication history
Published online: July 16, 2016
Identification
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© 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
