• Won S Choi, Laura A Beebe, Niaman Nazir, Baljit Kaur, Michelle Hopkins, Myrietta Talawyma, Theresa I Shireman, Hung-Wen Yeh, K Allen Greiner, and Christine M Daley.
• Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, Kansas; Center for American Indian Community Health, University of Kansas Medical Center, Kansas City, Kansas. Electronic address: wchoi@kumc.edu.
• Am J Prev Med. 2016 Nov 1; 51 (5): 743-751.

IntroductionAmerican Indians have the highest cigarette smoking prevalence of any racial/ethnic group in the U.S. There is currently no effective empirically based smoking-cessation program for American Indians. The purpose of this study was to determine if a culturally tailored smoking-cessation program, All Nations Breath of Life (ANBL), is more effective than a non-tailored cessation program among American Indian smokers.DesignA multisite RCT was conducted from September 2009 to July 2014; analysis was conducted in 2015.Setting/ParticipantsParticipants were rural or reservation-based American Indian smokers aged ≥18 years.InterventionSmokers were group randomized to either the culturally tailored ANBL or non-tailored current best practices (CBP) for a total enrolled sample size of 463 (ANBL, n=243; CBP, n=220).Main Outcome MeasuresThe primary outcome of interest was salivary cotinine-verified 7-day point prevalence smoking abstinence at 6 months. Results for both responder-only and intent-to-treat analyses for self-reported and cotinine-verified abstinence are presented.ResultsIntention-to-treat, imputing all non-responses as smokers, the self-reported point prevalence abstinence rates at 12 weeks were 27.9% in the ANBL arm and 17.4% in the CBP arm (p=0.028). There was a statistically significant difference in self-reported 6-month intent-to-treat point prevalence abstinence rates between ANBL (20.1%) and CBP (12.0%) arms (p=0.029). None of the cotinine-verified results were statistically significant.ConclusionsThe culturally tailored smoking-cessation program ANBL may or may not be an effective program in promoting cessation at 12 weeks and 6 months. Participants in the culturally tailored ANBL program were approximately twice as likely to quit smoking at 6 months compared with the CBP program, using self-reported abstinence.Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

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