SUCCESSFUL LATINO COMMUNITY PARTNERSHIP PROGRAM FOR SMOKING CESSATION

Abstract

A recent article by Lopez-Quintero et al.1 documented that US-based Latino smokers are less likely to receive smoking cessation advice than non-Latino White or African-American smokers. “Missed opportunities” in the primary-care setting for smoking cessation for Latinos include low acceptability of pharmacotherapies and counseling for smoking cessation.2–4 Innovative strategies, such as the use of community primary care–academic partnership models, are needed to overcome barriers to smoking treatment.1,5,6 In collaboration with the Rhode Island Department of Health and a community-based education and advocacy center, Progreso Latino, we implemented a smoking cessation program, iYa No Fumo! (“Right now, I am not smoking!”), using a community primary care–academic partnership model for 304 self-identified smokers of Central and South American origin. The program consisted of baseline intakes for assessment of nicotine dependence severity, medical and smoking histories, a group introductory workshop and motivational interviewing, and biweekly follow-up assessments—all conducted by bilingual tobacco treatment specialists. Recruitment—guided by focus groups and key informant interviews—was achieved through promotion at cultural events in the community, word of mouth, and statewide mass media campaigns. Nicotine replacement therapy (NRT; transdermal patches [21, 14, or 7 mg] or gum [2 or 4 mg]) was dispensed to all participants unless contraindicated (mean number of patches per participant = 34.3 [SD= 27.4]; patch strength = 21 [71.7%], 14 [27.8%], or 7 mg/day [0.6%]). Of those attending at least 1 follow-up session within 2 weeks of their target quit date (n = 96 [3 missing]), 45 (48.4%) reported abstinence from tobacco in the previous 7 days, 28 (30.1%) reported “cutting down” on their daily cigarette consumption, and the remaining 20 (21.5%) had relapsed. Using logistic regression, after controlling for nicotine dependence severity with a Spanish-translated, modified Horn-Russell scale,7 amount of patch received was found to significantly predict follow-up (B = 1.36; P < .001; n = 172) and self-reported abstinence status at follow-up (B = 1.08; P < .001). Abstinence rates were reported without biochemical verification. However, our observed abstinence rates were broadly consistent with published research performed in another study of NRT for Latino smokers.8 Findings suggest preliminarily that efforts to reduce disparities in smoking cessation counseling and treatment for Latino smokers may benefit from community primary care–academic partnership models—an approach that appears to maximize the acceptability and use of NRT.