domingo, 12 de julio de 2015

A National Asian-Language Smokers’ Quitline — United States, 2012–2014

full-text ►

A National Asian-Language Smokers’ Quitline — United States, 2012–2014

CDC. Centers for Disease Control and Prevention. CDC 24/7: Saving Lives. Protecting People.

Preventing Chronic Disease Logo

Prevent Birth Defects

 Ecard - Prevent Birth Defects
This month during National Cleft and Craniofacial Awareness and Prevention Month, learn what you can do to prevent birth defects. Send this e-card to share healthy pregnancy tips with the moms-to-be in your life.

A National Asian-Language Smokers’ Quitline — United States, 2012–2014

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:


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.

Author Information

Corresponding Author: Nicole Kuiper, MPH, Centers for Disease Control and Prevention, 4770 Buford Highway, MS-F79, Atlanta, GA 30341. Telephone: 770-488-5719. Email:
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.


  1. The health consequences of smoking — 50 years of progress: a report of the Surgeon General. Atlanta (GA): US Department of Health and Human Services; Public Health Service; 2014.
  2. Fiore MC. Treating tobacco use and dependence: 2008 update. Rockville (MD): US Department of Health and Human Services, Public Health Service; 2008.
  3. Centers for Disease Control and Prevention (CDC). Quitting smoking among adults—United States, 2001–2010. MMWR Morb Mortal Wkly Rep 2011;60(44):1513–9. PubMed
  4. Li S, Kwon SC, Weerasinghe I, Rey MJ, Trinh-Shevrin C. Smoking among Asian Americans: acculturation and gender in the context of tobacco control policies in New York City. Health Promot Pract 2013;14(5, Suppl):18S–28S. CrossRef PubMed
  5. Ma GX, Shive SE, Ma XS, Toubbeh JI, Tan Y, Lan YJ, et al. Social influences on cigarette smoking among mainland Chinese and Chinese Americans: a comparative study. Am J Health Stud 2013;28(1):12–20. PubMed
  6. Mukherjea A, Wackowski OA, Lee YO, Delnevo CD. Asian American, Native Hawaiian and Pacific Islander tobacco use patterns. Am J Health Behav 2014;38(3):362–9. CrossRef PubMed
  7. Zhu SH, Wong S, Stevens C, Nakashima D, Gamst A. Use of a smokers’ quitline by Asian language speakers: results from 15 years of operation in California. Am J Public Health 2010;100(5):846–52. CrossRef PubMed
  8. Cummins SE, Wong S, Bonnevie E, Lee HR, Goto CJ, McCree-Carrington J, et al. A multistate Asian-language tobacco quitline: addressing a disparity in access to care. Am J Public Health 2015;e1–6. CrossRef PubMed
  9. Tang H, Shimizu R, Chen MS Jr. English language proficiency and smoking prevalence among California’s Asian Americans. Cancer 2005;104(12, Suppl):2982–8. CrossRef PubMed
  10. Liao Y, Tsoh JY, Chen R, Foo MA, Garvin CC, Grigg-Saito D, et al. Decreases in smoking prevalence in Asian communities served by the Racial and Ethnic Approaches to Community Health (REACH) project. Am J Public Health 2010;100(5):853–60. CrossRef PubMed
  11. Zhu SH, Cummins SE, Wong S, Gamst AC, Tedeschi GJ, Reyes-Nocon J. The effects of a multilingual telephone quitline for Asian smokers: a randomized controlled trial. J Natl Cancer Inst 2012;104(4):299–310. CrossRef PubMed
  12. Tedeschi GJ, Zhu S-H, Cummins SE, Shin H, Nguyen MH. Counselling Asian smokers: key considerations for a telephone intervention. J Smok Cessat 2013;8(1):2–10. CrossRef
  13. McAfee T, Davis KC, Alexander RL Jr, Pechacek TF, Bunnell R. Effect of the first federally funded US antismoking national media campaign. Lancet 2013;382(9909):2003–11. CrossRefPubMed
  14. CHIS Adult Public Use File [Internet]. UCLA Center for Health Policy Research. California Health Interview Survey 2011. Accessed October 21, 2015.
  15. Pew Research Center. The rise of Asian Americans. 2013. Accessed October 13, 2014.
  16. Bush T, Zbikowski SM, Mahoney L, Deprey M, Mowery P, Cerutti B. State quitlines and cessation patterns among adults with selected chronic diseases in 15 states, 2005–2008. Prev Chronic Dis 2012;9:E163. CrossRef PubMed
  17. Cummins SE, Bailey L, Campbell S, Koon-Kirby C, Zhu SH. Tobacco cessation quitlines in North America: a descriptive study. Tob Control 2007;16(Suppl 1):i9–15. CrossRef PubMed
  18. Momin B, Neri A, McCausland K, Duke J, Hansen H, Kahende J, et al. Traditional and innovative promotional strategies of tobacco cessation services: a review of the literature. J Community Health 2014;39(4):800–9. CrossRef PubMed
  19. Centers for Disease Control and Prevention. State Tobacco Activities Tracking and Evaluation (STATE) System [Internet] 2014. Accessed October 28, 2015.
  20. Maher JE, Rohde K, Dent CW, Stark MJ, Pizacani B, Boysun MJ, et al. Is a statewide tobacco quitline an appropriate service for specific populations? Tob Control 2007;16(Suppl 1):i65–70.CrossRef PubMed
  21. US Census Bureau. American FactFinder [Internet]. 2014. Accessed February 4, 2014.
  22. Centers for Disease Control and Prevention. Media Campaign Resource Center (MCRC) [Internet] 2014. Accessed June 6, 2014.
  23. Tat J, Nguy M, Tong EK, Cheng AJ, Chung LY, Sadler GR. Disseminating tobacco control information to Asians and Pacific Islanders. J Cancer Educ 2015;30(1):26–30. CrossRef PubMed
  24. Centers for Disease Control and Prevention. Best practices for comprehensive tobacco control programs — 2014. Accessed May 6, 2015.
  25. Chae DH, Gavin AR, Takeuchi DT. Smoking prevalence among Asian Americans: findings from the National Latino and Asian American Study (NLAAS). Public Health Rep 2006;121(6):755–63.PubMed

No hay comentarios: