Abstract IA31: Reducing smoking related health disparities among American Indians: All Nations Breath of Life
Authors: Choi Won S. , Beebe Laura A. , Nazir Niaman , Hopkins Michelle , Talawyma Myrietta , Shireman Theresa I. , Yeh Hung-Wen , Greiner Allen , Daley Christine 
Published: March 2017

Background: American Indians have the highest cigarette smoking prevalence of any racial/ethnic group in the U.S. Although the smoking prevalence in the general population has declined during the past several decades, American Indians and Alaska Natives have not experienced the same decrease in smoking. Furthermore, the prevalence of smoking cessation is relatively low in this population compared to smokers in other racial/ethnic groups. There is currently no effective empirically-based smoking cessation program for American Indians and Alaska Natives.

Purpose: To determine if a culturally-tailored smoking cessation program, All Nations Breath of Life, is more effective than a non-tailored cessation program among American Indian smokers.

Methods: A randomized multi-site clinical trial was conducted from September 2009 to July 2014. Participants were rural or reservation-based American Indian smokers, at least 18 years old. Smokers were group randomized to either the culturally-tailored All Nations Breath of Life (ANBL) or the non-tailored Current Best Practices (CBP) for a total enrolled sample size of 463 (243=ANBL and 220=CBP). The primary outcome of interest was salivary cotinine verified 7-day point prevalence smoking abstinence at month 6. We present results using both responder only and intent-to-treat (ITT) analyses for both self-reported and cotinine verified abstinence.

Results:Intention-to-treat, imputing all non-responses as smokers, the self-reported abstinence rates for week 12 were 27.9% in the ANBL arm and 17.4% in the CBP group, p=0.030. There was a statistically significant difference in self-reported 6-month ITT abstinence rates between ANBL (20.1%) and CBP (12.0%) group, p=0.036. None of the cotinine verified results were statistically significant.

Conclusion: The culturally-tailored smoking cessation program “All Nations Breath of Life”may be an effective program in promoting cessation at week 12 and at 6 months. Participants in the culturally-tailored ANBL program were approximately twice as likely to quit smoking at 6 months compared to the CBP program, using self-reported abstinence. These findings support the need to provide additional funding for comprehensive smoking prevention and cessation efforts to reduce smoking related health disparities among American Indians and Alaska Natives.

Citation Format: Won S. Choi, Laura A. Beebe, Niaman Nazir, Michelle Hopkins, Myrietta Talawyma, Theresa I. Shireman, Hung-Wen Yeh, Allen Greiner, Christine Daley. Reducing smoking related health disparities among American Indians: All Nations Breath of Life. [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 IA31.