A concerted public health effort since the 1960s has reduced the overall prevalence of cigarette smoking in the United States by approximately 50%, with some states like California having even greater reductions. While these efforts are laudable and have led to reductions in morbidity and mortality for many, the gains have not been equal. In Los Angeles County, where only 10.4% of residents smoke cigarettes, alarmingly high prevalence is observed in select sub-groups that have economic and racial/ethnic disparities. Among Korean-Americans in Los Angeles County, smoking prevalence reaches 40% with reduced but still high rates of smoking among youth. This research project builds upon the commitment of community agencies, students and activists, County policymakers and academics to tailor an evidence-based smoking cessation intervention for use with Korean youth and to develop programming to deliver the intervention using the web and mobile Smartphones. The first phase of this research project involves consultative activities and focus group procedures to adapt and to tailor a 6-week, cognitive behavioral-motivational enhancement (CBME) cessation intervention specifically for Korean-American youth. Using iterative procedures between community and student key informants and technology experts, the adapted intervention will be programmed to be delivered using the web. The second phase of this research project involves conduct of an adequately powered, randomized controlled trial of the experimental intervention delivered on the web (n=120) compared to standard of care (n=120) for Korean-American youth (aged 14-19) seeking smoking cessation. Primary outcome variable is 7-day point prevalence of smoking abstinence verified by biomarkers at end of treatment, 24- and 52-week follow-up visits. We expect to find between 2-3 times increase in smoking cessation rates for the experimental group over the control group, which represents an outstanding morbidity reduction. If effective, the intervention will also provide an effective program for adaptation to young smokers of other ethnicities/races.
This research project is highly significant given the high rate of smoking prevalence in Korean youth and the benefits over the lifespan from stopping smoking. This is the first program in the nation to focus on using interactive web-based and mobile phone technologies and the first program to adapt these efforts specifically for Korean-Americans, a group with unacceptably high smoking prevalence rates.
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