Abstract A34: Understanding the Predictors of Smoking Cessation in a Culturally Tailored Smoking Cession Program Created for American Indians
Authors: Pacheco Joseph A. , Gunville Jordyn , Niaman Nazir , Smith T. Edward , Daley Sean M. , Choi Won S. , Daley Christine M. 
Published: March 2017

The purpose of this study was to test the effectiveness of the All Nations Breath of Life program (ANBL); a 12-week culturally-tailored smoking cessation program designed for use in a heterogeneous urban and suburban American Indian (AI) population. Through this process we looked at the secondary outcome: predictors of successful smoking cessation. ANBL was developed, implemented, and tested using a community-based participatory research (CBPR) approach in which AI community members were involved in all phases of the research. Participants in ANBL (N=312) self-selected into the study. Participants self-identified as AI (tribal enrollment was not required). Additional inclusion criteria included being 18 years of age or older, cotinine verified current cigarette smoker, self-expressed interest in quitting smoking in the 30 days following the informed consent process. The vast majority of ANBL group sessions were located primarily in the Heartland/Midwest and surrounding areas. ANBL has five primary components, as follows: Group Support Sessions, Individual Telephone Counseling, Educational Curriculum, Pharmacotherapy, and Participant Incentives. The primary endpoint was salivary cotinine verified continuous abstinence at 6-months. Participants were asked to self-report smoking status, “Since your quit date in ANBL, have you ever smoked at least part of a cigarette?” Those participants answering “no” to this question were asked to provide saliva for cotinine verification. At program completion, 53.3% of program completers remained abstinent; using an intent-to-treat analysis labeling those lost to follow-up as smokers resulted in a 41.4% quit rate. At 6 months post-baseline, 31.1% of retained participants quit smoking (p&lt;0.0001 compared to the highest quit rates among multi-tribal populations reported in the literature, 7%); final quit rate was 22.1% using an intent-to-treat analysis (p=0.002). Few items were found to be predictive of ability to quit at the primary endpoint. The most significant predictor of cessation was participation in one of the groups run in Mid-Missouri, all of which were run by one facilitator (OR=0.24, p=0.0005). An additional predictor of cessation included participants who had some form of home smoking rule (partial or full) (OR=0.35, p=0.0004). Other items that approached significance in relationship to quitting included use of traditional tobacco, which negatively impacted quit rates (OR=1.70, p=0.08), having higher self-confidence in one's ability to quit at baseline positively impacted quit rates (OR=2.20, p=0.16), and lack of use of other recreational tobacco products positively impacted quit rates (OR=2.42, p=0.07). Participants who had the longest history of smoking (greater than 20 years) were least likely to quit (OR=0.26; p=0.03). The data found will be incorporated into modifications to the program to assist other participants with successful cessation. Understanding the predictors of smoking cessation can ensure participant success in tailored smoking cession programs.

Citation Format: Joseph A. Pacheco, Jordyn Gunville, Nazir Niaman, T. Edward Smith, Sean M. Daley, Won S. Choi, Christine M. Daley. Understanding the Predictors of Smoking Cessation in a Culturally Tailored Smoking Cession Program Created for American Indians. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr A34.