Feasibility Study of Culturally Tailored Smoking Cessation Chinese Smokers in NYC
Tobacco use is a serious public health problem in the U.S. population, but is particularly so among low income Chinese Americans with limited English proficiency. Chinese comprise the largest Asian subgroup in the U.S. and in NYC. Several studies indicated that Chinese men are at high risk for morbidity and mortality with current smoking rate ranging from 24% to 30% and lifetime of 52% and acculturation and length of residency in the U.S. have a lesser differential effect on smoking behavior among Chinese than other populations. Studies have suggested that physician-delivered smoking intervention, in conjunction with increased intensity of smoking cessation counseling, can greatly increase smoking cessation rates. Although a few studies have investigated the effectiveness of smoking cessation programs for Asian Americans, none has examined the feasibility and efficacy of a smoking cessation that combines physician-led smoking intervention, intensive behavioral counseling, and pharmacological intervention for low income Chinese smokers in NYC. Our study showed that majority of Chinese smokers in NYC had not received health professional advice on cessation. The proposed pilot study, guided by Transtheoretical Model and Adapted Motivational Interviewing (AMI) strategies, is the first to examine the feasibility and the impact of a smoking cessation that includes a brief physician-led smoking intervention, intensive behavioral counseling, and pharmacological intervention for NYC Chinese smokers. The pilot study aims are: 1) to test the feasibility of a culturally tailored smoking cessation program (namely, Asian QUIT), through combined clinical, AMI, and NRT intervention for Chinese smokers in NYC; 2) to identify factors and techniques that can be used to further modify or improve the QUIT program for a full-scale randomized intervention trial for Chinese and other Asian American smokers; 3) to examine the short-term impact of QUIT on smoking reduction and quit rates; and 4) to use the findings to generate specific hypotheses about long-term effects of the combined intervention. The study will involve a randomized clinical trial (RCT), with pre-treatment assessment and multiple follow-up measures. Eligible participants (n=100) will be randomly assigned to intervention or control group. The treatment/intervention group will receive seven sessions in an individualized format, including physician-led clinical intervention, counselor-led intensive motivational interview sessions, and Nicoderm CQ Patches. The control group will be provided with an equal number of session contacts that will be limited, however, to self-help general health materials and Nicoderm CQ Patches. The pilot study aims represent an extension of an NCI-funded parent grant, ATECAR-Asian Community Cancer Network. The study will be an essential component of ATECAR's comprehensive tobacco control efforts and is directly related to ATECAR goals of reducing the incidence and risk behaviors of cancer among Asian Americans, stimulating partners' participation in and increasing research and training opportunities for Asian Americans in tobacco and cancer interventions. Findings will help lay the groundwork for a full-scale randomized intervention trial of a culturally tailored smoking intervention among Chinese and other Asians.