Nicotine dependence is very common among Asian Americans;yet, research on understanding and treating nicotine dependence in this group is almost nonexistent. Korean men have been known for very high smoking rates and the highest cancer death smoking-attributable fraction. In contrast, Korean women tend to initiate smoking as they acculturate into social norms of American women. Preliminary data of the applicant and others suggests interventions must be culturally adapted and a motivation-based and family-involved approach is most promising. The training plan will help the applicant develop an independent program of drug abuse research that focuses on better understanding and treating tobacco dependence among Asian Americans, including evaluating culturally competent and gender-specific interventions. For this reapplication, the applicant moved with her primary mentor, Dr. Ziedonis, to the University of Massachusetts Medical School, which offers the essential help this applicant will need to achieve her goal of becoming an established researcher in nicotine dependence. The research plan will examine the impact of culture and gender on nicotine dependence and utilize NIDA behavioral therapy development methods. The proposed research plan has two-phases and evaluates tobacco dependence treatment with Korean Americans (N = 164, 50% women). Phase 1 is a no-control group study (Stage la) that is aimed at developing an intervention manual of Group-based Motivational Interviewing (GMI) intervention, therapists'adherence and competence scales, training program, and small feasibility intervention study with 20 Korean-American (offered separately for men and women). Phase 2 is a randomized controlled trial (Stage Ib) with 144 Korean Americans that is conducted to assess feasibility and relative effectiveness of the GMI behavioral intervention in conjunction with NRT in comparison with a brief group medication management of NRT. Gender-interaction effects of psychosocial variables on treatment outcomes will be assessed, including acculturation and depression. This award will help prepare the applicant for an independent research career focusing on Asian Americans and Nicotine Dependence, including adapting and testing new interventions for different populations.
Korean Americans are the group at high risk for tobacco-related health problems. Korean man in the US has been identified as the group who has the highest cancer death rate from smoking within the Asian American population. Researchers must investigate ways to make the existing smoking cessation treatment more readily available and receptive to this group to eliminate the serious health problem within the group.
