Decisional balance and stage of change of quitting behaviors among Korean American smokers

Problem/Objective: Smoking rates are disproportionately high among Korean Americans. In order to develop efficacious and well-accepted smoking cessation interventions, it is essential to identify the key psychosocial variables that could influence quitting behaviors. Thus, this study evaluated the effect of decisional balance and stage of change of quitting behavior among Korean American smokers over time. Methods: The study used two-group experimental design with 100 Korean American adult smokers were randomly assigned to a culturally tailored smoking cessation program through combined motivational interviewing and intervention or general health counseling program. Both groups received nicotine replacement therapy. Assessment measures were conducted on the pros and cons of quitting, stages of change and nicotine dependence at baseline, 1-week, 1-month, 3-month and 6 month follow ups. Results: The majority of participants (72.7%) reported smoking regularly, not at all or little affected by physician's advice to quit (57%), and in the precontemplation stage (76.5%). Participants reported fewer cons and more pros of quitting over the course of the study. A greater proportion of intervention participants were in the Action stage at 1-week and 1-month follow-ups. Significant predictors of being in the Action stage for 3 and 6-month follow-ups were older age higher level of education. Conclusion: This intervention strategy has shown that it can successfully aid Korean Americans to quit smoking. Culturally and linguistically appropriate intervention strategies can be effective in promoting smoking cessation. Decisional balance and stages of change variables can be successfully adapted into evaluation of smoking intervention programs for Korean Americans.