Smokers' Quitline for Asian Language Speakers

• Continuous abstinence from cigarettes [ Time Frame: 4-months post enrollment ] [ Designated as safety issue: No ]
• Continuous abstinence from cigarettes [ Time Frame: 7-months post enrollment ] [ Designated as safety issue: No ]

• Rate of serious quit attempts [ Time Frame: 4-months post enrollment ] [ Designated as safety issue: No ]
• 30-day point prevalence [ Time Frame: 4-months post enrollment ] [ Designated as safety issue: No ]
• 30-day point prevalence [ Time Frame: 7-months post enrollment ] [ Designated as safety issue: No ]
• Rate of serious quit attempts [ Time Frame: 7-months post enrollment ] [ Designated as safety issue: No ]

• Rate of serious quit attempts [ Time Frame: 4-months post enrollment ] [ Designated as safety issue: No ]
• 30-day point prevalence [ Time Frame: 4-months post enrollment ]
• 30-day point prevalence [ Time Frame: 7-months post enrollment ]
• Rate of serious quit attempts [ Time Frame: 7-months post enrollment ]

The study tested the effects of telephone counseling for smokers from three Asian language speaking groups: Chinese, Korean, and Vietnamese. The specific aims were to: 1) test the efficacy of a culturally appropriate counseling protocol for smokers calling the California Smokers' Helpline on the Chinese, Korean and Vietnamese lines, 2) examine whether intervention effects varied by cognitive and behavioral predictors of cessation success, 4) examine whether family involvement plays a role in quitting success, and 5) assess differences in counseling effect across the three ethnic groups.

Asian Americans are among the least studied groups in smoking research, which has created a knowledge gap in understanding their behavior and in developing methods to help them quit. No efficacy data have been reported for telephone counseling of smokers who prefer to use Asian languages, although telephone intervention holds promise for these groups because of its convenience and its potential to reach large numbers of smokers. In this two-arm design subjects are stratified by language (Chinese, Korean, and Vietnamese) and randomized to telephone counseling (plus materials) or self-help materials only, which serves as the control. The study is significant in several ways. First, it provides timely information on a cessation approach for a traditionally under-served population (Asian language speakers). Second, effective telephone counseling can be widely applied because of the proliferation of quitlines with centralized services in recent years. Third, by targeting Asian language speakers this study addresses the issue of ethnic disparities, which has been identified by many (including the NCI Bypass Budget) as a research priority.

• Behavioral: Telephone Counseling
  Telephone counseling is conducted in Mandarin, Cantonese, Korean, or Vietnamese by veteran counselors at the California Smokers' Helpline. The counseling protocol is similar to that used by the Helpline in previous efficacy studies for English and Spanish speakers. However, the counseling is modified to make it culturally appropriate for Asian language speakers by: capitalizing on first contact, proactively presenting the Helpline as a credible quit smoking program staffed by "experts" and avoiding the term "counseling" since it is associated with mental illness, and assuming a more authoritative role and directive counseling style, in keeping with subject expectations. Counseling is proactive so after the smoker calls in subsequent calls are made by the counselor, a process that reduces attrition. Counseling includes a 30-40 minute comprehensive pre-quit session plus up to 5 shorter follow-up calls (about 10 minutes) that are scheduled according to the probability of relapse.
• Behavioral: Self-Help Materials
  All subjects (both in the telephone counseling group and the materials-only group) receive self-help materials in teh appropriate language. Materials were created in-house, are written in the appropriate language, and cover the essentials of the quitting process such as motivation, physiological and emotional responses to quitting, nicotine in the body, quitting aids, quitting strategies (including those that might be culturally specific such as acupuncture or herbs), setting a quit date, planning, relapse prevention, differentiating between slips and relapse, long-term maintenance, and developing the nonsmoker self-image.

• Experimental: Telephone Counseling
  Interventions:

  • Behavioral: Telephone Counseling
  • Behavioral: Self-Help Materials
• Active Comparator: Self-help Materials
  Intervention: Behavioral: Self-Help Materials

Inclusion Criteria:

• 18-75 years old,
• daily smoker,
• ready to quit within one month,
• first time caller,
• valid phone number,
• valid address,
• California (CA) resident,
• gave consent to participate in study and evaluation,
• called the Chinese, Korean or Vietnamese line

Exclusion Criteria:

• used other form of tobacco,
• major medical or psychiatric complication (e.g. lung cancer, major depressive disorder, anti-psychotic medicine, recent stroke, impending surgery)