Enhancing Tobacco Quitline Outcomes for African American Adults: An RCT of a Culturally Specific Intervention

Abstract

This study tested the effectiveness of a culturally specific tobacco cessation video intervention among African American quitline enrollees. This was a 3-arm semipragmatic RCT. African American adults (N=1,053) were recruited from the North Carolina tobacco quitline and data were collected between 2017 and 2020. Participants were randomized to receive (1) quitline services only; (2) quitline services plus a standard, general audience video intervention; or (3) quitline services plus Pathways to Freedom (PTF), a culturally specific video intervention designed to promote cessation among African American persons. The primary outcome was self-reported 7-day point prevalence smoking abstinence at 6 months. Secondary outcomes included 7-day and 24-hour point prevalence abstinence at 3 months, 28-day continuous abstinence, and intervention engagement. Data analyses occurred in 2020 and 2022. At 6 months, 7-day point prevalence abstinence was significantly greater in the Pathways to Freedom Video arm compared with quitline-only (OR=1.5, CI=1.11, 2.07). Twenty four-hour point prevalence abstinence was significantly greater in the Pathways to Freedom (than in quitline-only) group at 3 (OR=1.49, 95% CI=1.03, 2.15) and 6 (OR=1.58, 95% CI=1.10, 2.28) months. At 6 months, 28-day continuous abstinence (OR=1.60, 95% CI=1.17, 2.20) was significantly greater in the Pathways to Freedom Video arm than in the quitline-only arm. Views of the Pathways to Freedom Video were 76% higher than views of the standard video. Culturally specific tobacco interventions delivered through state quitlines can increase cessation and thus have the potential to decrease health disparities among African American adults. This study is registered at www. gov NCT03064971.