Application of an evidence-based smoking cessation approach to non-english speaking smokers and other underserved groups

Put it Out Rockland is an evidence-based smoking cessation program. Originally funded by the county's share of MST funds, now supported directly by the county, it is part of the Health Department's larger comprehensive tobacco control effort. The county's annual survey shows that while tobacco use has dropped to nearly 12% countywide, smoking rates are significantly higher among Latinos (17%, p<.000), and respondents with no health insurance (24.2% p<.000). The PIOR program, translated into Spanish and Creole, is offered by trained specialists from within the county's very low income Latino and Haitian communities but has struggled to reach and retain smokers in those groups. In 2005, a survey was conducted at adult education sites for speakers of English as a second language. Over 600 non-English speaking adults completed the survey, reporting higher smoking rates among Spanish speakers than all other languages (22.2% vs. 16.6%, p<.01). Few non-English speaking smokers had used or indicated they would use a group support program. Many did not believe in the efficacy or safety of NRT. The county now offers its PIOR One-on-One approach, based on the success of its group model, tailored to these specific needs. Staff provide NRT and individual counseling onsite after ESL classes, at WIC clinics, and at other locations serving non- English speaking and uninsured smokers. Multi-lingual materials focus on the safety and efficacy of NRT. Public health efforts can decrease tobacco use, but need a special focus on groups which have not historically been served by cessation resources.