Lung cancer is the leading cause of cancer death in Latinos and smoking is responsible for almost 90% of these deaths. Cultural factors unique to Latinos may act to either increase (e.g., family) or decrease (e.g., machismo) success of smoking cessation. In a community needs assessment, LACRC community clinic partners indicated that tobacco cessation services were a high priority. In our prior work in the LACRC, we also found that smokers were interested in cessation and would agree to participate in smoking studies. Of note, this work also demonstrated that depression and alcohol use were associated with smoking behavior. Research by others has shown that telephone counseling is effective and cost-effective in non-Latino groups and our partners have indicated that this approach was feasible in their clinics. In this pilot, we use the Social Networks Model to evaluate a randomized clinical trial (n=175) of a 6-session (and one 3 month booster), culturally-tailored telephone counseling intervention delivered by a lay health worker (LHW) compared to usual care (referral to a non-tailored Spanish tobacco quit line). We will also provide screening and referral for depression and alcohol use and inform participants about pharmaceutical support for nicotine withdrawal. Our overarching goal is to assess the impact of cultural tailoring and delivery by a peer from the participant's social network compared to use of simple language translation of existing materials. The associated aims are to: 1) test the hypothesis that the intervention group will have higher rates of quit attempts and abstinence than the control group at 6 weeks and 3 months, 2) explore whether cultural beliefs moderate the effects of the intervention, and 3) explore whether co-morbid alcohol use and depression mediate the effects of the intervention. If effective, the trained LHWs will be able to continue the counseling program at the clinics. The results will also be used to extend this trial and develop additional tobacco cessation research. Dr. Spernak, the project leader, will also be able to use this pilot to gain mentoring in tobacco control and grounding in Latino culture so that she can become an independent researcher in cancer disparities. ? ? ?
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