Development of a culturally appropriate smoking cessation program for Chinese-American youth.

PURPOSE: To identify potential cultural factors to enhance the efficacy of smoking cessation curricula for Asian-American adolescents, Chinese-Americans, and to present the process and challenges of implementing a culturally specific curriculum.
METHODS: Chinese-American male (n = 17) youth smokers, aged 14-19 years, were recruited from community-based Asian-American organizations in the Delaware Valley Region of Pennsylvania and New Jersey. A 36-item questionnaire was developed to measure smoking behavior, attitudes, and culturally related factors. Focus groups were conducted. Cultural themes were addressed, such as interdependency and collective orientation of the Asian culture, importance of harmony in Asian families, and culturally related factors for smoking initiation and maintenance. A pre-post quasi-experimental research design was used. Data were analyzed using the Mann-Whitney U test to determine differences in the intervention and control groups in smoking behavior and the Chi-square test for differences in program characteristics.
RESULTS: Participants almost never read their native language, they disagreed that their friends would accept them more if they were nonsmokers, and they thought they smoked because of high parental expectations. Asian teens perceived that a high percentage of their Asian-American peers smoke. The most important facilitator characteristics, program processes, relevant cultural factors and topics were identified for the program. Two groups were compared, a standard smoking cessation curriculum (SC) and a culturally modified program (ACT) for Asian adolescents. A 23.1% quit rate for the SC program and an 18.2% quit rate for the ACT program at 3-month follow-up was achieved. Among participants who continued to smoke, there was a larger reduction in reported weekend and weekday cigarette use among ACT participants, than the Standard (SC) group. There was a reduction of 6.7 cigarettes on a typical weekday and 6 cigarettes on a typical weekend day for ongoing smokers of the ACT group.
CONCLUSIONS: Given the positive results among a high-risk population, the ACT program needs to be tested among a larger population of Chinese-Americans.