Efficacy of a multilingual telephone quitline for Asian smokers

Although telephone counseling has been demonstrated in many studies to be an efficacious behavioral intervention for smoking cessation, there continues to be doubt about its efficacy for Asian populations. The reasoning is that “talk therapy” is not a familiar concept to recent immigrants from Asian countries, whose culture generally does not consider outside professional help as a way to solve behavioral health problems. In this study, we tested the effects of telephone counseling for smoking cessation in Chinese-, Korean-, and Vietnamese-speaking smokers.  We conducted a large randomized trial embedded in the California quitline service. Smokers who called the quitline’s Chinese, Korean, and Vietnamese telephone lines were recruited to the trial (N=2,277).  Participants were stratified by language and randomly assigned to telephone counseling (self-help materials and up to six counseling sessions; n = 1124 subjects) or self-help (self-help materials only; n = 1153 subjects).  The numbers of smokers by language groups were 729 Chinese, 848 Korean and 700 Vietnamese. In the intention-to-treat analysis, counseling increased the 6-month prolonged abstinence rate among all smokers compared with self-help (counseling vs self-help, 16.4% vs 8.0%, difference = 8.4%, 95% confidence interval [CI] = 5.7% to 11.1%, P < .001).  Furthermore, the differences between counseling and self-help were significant for each of the three language groups.  This large trial demonstrated that telephone counseling was effective for Chinese-, Korean-, and Vietnamese-speaking smokers.  It provides a strong evidence base for the application of the counseling protocol within the context of state quitlines across the United States.