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Barriers and Supports for Smoking Cessation: Latinos in Addiction Treatment

Institution: HBSA, Inc.
Investigator(s): Anna Pagano, Ph.D.
Award Cycle: 2017 (Cycle 26) Grant #: 26IR-0010 Award: $498,793
Subject Area: Tobacco-Related Health Disparities
Award Type: High Impact Research Project Award

Initial Award Abstract

Tobacco use is a major health risk and leading cause of death for people recovering from abuse of alcohol and other drugs. People in addiction treatment smoke at 3 to 4 times the rate of the general U.S. population. Studies show that quitting smoking during substance abuse treatment can also make it easier to stop using drugs. The public health community—treatment providers, researchers, and health policy makers—are beginning to realize the importance of helping people to quit smoking while in treatment. However, there are still too few services available to help people in treatment stop smoking—less than half of addiction treatment programs in the U.S. offer counseling or medication for quitting. Additionally, some groups of people recovering from alcohol or drug abuse may have unequal access to smoking-related services. Latinos are one such group. Although they are equally likely as other racial and ethnic groups to need substance abuse treatment, they are less likely to get it. If they enter treatment, Latinos are less likely to receive help with problems other than their primary addiction, like smoking. This is an equity issue that is especially important for California because one-third of all clients in addiction treatment are Latino men and women. Currently, there is no research on Latinos’ access to smoking-related services while in addiction treatment programs. Most existing research has been conducted with mainly non-Latino whites in treatment. Low-income Latinos may have special barriers that prevent them from quitting smoking during treatment, such as lack of health insurance, lack of a primary care physician, or limited ability to use educational materials or services provided in English. Therefore, we are proposing a study on Latinos’ smoking habits, use of any available smoking-related services, and specific barriers and supports for reducing or quitting smoking while in treatment for substance abuse. We propose to spend time observing and talking to Latino clients in five residential treatment centers in the San Francisco Bay Area that serve mostly Latinos. We will also interview 30 Latino clients who are current smokers, as well as one director from each program. We will ask clients about when and how they started smoking, how much and how often they currently smoke, whether they have tried to quit, whether they want to try to quit during their recovery from drug abuse, and what kinds of help they would like to receive from their treatment programs if they decide to quit smoking. We will use the information gained from observations and interviews to create a survey that reflects Latino addiction treatment clients’ particular characteristics and smoking behaviors. Then, we will survey 100 Latino clients from the 5 participating programs in order to gather more standardized information on personal characteristics (for example, age, gender, education), smoking behaviors, quit attempts, and products or services used to help quit smoking. Using these three methods, we will learn more about the barriers and supports encountered by Latinos in addiction treatment when they try to stop smoking. In the future, we hope to use this information to adapt and develop programs to help Latinos stop smoking while in recovery. In this way, our research may eventually help to make smoking-related services more effective and more accessible to all addiction treatment clients, while at the same time creating services that reflect the unique cultural characteristics of this diverse population.