Impact of a smoke‐free–living educational intervention for smokers and household nonsmokers: A randomized trial of Chinese American pairs

• Published in: Cancer 2018-04, Vol.124 (S7), p.1590-1598
• Main Authors: Tong, Elisa K., Saw, Anne, Fung, Lei‐Chun, Li, Chin‐Shang, Liu, Yu, Tsoh, Janice Y.
• Format: Article
• Language: English
• Subjects: 4‐(methylnitrosamino)‐1‐(3‐pyridyl)‐1‐butanol (NNAL) biomarker; Adolescent; Adult; Aged; Aged, 80 and over; Asian Americans - psychology; Biochemistry; Butanol; Cancer; Chinese; Community-Based Participatory Research; Counseling; Early Intervention (Education); Education; Exposure; Female; Follow-Up Studies; Health Behavior; Health Knowledge, Attitudes, Practice; Households; Humans; Intervention; Male; Middle Aged; Non-Smokers - psychology; Oncology; Prognosis; San Francisco - epidemiology; secondhand smoke; Smoke; Smokers - psychology; smoke‐free home; Smoking; Smoking Prevention - methods; Teaching methods; Tobacco; tobacco cessation; Tobacco Use Disorder - epidemiology; Tobacco Use Disorder - prevention & control; Tobacco Use Disorder - psychology; Young Adult
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/cncr.31115

BACKGROUND Chinese American men smoke at a high rate, which puts household nonsmokers at risk. The objective of this study was to evaluate the effectiveness of a brief‐intensity versus moderate‐intensity smoke‐free–living educational intervention for household pairs. METHODS The authors conducted a randomized controlled trial of Cantonese‐speaking Chinese American smoker and household nonsmoker pairs in San Francisco, California. Pairs were randomized to moderate‐intensity or brief‐intensity group sessions with their household partner. The moderate‐intensity group received 2 group sessions, a laboratory report of their baseline smoke exposure, as measured by 4‐(methylnitrosamino)‐1‐(3‐pyridyl)‐1‐butanol (NNAL), and 3 follow‐up calls over 6 months. The brief‐intensity group received 1 group session on tobacco‐cessation resources. Primary outcomes were biochemically validated, past‐month smoking abstinence and elimination of nonsmoker household exposure at 12 months. RESULTS Participant pairs (n = 203) were male smokers, one‐half of whom did not intend to quit within 6 months, with mostly female spouses as household nonsmokers. Approximately three‐quarters of nonsmokers in both groups already had smoke‐free home rules. At 12 months, smokers in both groups had similar biochemically validated 30‐day abstinence rates (moderate‐intensity group, 0%‐20.7%; brief‐intensity group, 0%‐20.0%; P = .002 over time). More smokers in the moderate‐intensity group used subsequent cessation group classes (moderate‐intensity group, 50%; brief‐intensity group, 24%; P = .004). Household nonsmokers in both groups had similar biochemically validated rates of no home exposure (moderate‐intensity group, 24.5%‐42.2%; brief‐intensity group, 24.8%‐33.3%; P = .0001 over time). CONCLUSIONS A moderate‐intensity smoke‐free–living educational intervention for Chinese‐speaking household pairs was not more effective than a brief‐intensity intervention for smoking abstinence and elimination of household nonsmoker exposure. Abstinence rates were similar to those achieved with standard group counseling. Cancer 2018;124:1590‐8. © 2018 American Cancer Society. Chinese American men smoke at a high rate, which puts household nonsmokers at risk. A moderate‐intensity smoke‐free educational intervention for Chinese‐speaking household pairs is not more effective than a brief‐intensity intervention for smoking cessation and elimination of household nonsmoker exposure, but abstinence rates are similar to