Web-based Smoking Cessation Program for Tribal College Students

Many of the approximately 25,000 American Indian (AI) students enrolled in tribal
colleges/universities in the US arrive there as smokers. A 2011 study of high school seniors
reported that the smoking prevalence among AI students is approximately 40%, the highest rate
among all racial and ethnic groups studied. Although prevalence data on smoking among AI
college students are limited, studies have shown that the majority of smokers in high school
continue to smoke once they reach college. Prohibited from marketing to adolescents and
children, the tobacco industry in recent years has shifted its most intense marketing to
college students, resulting in increases in smoking rates among them. The transition to
college provides amble opportunities for young adults to acquire new and harmful habits. Many
of these habits do not seem so alien to young AIs: Cigarette smoking is the number one cause
of preventable death among AIs. Cancer is the second leading cause of death among AIs, and
lung cancer is the leading cause of cancer deaths for both AI men and women. Cultural
factors, socioeconomic circumstances, and lack of culturally-tailored cessation programs for
American Indian tribal college students have prevented access to effective interventions that
promote smoking cessation. To date, few studies have focused on methods to encourage smoking
cessation among tribal college students and no randomized clinical trials have yet been
conducted. To address this public health deficit, we propose an innovative, effective,
culturally and individually-tailored smoking cessation programs to promote cessation.

Primary aim is to: To test the effectiveness of a culturally-tailored internet-based smoking
cessation intervention (I-ANBL) compared to an internet-based heart healthy diet
(I-FV:fruit/vegetable) control condition in a randomized controlled trial with Tribal College
students. Our hypothesis is that American Indian tribal college students randomized to the
culturally-tailored smoking cessation arm will have significantly higher 7-day point
prevalence abstinence (defined as no cigarettes in the past 7 days, biochemically verified)
rates at 6 months than those receiving the heart healthy diet intervention.

Inclusion Criteria:

- Currently enrolled at Salish Kootenai College

- Have a valid telephone number and email address

- Willing to participate in all study components

- Willing to be followed-up for 6 months

- Self identifies as American Indian or Alaska Native

- Is a current smoker

Exclusion Criteria:

- Planning to leave college within next 6 months

- Medically ineligible as a result of screening questions