Building an evidence base for tailored tobacco dependence treatment for racial and ethnic populations

Ample evidence exists for the effectiveness of tobacco dependence treatment for the general population. While the U.S. Public Health Service Clinical Practice Guideline states that tobacco dependence treatment for ethnic populations should be tailored to be culturally appropriate, little has been documented on the efficacy of such approaches. Since 2004, ClearWay Minnesota has funded five community-based organizations to provide tailored tobacco cessation assistance to Minnesota's racial and ethnic minority communities. Noting the limited evidence base for these tailored curricula, a comprehensive evaluation was implemented.

During the initial phases of evaluation, significant adaptations to existing tailored curricula were made within each of the different communities. The initial phases of evaluation focused on documenting these curricula changes. This included modifications from group to individual counseling sessions and the need to provide assistance in private settings, due to the stigma associated with tobacco use in certain communities. Over 800 participants were served in the first phase. Those reached at 30-day follow-up reported a 30% increase in confidence in their ability to quit. While abstinence measures and other cessation outcomes were captured, these data were subject to several limitations including low response rates at follow-up and suspected social desirability bias on self-reported cessation outcomes.

The current phase of evaluation is focused on program outcomes, with strategies undertaken to address previous limitations in the data. These strategies will be presented along with outcome findings. Future directions for building the evidence base for community-tailored programs will be discussed.