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© 2007 American Public Health Association
DOI: 10.2105/AJPH.2007.111237
LETTER |
Sean P. David is with the Primary Care Genetics and Translational Research Center, Providence, RI. Sean David, Marcia Smith, and Garrett Sullivan are with the Department of Family Medicine, Memorial Hospital of Rhode Island, Pawtucket, and the Warren Alpert Medical School, Brown University, Providence. Christina S. Lee is with the Center for Alcohol and Addiction Studies, Brown University, Providence, and the Warren Alpert Medical School, Brown University.
Correspondence: Requests for reprints should be sent to Sean P. David, Brown University Center for Primary Care & Prevention, 111 Brewster Street, Pawtucket, RI 02860 (e-mail: sean_david{at}brown.edu).
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, ¡Ya 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.
Acknowledgments
This work was funded by the Rhode Island Department of Health subsequent to the 1998 Master Settlement (gran 1193-10100-589).
We thank Arlene Ayala, Jackie Torres, Helen Orellana, Fred Ordones, Edwin Cancel-Rios, Dania Keissling, and the staff at Progreso Latino, Inc, along with Donna Levesque, Germaine Dennaker, and Elizabeth Harvey from the Division of Tobacco Control, Rhode Island Department of Health.
Footnotes
Contributors
S. P. David and M. Smith originated the study, designed the program, obtained grant funding, developed the program with partners in Progreso Latino, and collected and analyzed the data. M. Smith directly supervised the administration of the program with the staff of Progreso Latino. C. S. Lee conceptualized the research question and analyzed data. G. Sullivan compiled, entered, and cleaned the data.
Accepted for publication January 30, 2007.
References
1. Lopez-Quintero C, Crum RM, Neumark YD. Racial/ethnic disparities in report of physician-provided smoking cessation advice: analysis of the 2000 National Health Interview Survey. Am J Public Health. 2006;96:2235–2239.
2. Levinson AH, Borrayo EA, Espinoza P, Flores ET, Perez-Stable EJ. An exploration of Latino smokers and the use of pharmaceutical AIDS. Am J Prev Med. 2006; 31:167–171.[CrossRef][Web of Science][Medline]
3. Levinson AH, Perez-Stable EJ, Espinoza P, Flores ET, Byers TE. Latinos report less use of pharmaceutical aids when trying to quit smoking. Am J Prev Med. 2004;26:105–111.[CrossRef][Web of Science][Medline]
4. Perez-Stable EJ, Marin G, Posner SF. Ethnic comparison of attitudes and beliefs about cigarette smoking. J Gen Intern Med. 1998;13:167–174.[CrossRef][Web of Science][Medline]
5. Marin G, Perez-Stable EJ. Effectiveness of disseminating culturally appropriate smoking-cessation information: Programa Latino Para Dejar de Fumar. J Natl Cancer Inst Monogr. 1995;18:155–163.
6. Kreling BA, Canar J, Catipon E, et al. Latin American Cancer Research Coalition: community primary care/academic partnership model for cancer control. Cancer. 2006;107(suppl 8):2015–2022.[CrossRef][Web of Science][Medline]
7. Russell MAH, Peto J, Patel UA. The classification of smoking by factorial structure of motives. J R Stat Soc (Ser A). 1974;3:313–346.
8. Hill AL, Roe DJ, Taren DL, Muramoto MM, Leischow SJ. Efficacy of transdermal nicotine in reducing post-cessation weight gain in a Hispanic sample. Nicotine Tob Res. 2000;2:247–253.
This article has been cited by other articles:
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  C. Lopez-Quintero, R. M. Crum, and Y. D. Neumark LOPEZ-QUINTERO ET AL. RESPOND Am J Public Health, August 1, 2007; 97(8): 1349 - 1349. [Full Text] [PDF]
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