This research will be done primarily in La Pintana, Chile in collaboration with Klaus Puschel of the Catholic University of Chile as an extension of NIH Grant # CA74968. Smoking is a major problem in the developing world. In Chile, for example, nearly 50% of men and women smoke. The problem is particular acute among women of child-bearing age, where over 47% of women are smokers. In this proposed project, we will build on research being conducted in the parent project in the Yakima Valley of Eastern Washington. The Valley is largely Hispanic, many of its residents are of low socio-economic status and have few years of education. In the parent project, we have developed many activities and materials for low literacy level, monolingual Spanish speakers. In this proposed developmental study, a comprehensive smoking cessation program will be implemented in a public health clinic serving individuals in a poor suburb of Santiago, Chile. The program will be directed toward women of child-bearing age. Clinic smoking cessation activities will be supplemented with activities in the community. Because this is a developmental study, evaluation will not involve a randomized trial; however, we have added a control clinic, also located in La Pintana, to provide information on the secular trend in a similar population during the time of this study. A cohort of women of child-bearing age who smoke will be accrued in two clinics in the suburb. In one clinic, smoking cessation activities will be directed toward the women who smoke, while """"""""usual practice"""""""" toward smokers will continue in the other clinic. Quit rates at 3 months, 6 months, and 12 months will be documented in the cohort in both clinics. We propose to train health care providers to counsel their pregnant patients and mothers of young children who smoke to stop smoking by using the NCI """"""""5 As"""""""" program and motivational interviewing (MI). The health care provider intervention will be supplemented with other clinic activities, such as availability of self-help quit materials, a non-smoking environment, a Quit & Win contest, signage, and other activities deemed appropriate by a Community Advisory Board convened for this project. The primary outcome will be change in smoking cessation rates among a cohort of women of child-bearing age identified and recruited from the El Roble Clinic compared to smoking cessation rates among a cohort of similarly aged women recruited through the Santiago de Nueva Extremadura (SNE) Clinic. Long-term smoking cessation is defined as self-reported 6 months of continuous cessation. Short-term cessation is defined as seven day cessation at the 6 or 12 month follow-ups. We have ample power to detect a 7.5 percentage point difference in smoking cessation rates.
| Puschel, Klaus; Thompson, Beti; Olcay, Fabiola et al. (2009) [Predictive factors for smoking initiation and quitting among a cohort of Chilean women followed for 5.5 years]. Rev Med Chil 137:1001-9 |
| Puschel, Klaus; Thompson, Beti; Coronado, Gloria et al. (2008) Effectiveness of a brief intervention based on the '5A'model for smoking cessation at the primary care level in Santiago, Chile. Health Promot Int 23:240-50 |
