Long-term effectiveness of smoking cessation courses for Turkish-speaking migrants in Switzerland

Abstract

Abstract Background Migrant populations usually report higher smoking rates. Among those migrant populations, Turkish- and Kurdish-speaking migrants are often overrepresented. Providing equal access to health services is one of major challenges of our time. The need for adapted smoking-cessation treatments for Turkish-speaking populations to achieve equity in health led, in 2006, to the development and implementation of the Tiryaki-Kukla smoking-cessation program in Switzerland. Since 2006, 5'305 Turkish-speaking migrants in Switzerland were reached with tobacco-related information and the offer of tailored treatment. In short, the treatment was grounded in behavioral therapy and was adapted from the weekly group-counseling sessions applied by the Cancer League Zurich. The adaptation focused on language, cultural and health literacy issues. The aims of the study were to evaluate one-year quit rates for smoking-cessation courses held from 2006 to 2018 and investigate whether certain characteristics predict long-term abstinence. Methods Evaluation of the program included a pre/post questionnaire (session 1/ 3 months after the quit day) and a follow-up telephone call twelve months after the quit day. To elucidate factors associated with long-term abstinence, Cox regression analysis and Weighted Generalized Equation Models were used. Results Of the 478 who participated in smoking-cessation courses, 45.4% declared themselves non-smokers at one-year follow-up. Characteristics associated with long-term abstinence were length of the course (eight vs. six sessions), adherence to the course, use of pharmacotherapy or NRT products, and baseline level of dependence. Conclusions Our findings are consistent with existing evidence supporting culturally-adapted smoking cessation interventions to reduce health inequity in migrant populations. However, achieving harm reduction in smokers with higher dependence scores remains challenging. Key messages A culturally-adapted smoking cessation course showed effective to reduce health inequity. One challenge remains: Achieving harm reduction in migrants with higher dependence scores.