Lessons Learned and Baseline Data from Initiating Smoking Cessation Research with Southeast Asian Adults

PURPOSES OF THE PAPER: The purposes of this paper are as follows: (1) discuss seven design considerations and their respective lessons learned or resolutions in initiating the National Institutes of Health's only funded smoking cessation grant targeting Asian Americans; (2) present empirical findings that resulted from the design considerations alluded to previously; and (3) delineate unresolved challenges on conducting smoking cessation research particularly for adult Southeast Asians. SUMMARY OF METHODS UTILIZED: The authors base this paper on their empirical data collected as part of the "Lay-led Smoking Cessation Approach for S.E. Asian men" study. Data collected include baseline data from 1553 adult Southeast Asians (721 women and 832 men) in Ohio as well as subsequent data collected on selected individuals. The investigators faced seven major, conceptual issues in initiating smoking cessation research focusing on Southeast Asian adults. These seven considerations related to: language, culture, nicotine addiction characteristics, verification of smoking exposure and smoking status, knowledge of the health consequences of smoking, social environmental factors, and criteria for evaluating effectiveness of the proposed intervention. Smoking cessation interventions must be conducted in the appropriate Asian language because current smokers are the least likely to understand spoken English. Culturally speaking, Cambodian and Laotian male smokers are significantly more likely to have traditional Southeast Asian values than their never smoker counterparts. As a measure of addiction to nicotine, the median time until the first cigarette was 30 minutes for both Cambodians and Vietnamese suggesting that these men are highly addicted. Cotinine levels were negatively correlated with time to the first cigarette and positively correlated with numbers of cigarettes. Knowledge of the health consequences of smoking is lower than mainstream populations. Almost 100 per cent of Southeast Asian male smokers have at least one "best" friend who smokes. Verification of smoking status through saliva cotinine testing suggest that actual smoking rates among Southeast Asians are higher than self­report rates. The largest proportion of Cambodian and Vietnamese smokers are in the precontemplation stage while Laotian smokers are proportionally more likely to be in the contemplation stage. CONCLUSIONS: Design considerations discussed represent considerations beyond those that are normally considered in community­based research for majority populations. The quality and quantity of empirical data collected with due attention to these conceptual considerations appear to substantiate the validity of these considerations. Authors delineated challenges for initiating smoking cessation research among Southeast Asians. RELEVANCE TO ASIAN PACIFIC ISLANDER AMERICAN POPULATIONS: This paper is particularly relevant for increasing the data base on adult Cambodians, Laotians, and Vietnamese. KEY WORDS: Asian Americans, Cambodians, Laotians, Vietnamese, culture, language, tobacco, smoking cessation, nicotine