Keeping Each Other Accountable: Social Strategies for Smoking Cessation and Healthy Living in Vietnamese American Men

Gaps in smoking cessation counseling administered by healthcare providers to BIPOC gay men who smoke daily in the U.S

BACKGROUND

Black, Indigenous, and People of Color (BIPOC) racial/ethnic groups, sexual minorities (SM), and men have higher odds of smoking, less access to smoking cessation education and services, and lower smoking cessation rates than their white, heterosexual, and women counterparts. The purpose of this study is to examine the experiences of BIPOC gay men in accessing smoking cessation counseling from their healthcare providers and understand the facilitators and barriers to smoking cessation.

METHODS

This study analyzed data from BIPOC gay men who smoke daily via social media and organizational listservs throughout the United States and conducted semi-structured individual qualitative interviews. Two trained coders used thematic analysis to analyze the data.

RESULTS

Findings identified three overarching themes: 1) Sources of Information, 2) Facilitators and Barriers, and 3) Areas of Improvement for Smoking Cessation Counseling. Participants reported trusting advice from community members over healthcare providers regarding smoking cessation counseling. They also felt that the smoking cessation advice received from healthcare providers was, at times, confusing and inadequate. Identity concordance between patient and healthcare provider helped participants feel seen by their provider, which motivated them to engage in smoking cessation counseling. Finally, participants suggested improvements for smoking cessation counseling for BIPOC gay men such as integrating mental health support in smoking cessation services, accountability for patients, and providing harm reduction alternatives instead of smoking cessation only.

CONCLUSION

BIPOC gay men who smoke daily value the importance of receiving culturally adaptive and gender-affirming care from healthcare providers who share their identities when receiving smoking cessation and harm reduction counseling.

Family Involvement in Asian American Health Interventions: A Scoping Review and Conceptual Model

Family members play a crucial role in the health of Asian American communities, and their involvement in health interventions can be pivotal in optimizing impact and implementation. To explore how family members can be effectively involved in Asian American health interventions and develop a conceptual framework of methods of involvement at the stages of intervention development, process, and evaluation, this scoping review documented the role of Asian American family members in interventions (across any health objective). Of the 7175 studies identified through database and manual searches, we included 48 studies in the final analysis. Many studies focused on Chinese (54%) or Vietnamese (21%) populations, were conducted in California (44%), and involved spouses (35%) or parents/children (39%). We observed involvement across 3 stages: (1) intervention development (formative research, review process, material development), (2) intervention process (recruitment, receiving the intervention together, receiving a parallel intervention, enlisting support to achieve goals, voluntary intervention support, agent of family-wide change, and participation gatekeepers), and (3) intervention evaluation (received evaluation together, indirect impact evaluation, and feedback during intervention). Impact of family member involvement was both positive (as sources of encouragement, insight, accountability, comfort, and passion) and negative (sources of hindrance, backlash, stigma, obligation, and negative influence). Suggestions for future research interventions include (1) exploring family involvement in South Asian or young adult interventions, (2) diversifying types of family members involved (eg, extended family), and (3) diversifying methods of involvement (eg, family members as implementation agents).

Informing the development of interventions for e-cigarette use and prevention of transition to cigarette smoking in young adults: A qualitative study

E-cigarette use in young individuals may increase risk for cigarette smoking initiation. Over half of young adults who use e-cigarettes voiced their desire to quit e-cigarettes. Mobile-based interventions may allow for an easy-to-use platform to engage young adults in cessation services and reduce risk for cigarette uptake. To inform development of such programs, this study sought to gather information about what young adults want to see included in e-cigarette cessation interventions that also target future smoking risk. Nine online focus groups (n = 33) were conducted in July and August 2022 with young adults who either (1) currently used e-cigarettes, (2) formerly used e-cigarettes, or (3) initiated nicotine use with e-cigarettes but subsequently smoked cigarettes (dual use). Two research team members independently coded the transcripts and identified themes. A third researcher independently reviewed the coding and thematic analysis. Participants believed that mobile-based interventions should include peer support, ways to track cessation progress, education about the harms of e-cigarettes, gamification, and incentivization. They also believed that to prevent future cigarette smoking, interventions need to include education about the harms of smoking, teach refusal skills for offers to smoke, and incorporate personal anecdotes from former smokers. To increase their readiness, motivation, and self-efficacy to quit, participants who continue to use e-cigarettes reported needing effective substitutions to replace e-cigarettes, barriers to hinder their access to e-cigarettes, and social support. Findings from this study may be useful to incorporate when developing interventions designed to reduce e-cigarette use and risk of progression to smoking for young adults.

The Role of Family Social Networks in Cardiovascular Health Behaviors Among Asian Americans, Native Hawaiians, and Pacific Islanders

Asian American, Native Hawaiians, and Other Pacific Islander (AANHPI) populations experience significant disparities in cardiovascular health. AANHPI populations also have strong, family-centered social relationships and networks. Since social networks may influence health behaviors, this review aimed to summarize research on the relationship between family social networks and cardiovascular health behaviors among AANHPI individuals. Current evidence suggests that family social network structures may play a particularly important role in smoking, dietary pattern, and physical activity behaviors among AANHPI individuals. Family networks may hinder or promote healthy behaviors through several social network mechanisms including social support, social influence, and social control. These effects vary across different AANHPI subgroups. Recommendations for future research on the role of social networks in health behaviors among AANHPI individuals are provided. Drawing on methodological advances and interventions that leverage social networks in AANHPI populations may be an avenue to improve health and reduce disparities.

Family Support and Readiness to Consider Smoking Cessation among Chinese and Vietnamese American Male Smokers

Introduction

Smoking prevalence is disproportionately high among Asian American immigrant men with limited English proficiency. Understanding the role of family support may provide insights on culturally acceptable strategies to promote smoking cessation.

Aims

This study examined how family support was associated with readiness to consider smoking cessation among Chinese and Vietnamese American male daily smokers.

Methods

We analyzed baseline data (N=340) from a cluster randomized trial of a family-based healthy lifestyle intervention. We assessed the frequency of receiving family support in various forms (encouraging use of cessation resources; praising efforts; checking-in; reminding of familial role). Multiple regression analysis was used to determine associations between family support areas and readiness to consider smoking cessation, controlling for covariates.

Results/Findings

Reporting a higher frequency of receiving praise and encouragement for one's efforts to quit was positively associated with readiness to consider cessation. Other areas of family support were not significant.

Conclusions

These findings provide evidence to explore specific areas of family support in enhancing Asian American smokers' readiness to consider cessation. As there is high interest from Asian American family members to support their smokers for quitting, culturally specific and acceptable strategies are needed to promote smoking cessation among Asian Americans.