Background: Tobacco use is the leading cause of morbidity and mortality in the USA, with smoking rates remaining disproportionately high among Asian-Americans, particularly in males with limited English proficiency, including Vietnamese (43%), Korean (37%), and Chinese (29%) Americans. Barriers to smoking cessation in this population include high social acceptability of smoking in participants' countries of origin, low quit intention, and limited use of linguistically appropriate smoking cessation resources. This paper aims to conduct a systematic review of studies evaluating the effectiveness of smoking cessation interventions targeting Asian-Americans.
Methods: The researchers conducted a thorough search of Scopus, Medline, Cochrane Central, and Google Scholar from 2006 through March 2022, as well as reference lists of relevant articles. The inclusion criteria for the studies were that they described smoking cessation interventions for Asian-Americans and Asian immigrants, and reported outcomes related to feasibility, acceptability, usability, and smoking-related outcomes.
Results: The review identified 14 studies with a total of 5607 participants, with participant numbers ranging from 26 to 2277. The interventions varied across 14 distinct approaches, with individual counseling being a prominent component. These interventions were found to be feasible and culturally acceptable. All studies reported positive smoking-related outcomes, including abstinence rates ranging from 26.7 to 68% and an increase in quit attempts. Culturally sensitive components and linguistically tailored content played a significant role in promoting participant engagement. The retention rates in the studies ranged from 42 to 100%, highlighting the importance of partnership with the Asian community, cultural and ethnic congruence, and family involvement and support.
Conclusion: The review highlighted the lack of direct in-language treatment as a disadvantage for Asian-American smokers in accessing evidence-based treatments. Despite this, the review reported the feasibility, acceptability, and effectiveness of a limited number of culturally targeted interventions for Asian-Americans, who are the fastest-growing racial-ethnic group. Future research should focus on exploring novel community-based and culturally adapted approaches for hard-to-reach and high-risk ethnic Asian subgroups to further improve smoking cessation outcomes in this population.
Keywords: Asian Americans; Immigrants; Intervention; Smoking cessation; Tobacco.
© 2023. W. Montague Cobb-NMA Health Institute.