Smokefree counseling in Chinese immigrant household pairs: Developing a multi-component program

BACKGROUND: Smokefree policies benefit public health at the community level but have not yet been fully translated into interventions at the individual level. Chinese American immigrants have a higher male smoking prevalence than the general population, but their collectivist society may make them particularly responsive to smokefree social norm messages. Chinese passive smokers, typically female, may need assistance to establish and enforce smokefree environments.

METHODS: We collaborated with a Chinese community-based partner to conduct focus groups about a proposed smokefree counseling intervention that uses adult dyads of smokers and household nonsmokers. The intervention is based on the Health Belief model and involves group education on secondhand smoke health effects, policies, and communication strategies; dyad-level motivational interviewing to quit and eliminate smoke exposure; and individual lab results of long-term smoke exposure. Focus group transcripts were analyzed for themes related to the acceptability of the intervention.

RESULTS: A total of 36 participants were recruited for 4 focus groups, separated by smoking status and years in the U.S. (<10 or 10+ years). Almost all dyads were spousal/partner. Themes that emerged across groups include 1) learning that secondhand smoke was more dangerous than participants previously thought, 2) acceptability of a group format for education and discussion across dyads, and 3) a high level of interest in lab results with preference for urine instead of hair collection.

SUMMARY: The proposed smokefree counseling intervention was culturally acceptable and novel to participants. Educational material and protocol for the full intervention will be revised according to themes elicited.