A Culturally Adapted Smoking Cessation Intervention for Korean Americans: A Mediating Effect of Perceived Family Norm Toward Quitting

Abstract

Korean men and women have the highest current smoking rates across all Asian ethnic subgroups in the United States. This is a 2-arm randomized controlled study of a culturally adapted smoking cessation intervention. The experimental condition received eight weekly 40-min individualized counseling sessions that incorporated Korean-specific cultural elements, whereas the control condition received eight weekly 10-min individualized counseling sessions that were not culturally adapted. All participants also received nicotine patches for 8 weeks. One-hundred nine Korean immigrants (91 men and 18 women) participated in the study. The rate of biochemically verified 12-month prolonged abstinence was significantly higher for the experimental condition than the control condition (38.2 vs. 11.1 %, χ (2) = 10.7, p < 0.01). Perceived family norm significantly mediated the effect of cessation intervention on abstinence. Smoking cessation intervention for Korean Americans should be culturally adapted and involve family members to produce a long-term treatment effect.

Figures

Figure 1

CONSORT diagram showing a flow of subjects in the trial of a culturally tailored smoking cessation intervention

Figure 2

Kaplan-Meier Survival curves of participants with biochemically confirmed prolonged abstinence (log-rank test χ2 = 14.31, p < 0.001)

Figure 3

A meditational model of abstinence (N = 68). Intervention condition was related to abstinence through the mediation of perceived family norm in the path (cessation intervention → 3-M F/U Perceived Family Norm → 6-M F/U Perceived Family Norm → 12-M prolonged abstinence). All coefficients in the diagram are unstandardized. Note. M = month, F/U = follow-up, †p < 0.10, *p < 0.05, **p < 0.01, and ***p < 0.001.