A pilot randomized trial examining the feasibility and acceptability of a culturally tailored and adherence-enhancing intervention for Latino smokers in the U.S.

Marcel A De Dios,Ellen L Vaughan,Morgan M Mcneel,Raymond S Niaura,Laura M Harvey,Sarah D Childress,Miguel Ángel Cano,Lion Shahab

doi:10.1371/journal.pone.0210323

Abstract

Latino smokers in the United States (US) are known to experience smoking cessation treatment disparities due to their under-utilization of services, limited access to health care, and poor smoking cessation treatment outcomes. A limited number of studies have focused on developing and testing smoking cessation treatments for Latino smokers in the US. The objectives of this study were to conduct a feasibility pilot randomized trial testing three smoking cessation interventions for Latinos. Twenty-five adult Latino smokers were randomized to one of three groups: Culturally-Tailored Smoking Cessation plus Adherence Enhancement (CT+AE), Culturally-Tailored Smoking Cessation (CTSC), and a Health Education (HE) control group. All participants received three counseling sessions along with nicotine replacement therapy (NRT). Data relating to intervention acceptability and NRT adherence were collected. Self-reported 7-day point prevalence smoking was collected at 3 and 6 month follow-up and biochemically verified with expired carbon monoxide testing. Overall, the interventions demonstrated high levels of feasibility and acceptability. Days of nicotine patch use were found to be higher in the CT+AE group (mean (M) = 81.3;standard deviation (SD) = 3.32) than the CTSC (M = 68.6;SD = 13.66) and HE (M = 64;SD = 17.70) groups. At 3-month follow-up, approximately 50% of the CT+AE group were smoking abstinent, 25% of the CTSC group, and 44% of the HE group. At 6-month follow-up, 37.5% of the CT+AE group were abstinent, 25% of the CTSC group, and 44.4% of the HE group. This study is the first to target Latino smokers in the US with a culturally-tailored intervention that addresses treatment adherence. Results support the preliminary feasibility and acceptability of the CT+AE intervention.Trial Registration: ClinicalTrials.gov NCT02596711.

Highlights

15.5% of the adult population (38.7 million) in the United States (US) smokes tobacco [1]
The current study extends this line of research and pilot tests a culturally-tailored smoking cessation intervention (CTSC), as well as an adherence enhancement “add-on” intervention (CT+Adherence Enhancement (AE))
Exclusion criteria included individuals: (a) suffering from any unstable medical condition precluding the use of Nicotine replacement therapy (NRT); (b) currently using smokeless tobacco, electronic nicotine delivery systems (ENDS), NRT, or other smoking cessation treatment; (c) pregnant or nursing; (d) suffering from a severe psychiatric disorder that would interfere with participation; (e) diagnosed with any substance dependence disorder other than nicotine and screened with the Diagnostic and Statistical Manual of Mental Disorders 4th Edition, Text Revised (DSM-IV-TR) [39], and (f) no access to a working telephone

Summary

Introduction

15.5% of the adult population (38.7 million) in the United States (US) smokes tobacco [1]. It is the leading cause of preventable disease and death with over 480,000 deaths attributed to smoking each year [1]. A 2014 national survey of Latino health in the US found an overall daily and non-daily smoking prevalence rate of 26.1% among Latino males and 16.4% among Latina females, with substantial disparities by both gender and national origin [2]. Among Latinos in the US, which are estimated to be 18% (~58 million individuals) of the US population [3], three out of the four leading causes of death (cancer, heart disease, and stroke) are associated with smoking [4]. Lung cancer is the foremost cause of cancer death for Latino men and the second leading cause of death for Latina women [4]

Objectives

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Conclusion