Tobacco Dependence Treatment for Asian Americans
| Status: | Completed |
|---|---|
| Conditions: | Smoking Cessation, Tobacco Consumers |
| Therapuetic Areas: | Pulmonary / Respiratory Diseases |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 3/15/2019 |
| Start Date: | October 2009 |
| End Date: | January 2014 |
A Randomized Controlled Clinical Trial of a Combination of Pharmacotherapy and Culturally Tailored Cognitive Behavior Therapy With Korean Americans
Nicotine dependence is very common among Asian Americans; yet, research on understanding and
treating nicotine dependence in this group is almost nonexistent. The proposed study is a
first attempt to develop a smoking cessation program that is tailored to Korean-culture
specific aspects. It is proposed that Korean Americans who receive a culturally tailored
smoking cessation program will be more likely to have prolonged abstinence at 12-month
follow-up than their counterparts who receive brief cessation counseling. Subjects in both
arms receive nicotine patches for 8 weeks. Self-reported abstinence is validated with exhaled
carbon monoxide and salivary cotinine tests.
treating nicotine dependence in this group is almost nonexistent. The proposed study is a
first attempt to develop a smoking cessation program that is tailored to Korean-culture
specific aspects. It is proposed that Korean Americans who receive a culturally tailored
smoking cessation program will be more likely to have prolonged abstinence at 12-month
follow-up than their counterparts who receive brief cessation counseling. Subjects in both
arms receive nicotine patches for 8 weeks. Self-reported abstinence is validated with exhaled
carbon monoxide and salivary cotinine tests.
Korean men have been known for very high smoking rates and the highest cancer death
smoking-attributable fraction. In contrast, Korean women reportedly smoke at low rates
compared to the general U.S. population. However, recent population-based survey data
indicate steady increases in smoking prevalence of Korean American women. Particularly, it
has been found that they tend to initiate smoking as they acculturate into social norms of
American women. Preliminary data of the applicant and others suggests interventions must be
culturally adapted and a motivation-based and family-involved approach is most promising. The
training plan will help the applicant develop an independent program of drug abuse research
that focuses on better understanding and treating tobacco dependence among Asian Americans,
including evaluating culturally competent and gender-specific interventions. The research
plan will examine the impact of culture and gender on nicotine dependence and utilize
National Institute on Drug Abuse behavioral therapy development methods. The proposed
research plan has two-phases and evaluates tobacco dependence treatment with Korean Americans
(N = 164, 50% women). Phase 1 is a no-control group study (Stage Ia) that is aimed at
developing an intervention manual of Group-based Motivational Interviewing (GMI)
intervention, therapists' adherence and competence scales, training program, and small
feasibility intervention study with 20 Korean-American (offered separately for men and
women). Phase 2 is a randomized controlled trial (Stage Ib) with 144 Korean Americans that is
conducted to assess feasibility and relative effectiveness of the GMI behavioral intervention
in conjunction with Nicotine Replacement Therapy (NRT) in comparison with a brief group
medication management of NRT. Gender-interaction effects of psychosocial variables on
treatment outcomes will be assessed, including acculturation and depression. This award will
help prepare the applicant for an independent research career focusing on Asian Americans and
Nicotine Dependence, including adapting and testing new interventions for different
populations.
smoking-attributable fraction. In contrast, Korean women reportedly smoke at low rates
compared to the general U.S. population. However, recent population-based survey data
indicate steady increases in smoking prevalence of Korean American women. Particularly, it
has been found that they tend to initiate smoking as they acculturate into social norms of
American women. Preliminary data of the applicant and others suggests interventions must be
culturally adapted and a motivation-based and family-involved approach is most promising. The
training plan will help the applicant develop an independent program of drug abuse research
that focuses on better understanding and treating tobacco dependence among Asian Americans,
including evaluating culturally competent and gender-specific interventions. The research
plan will examine the impact of culture and gender on nicotine dependence and utilize
National Institute on Drug Abuse behavioral therapy development methods. The proposed
research plan has two-phases and evaluates tobacco dependence treatment with Korean Americans
(N = 164, 50% women). Phase 1 is a no-control group study (Stage Ia) that is aimed at
developing an intervention manual of Group-based Motivational Interviewing (GMI)
intervention, therapists' adherence and competence scales, training program, and small
feasibility intervention study with 20 Korean-American (offered separately for men and
women). Phase 2 is a randomized controlled trial (Stage Ib) with 144 Korean Americans that is
conducted to assess feasibility and relative effectiveness of the GMI behavioral intervention
in conjunction with Nicotine Replacement Therapy (NRT) in comparison with a brief group
medication management of NRT. Gender-interaction effects of psychosocial variables on
treatment outcomes will be assessed, including acculturation and depression. This award will
help prepare the applicant for an independent research career focusing on Asian Americans and
Nicotine Dependence, including adapting and testing new interventions for different
populations.
Inclusion Criteria:
Korean-speaking Koreans who:
1. Are ages of 18 and older
2. Have been smoking at least 10 or more cigarettes on average per day for the past 30
days; AND
3. Are willing to quit smoking and receive NRT
Exclusion Criteria:
1. Inability to speak and understand Korean or English
2. Involvement in behavioral or other pharmacological smoking cessation programs
3. History of serious cardiac diseases and/or presence of skin diseases (see Human
Subjects); OR
4. Pregnancy, lactation or plans to become pregnant in the next 12 months
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