Skip to main content

Advertisement

SpringerLink
Log in

Who Wants to Quit? Characteristics of American Indian Youth Who Seek Smoking Cessation Intervention

  • Original Paper
  • Published:
Journal of Community Health Aims and scope Submit manuscript

Abstract

No group is more at-risk for tobacco-related health disparities than are American Indian youth. Little is known about their readiness to quit smoking and the extent to which cessation programs may require cultural tailoring related to recruitment, implementation, or content. This study identifies unique characteristics of American Indian teen smokers who enrolled in a school-based smoking cessation program, Not On Tobacco (called N-O-T). Using data from N-O-T intervention trials conducted in North Carolina between 2001 and 2004, the present study (a) describes the characteristics of American Indian participants (n = 91); (b) determines if basic demographics and smoking history affect intervention readiness; and (c) compares findings with non-Native participants (n = 138) enrolled in N-O-T within the same state. Upon enrollment, 80% of the sample reported that they planned to quit smoking in the next 1–6 months. We found significant differences between American Indian and non-Native youth on smoking history, with non-Natives smoking with greater intensity and frequency. Contrary to previous reports, American Indian youth in this study smoked with less intensity and were more ready to quit smoking than non-Native youth. Results reveal previously unreported characteristics of American Indian teen smokers. Study findings may advance the development of effective marketing, recruitment, and programming among American Indian teen smokers into cessation programs, particularly N-O-T, which is the only teen smoking cessation program which includes an adaptation specifically for American Indians.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Heaton, T. B., Chadwick, B. A., & Jacobson, C. K. (2000). Statistical handbook on racial groups in the United States. Table A3.5. Phoenix: Oryx Press.

    Google Scholar 

  2. U.S. Department of Health, Human Services. (2000). Reducing tobacco use: A report of the surgeon general—executive summary. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.

    Google Scholar 

  3. Substance Abuse and Mental Health Services Administration (SAMHSA). Tobacco use in america: findings from the 1999 national household survey on drug abuse. (Analytic series: A-15, DHHS Publication No. SMA 02-3622.) Rockville, MD: Substance Abuse and Mental Health Services Administration, Office of Applied Studies, 2001.

  4. Johnson, L. D., O’Malley, P. M., & Bachman, J. G. (2002). Monitoring the future national survey results on drug use, 1975–2002. (NIH Publication No. 03–5375).Vol. 1: Secondary school students. Bethesda, MD: National Institute on Drug Abuse.

    Google Scholar 

  5. U.S. Department of Health and Human Services. Healthy people 2010: Understanding and improving health, 2nd ed. Washington, DC: U.S. government printing office, 2000. Available at http://www.healthypeople.gov/.

  6. Horn, K., McGloin, T., Dino. G., et al. (2005). Quit and reduction rates for a pilot study of the American Indian Not On Tobacco (NOT) program. Preventing Chronic Disease, 2(4). Available at http://www.cdc.gov/pcd/issues/2005/oct/05_0001.htm.

  7. Davis, S., Lambert, L. C., Cunningham-Sabo, L., & Skipper, B. J. (1995). Tobacco use: Baseline results from pathways to health, a school-based project for Southwestern American Indian youth. Preventive Medicine, 24(5), 454–460.

    Article  PubMed  CAS  Google Scholar 

  8. Piper, M. E., Fox, B. J., Welsch, S. K., Fiore, M. C., & Baker, T. B. (2001). Gender and racial/ethnic differences in tobacco-dependence treatment: A commentary and research recommendations. Nicotine Tobacco Research, 3(4), 291–297.

    Article  PubMed  CAS  Google Scholar 

  9. American Legacy Foundation. Executive summary for the Native American/Alaskan Native Forum. Available at www.americanlegacy.org/135.htm.

  10. Loretto, G., Beauvais, F., & Oetting, E. (1988). The primary cost of drug abuse: What Indian youth pay for drugs. American Indian and Alaska Native Mental Health Research, 2(1), 21–32.

    PubMed  CAS  Google Scholar 

  11. Jones, D. (2006). The persistence of American Indian health disparities. American Journal of Public Health, 96(12), 2122–2134.

    Article  PubMed  Google Scholar 

  12. U.S. Census Bureau. The American Indian and Alaska Native population: 2000. (Census 2000 Brief, C2KBR/01-15.) Washington, DC: U.S. census bureau, 2002. Available at www.census.gov/prod/2002pubs/c2kbr01-15.pdf.

  13. Wallace, J. M., Jr., Bachman, J. G., O’Malley, P. M., Johnston, L. D., Schulenberg, J. E., & Cooper, S. M. (2002). Tobacco, alcohol, and illicit drug use: Racial and ethnic differences among US high school seniors, 1976–2000. Public Health Reports, 117, S67–S75.

    PubMed  Google Scholar 

  14. Cooper, L. A., Hill, M. N., & Powe, N. R. (2002). Designing and evaluating interventions to eliminate racial and ethnic disparities in health care. Journal of General Internal Medicine, 17(6), 4477–4486. Review.

    Article  Google Scholar 

  15. Keyzer, J. F., Melnikow, J., Kuppermann, M., et al. (2005). Recruitment strategies for minority participation: Challenges and cost lessons from the POWER interview. Ethnicity and Disease, 15(3), 395–406.

    PubMed  Google Scholar 

  16. Sussman, S., Sun, P., & Dent, C. W. (2006). A meta-analysis of teen cigarette smoking cessation. Health Psychology, 25(5), 549–557.

    Article  PubMed  Google Scholar 

  17. Robinson, M. L., Berlin, I., & Moolchan, E. T. (2004). Tobacco smoking trajectory and associated ethnic differences among adolescent smokers seeking cessation treatment. Journal of Adolescent Health, 35(3), 217–224.

    PubMed  Google Scholar 

  18. Swanson, G. M., & Ward, A. J. (1995). Recruiting minorities into clinical trials: Toward a participant-friendly system. Journal of the National Cancer Institute, 87(23), 1747–1759. Review.

    Article  PubMed  CAS  Google Scholar 

  19. Watts, L. K. (2001). Applying a cultural models approach to American Indian substance dependency research. American Indian and Alaska Native Mental Health Research, 10(1), 34–50.

    PubMed  CAS  Google Scholar 

  20. Horn, K., Dino, G., Kalsekar, I., & Mody, R. (2005). The impact of Not On Tobacco on teen smoking cessation: End-of-program evaluation results, 1998 to 2003. Journal of Adolescent Research, 20(6), 640–661.

    Article  Google Scholar 

  21. Dino, G. A., Horn, K. A., Zedosky, L., & Monaco, K. (1998). A positive response to teen smoking: Why N-O-T? NASSP Bulletin, 82(601), 46–58.

    Article  Google Scholar 

  22. Sussman, S., Dent, C. W., Burton, D., Alan, W., Stacy, A. W., & Flay, B. R. (1995). Developing school-based tobacco use prevention and cessation programs. Thousand Oaks, CA: Sage Publications, Inc.

    Google Scholar 

  23. Plested, B., Smitham, D. M., Jumper-Thurman, P., Oetting, E., & Edwards, R. (1999). Readiness for drug use prevention in rural minority communities. Substance Use and Misuse, 34(4–5), 521–544.

    Article  PubMed  CAS  Google Scholar 

  24. Sussman, S. (2002). Effects of sixty-six adolescent tobacco use cessation trials and seventeen prospective studies of self-initiated quitting. Tobacco Induced Diseases, 1(1), 35–81.

    Article  CAS  PubMed  Google Scholar 

  25. Dino, G., Horn, K., Goldcamp, J., Fernandes, A., Kalsekar, I., & Massey, C. (2001). A 2-year efficacy study of Not On Tobacco in Florida: An overview of program successes in changing teen smoking behavior. Preventive Medicine, 33(6), 600–605.

    Article  PubMed  CAS  Google Scholar 

  26. Prochaska, J. O., & DiClemente, C. C. (1983). Stages and processes of self-change of smoking: Toward an integrative model of change. Journal of Consulting and Clinical Psychology, 51(3), 390–395.

    Article  PubMed  CAS  Google Scholar 

  27. Pomerleau, C. S., Carton, S. M., Lutzke, M. L., Flessland, K. A., & Pomerleau, O. F. (1994). Reliability of the Fagerstrom Tolerance Questionnaire and the Fagerstrom Test for Nicotine Dependence. Addictive Behaviors, 19(1), 33–39.

    Article  PubMed  CAS  Google Scholar 

  28. Fagerström, K. O. (1978). Measuring the degree of physical dependence to tobacco smoking with reference to individualization of treatment, Addictive Behaviors, 3, 235–241.

    Google Scholar 

  29. Zhu, S. H., Sun, J., Billings, S. C., Choi, W. S., & Malarcher, A. (1999). Predictors of smoking cessation in U.S. adolescents. American Journal of Preventive Medicine, 16(3), 202–207.

    Article  PubMed  CAS  Google Scholar 

  30. Curry, S. J., Grothaus, L., & McBride, C. (1997). Reasons for quitting: Intrinsic and extrinsic motivation for smoking cessation in a population-based sample of smokers. Addictive Behaviors, 22(6), 727–739.

    Article  PubMed  CAS  Google Scholar 

  31. Carey, K. B., Purnine, D. M., Maisto, S. A., & Carey, M. P. (1999). Assessing readiness to change substance abuse: A critical review of instruments. Clinical Psychology: Science and Practice, 6(3), 245–266.

    Article  Google Scholar 

  32. Biener, L., & Abrams, D. B. (1991). The Contemplation Ladder: Validation of a measure of readiness to consider smoking cessation. Health Psychology, 10(5), 360–365.

    Article  PubMed  CAS  Google Scholar 

  33. Prokhorov, A. V., Hudmon, K. S., & Stancic, N. (2003). Adolescent smoking: Epidemiology and approaches for achieving cessation. Paediatric Drugs, 5(1), 1–10.

    PubMed  Google Scholar 

  34. Horn, K., Dino, G., Branstetter, B., Zhang, J., Kelley, G., & Noerachmanto, N. (2008). A profile of teen smokers who voluntarily sought smoking cessation intervention. In press. Tobacco Induced Diseases, 4(6). Available at http://www.tobaccoinduceddiseases.com/content/4/1/6.

  35. Pedhazur, E. J. (1997). Multiple regression in behavioral research. Harcourt Brace: Orlando, Fl.

    Google Scholar 

  36. Horn, K., Dino, G., Kalsekar, I., & Fernandes, A. W. (2004). Appalachian teen smokers: Not On Tobacco 15 months later. American Journal of Public Health, 94(2), 181–184.

    Article  PubMed  Google Scholar 

  37. Dino, G. A., Horn, K. A., Goldcamp, J., Maniar, S. D., Fernandes, A., & Massey, C. J. (2001). Statewide demonstration of Not On Tobacco: A gender-sensitive teen smoking cessation program. Journal of School Nursing, 17(2), 90–97.

    PubMed  CAS  Google Scholar 

  38. Horn, K., Fernandes, A., Dino, G., Massey, C. J., & Kalsekar, I. (2003). Adolescent nicotine dependence and smoking cessation outcomes. Addictive Behaviors, 28(4), 769–776.

    Article  PubMed  Google Scholar 

  39. Montana Office of Public Instruction. (2005). Montana youth risk behavior survey (YRBS): American Indian students on reservations, 2005. Helena, MT: U.S. Montana Office of Public Instruction.

    Google Scholar 

  40. Montana Office of Public Instruction. (2005). Montana youth risk behavior survey (YRBS): American Indian students in urban schools, 2005. Helena, MT: U.S. Montana Office of Public Instruction.

    Google Scholar 

  41. Kandel, D. B., Kiros, G. E., Schaffran, C., & Hu, M. (2004). Racial/ethnic differences in cigarette smoking initiation and progression to daily smoking: A multilevel analysis. American Journal of Public Health, 94(1), 128–135.

    Article  PubMed  Google Scholar 

  42. Grimshaw, G. M., Stanton, A. (2006). Tobacco cessation interventions for young people. Cochrane Database of Systematic Reviews 2006, Issue 4. Art. No.: CD003289. DOI: 10.1002/14651858.CD003289.pub4.

Download references

Acknowledgments

The data from this investigation resulted in part from a research project funded by the American Legacy Foundation (Grant # 5076), the Centers for Disease Control and Prevention (R06-CCR321438-01), and the NC Health and Wellness Trust Fund Commission.

Human Participation Protection

The study adhered to the non-discriminatory Institutional Review Board (IRB) policies and procedures of two academic institutions, tribal council permission, and formal tribal approval as required. Participants provided signed IRB-approved parental consent and participant assent forms prior to study enrollment.

Author information

Authors and Affiliations

  1. Translational Tobacco Reduction Research Program, Mary Babb Randolph Cancer Center and Prevention Research Center, West Virginia University, PO Box 8110, Morgantown, WV, 26506-8110, USA

    Kimberly Horn, N. Noerachmanto, Geri Dino & Karen Manzo

  2. North Carolina Commission of Indian Affairs, 1317 Mail Service Center, Raleigh, NC, 27699-1317, USA

    Missy Brayboy

Authors
  1. Kimberly Horn
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. N. Noerachmanto
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Geri Dino
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Karen Manzo
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Missy Brayboy
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kimberly Horn.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Horn, K., Noerachmanto, N., Dino, G. et al. Who Wants to Quit? Characteristics of American Indian Youth Who Seek Smoking Cessation Intervention. J Community Health 34, 153–163 (2009). https://doi.org/10.1007/s10900-008-9131-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10900-008-9131-7

Keywords

Search

Navigation