A National Asian-Language Smokers’ Quitline — United States, 2012–2014
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A National Asian-Language Smokers’ Quitline — United States, 2012–2014
ORIGINAL RESEARCH — Volume 12 — June 25, 2015
Nicole Kuiper, MPH; Lei Zhang, PhD; Joann Lee, DrPH; Stephen D. Babb, MPH; Christopher M. Anderson; Curt Shannon; MaryBeth Welton; Rod Lew, MPH; Shu-Hong Zhu, PhD
Suggested citation for this article: Kuiper N, Zhang L, Lee J, Babb SD, Anderson CM, Shannon C, et al. A National Asian-Language Smokers’ Quitline — United States, 2012–2014. Prev Chronic Dis 2015;12:140584. DOI: http://dx.doi.org/10.5888/pcd12.140584.
Until recently, in-language telephone quitline services for smokers who speak Asian languages were available only in California. In 2012, the Centers for Disease Control and Prevention (CDC) funded the national Asian Smokers’ Quitline (ASQ) to expand this service to all states. The objective of this study was to examine characteristics of ASQ callers, how they heard about the quitline, and their use of the service.
Characteristics of callers from August 2012 through July 2014 were examined by using descriptive statistics. We examined demographics, cigarette smoking status, time to first cigarette, how callers heard about the quitline, and service use (receipt of counseling and medication) by using ASQ intake and administrative data. We analyzed these data by language and state.
In 2 years, 5,771 callers from 48 states completed intake; 31% were Chinese (Cantonese or Mandarin), 38% were Korean, and 31% were Vietnamese. More than 95% of all callers who used tobacco were current daily cigarette smokers at intake. About 87% of ASQ callers were male, 57% were aged 45 to 64 years, 48% were uninsured, and educational attainment varied. Most callers (54%) were referred by newspapers or magazines. Nearly all eligible callers (99%) received nicotine patches. About 85% of smokers enrolled in counseling; counseled smokers completed an average of 4 sessions.
ASQ reached Chinese, Korean, and Vietnamese speakers nationwide. Callers were referred by the promotional avenues employed by ASQ, and most received services (medication, counseling, or both). State quitlines and local organizations should consider transferring callers and promoting ASQ to increase access to cessation services.
More than two-thirds of smokers want to quit (1), but few use evidence-based treatments that can increase successful quitting (2,3). Telephone quitlines increase quit rates, have broad reach, and are effective with diverse populations (2). However, certain Asian subgroups experience disparities in smoking prevalence and access to cessation treatments (2,4–6). Until recently, California was the only state to provide in-language quitline services for Asian language speakers (7,8). Because some Asian subgroups with limited English fluency smoke at higher rates than those with higher English fluency (9,10), this disparity represented a gap in services in other states.
California’s experience helped address the misperception that Asians will not call quitlines because they are unfamiliar or uncomfortable with behavioral counseling (7,11). Data from 15 years of operation in California showed that Asian-language speakers were just as likely to call as English-speaking white smokers (7). A randomized controlled trial demonstrated the effectiveness of culturally tailored Asian-language protocols and services for Chinese, Korean, and Vietnamese (CKV) smokers (11). A subsequent 6-state dissemination project demonstrated the value of a multistate Asian-language quitline but suggested that a centralized promotional effort and uniform protocol for distributing nicotine replacement therapy through the quitline might be helpful (8).
In response to this evidence, in 2012, the Centers for Disease Control and Prevention (CDC) funded the Asian Smokers’ Quitline (ASQ), expanding California’s in-language program nationally. No studies to date have examined ASQ’s reach or whom it serves. CDC engaged ASQ stakeholders to design a multiyear evaluation to explore the implementation, feasibility, utility, and effectiveness of ASQ. The objective of this study is to describe the first 2 years of ASQ by examining caller characteristics, how callers heard about the quitline, and their use of the service. Results will be used to guide ASQ promotion, program improvements, and subsequent analyses
The authors thank Joseph Chu (UCSD) for administrative support and both him and Caroline Chen (UCSD) for reviews of the manuscript; Shiushing Wong (UCSD) for statistical analysis support; and Karen Debrot and LaTisha Marshall (CDC/OSH) for pre-clearance manuscript review. Funding for implementation of the Asian Smokers’ Quitline was provided by the Centers for Disease Control and Prevention through grant no. 1U58DP004038. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
Corresponding Author: Nicole Kuiper, MPH, Centers for Disease Control and Prevention, 4770 Buford Highway, MS-F79, Atlanta, GA 30341. Telephone: 770-488-5719. Email: NKuiper@cdc.gov.
Author Affiliations: Lei Zhang, Stephen D. Babb, Curt Shannon, MaryBeth Welton, Centers for Disease Control and Prevention, Atlanta, Georgia; Joann Lee, Rod Lew, Asian Pacific Partners for Empowerment, Advocacy and Leadership (APPEAL), Oakland, California; Christopher M. Anderson, Shu-Hong Zhu, University of California, San Diego, California. Joann Lee was affiliated with the University of California, San Diego, during the writing of this article.
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