Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA.
The Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Rochester, MN, USA.
Nicotine Tob Res. 2023 Jan 1;25(1):3-11. doi: 10.1093/ntr/ntac181.
Indigenous North Americans have the highest cigarette smoking prevalence among all racial and ethnic groups in the United States. We seek to identify effective components of smoking cessation interventions in Indigenous people in the United States associated with favorable cessation outcomes.
A review of literature studying smoking cessation interventions in Indigenous North Americans (American Indians and Alaska Natives) from January 2010 through August 2021 was completed. The primary objective of this study was to identify components of interventions associated with positive smoking cessation outcomes in Indigenous people. The studies identified were synthesized in a meta-narrative approach.
Ten studies out of 608 titles were included (6 randomized trials, 2 single-arm studies, 1 cohort study, and 1 prospective observational study). Five categories of smoking cessation interventions were identified; phone or web-based tools, culturally-tailored interventions, the inclusion of Indigenous study personnel, pharmaceutical cessation aids, and behavioral health interventions. Phone and web tools, cultural tailoring, and inclusion of Indigenous personnel conditions inconsistently influenced smoking cessation. Pharmaceutical aids were viewed favorably among participants. Individualized behavioral counseling sessions were effective at promoting smoking cessation, as was input from local communities in the planning and implementation phases of study.
A successful smoking cessation intervention in Indigenous North Americans includes Tribal or community input in intervention design and implementation; should provide individualized counseling sessions for participants, and offer access to validated smoking cessation tools including pharmacotherapy.
This study identifies a paucity of smoking interventions utilizing standard of care interventions in Indigenous North Americans. Standard of care interventions including individualized cessation counseling and pharmacotherapy were effective at promoting cessation. The use of novel culturally tailored cessation interventions was not more effective than existing evidence-based care with the exception of including Tribal and local community input in intervention implementation. Future smoking cessation interventions in Indigenous North Americans should prioritize the use of standard of care cessation interventions.
美国原住民的吸烟率是所有种族和族裔中最高的。我们旨在确定与有利的戒烟结果相关的美国土著人群中戒烟干预措施的有效组成部分。
对 2010 年 1 月至 2021 年 8 月期间研究美国土著北美原住民（美洲印第安人和阿拉斯加原住民）戒烟干预措施的文献进行了回顾。本研究的主要目的是确定与土著人群戒烟结果相关的干预措施组成部分。通过元叙述方法对确定的研究进行了综合分析。
在 608 篇标题中，有 10 项研究（6 项随机试验、2 项单臂研究、1 项队列研究和 1 项前瞻性观察研究）入选。确定了五类戒烟干预措施；电话或网络工具、文化定制干预、包括土著研究人员、戒烟药物辅助和行为健康干预。电话和网络工具、文化定制和包括土著人员的条件并不能始终如一地影响戒烟。参与者对药物辅助戒烟持赞成态度。个性化行为咨询有助于促进戒烟，在研究的规划和实施阶段，当地社区的参与也有帮助。
在北美原住民中成功实施戒烟干预措施需要部落或社区参与干预措施的设计和实施；应为参与者提供个性化的咨询服务，并提供包括药物治疗在内的经证实的戒烟工具。
本研究确定了在北美原住民中利用标准护理干预措施进行戒烟干预的方法较少。标准护理干预措施，包括个性化的戒烟咨询和药物治疗，在促进戒烟方面是有效的。除了在干预实施中纳入部落和当地社区的意见外，使用新颖的文化定制戒烟干预措施并不比现有的循证护理更有效。未来在北美原住民中进行的戒烟干预措施应优先使用标准护理戒烟干预措施。
