Identifying pragmatic solutions to reduce cigarette smoking prevalence in Indigenous North Americans: A sequential...

Area of Science:

• Public Health
• Health Disparities
• Behavioral Science

Background:

• American Indians and Alaska Natives (AI/AN) exhibit the highest U.S. smoking prevalence.
• Existing cessation efforts have not sufficiently addressed sustained cessation or pregnancy-related behaviors.
• Longitudinal studies suggest maintenance of cessation and pregnancy are key intervention points for AI/AN populations.

Purpose of the Study:

• To identify pragmatic elements for effective smoking cessation interventions tailored to AI/AN individuals.
• To understand key drivers of smoking relapse and unique experiences of smoking during pregnancy in AI/AN people.
• To inform the development of a pilot smoking cessation intervention for AI/AN communities.

Main Methods:

• A sequential exploratory mixed-methods study integrating qualitative and quantitative approaches.
• Qualitative phase: 45 AI/AN individuals in group or one-on-one interviews to identify cessation intervention components.
• Quantitative phase: Discrete choice experiment survey and a large-scale survey (n=898) of an AI/AN cohort in Olmsted County, MN.

Main Results:

• Qualitative data will characterize relapse drivers and pregnancy smoking experiences.
• Discrete choice experiment will evaluate intervention elements.
• Survey data will provide a broader understanding of cessation needs in the AI/AN population.

Conclusions:

• The study outlines methods to optimize sustained smoking cessation strategies for AI/AN individuals, including during pregnancy.
• Findings are crucial for developing a targeted pilot intervention to reduce smoking prevalence in AI/AN populations.
• Community engagement throughout the study ensures relevance and cultural appropriateness.