Tobacco use is highly related to the leading causes of death among Latinos in the U.S. (cancer, heart disease, stroke, etc.). While smoking rates are declining in most racial and ethnic groups, smoking is increasing among Latinos. It is known that:
- Every 6 seconds, one person is killed by tobacco
- 1 out of 2 smokers will die from a tobacco-related disease
- 17% of Latinos in the U.S. are current smokers
- 14% of Latino high school students in the U.S. smoke
- 36% of Latino smokers are non-daily smokers
- 41% of Latino smokers are light smokers (<10 cigarettes/day)
JUNTOS, in partnership with Agile Health, came up with the initiative to implement a tobacco cessation, text-message coaching program designed to engage smokers in a personal intensive process of behavioral change tailored to Latinos. Latinos in the U.S. are the highest utilizers of mobile technologies, with text-message being used at a rate higher than non-Hispanic Whites. An effective, feasible model for engaging and treating Latino smokers through mobile technology has the potential for immediate widespread adoption and dissemination that could eventually overcome disparities.
JUNTOS implemented a pilot study with 20 smokers to evaluate the feasibility, cultural appropriateness, acceptability, and preliminary outcomes of the smoking cessation text-messaging intervention among Latino smokers, as described below.
The program consisted of: 1. Pre-scheduled messages at different times of the day providing motivational and informative tips to quit smoking. 2. Messages in response to pre-set keywords (e.g., Crave, Stress, Alcohol, Bored, Slip-Up, and Relapse). 3. Ad-hoc messages where participants interacted with a smoking cessation coach.
Latino smokers were recruited by our promotoras de salud (community health workers) at different health events. Participants were prompted to request Nicotine Replacement Therapy (patches, lozenges, and gum) at no cost.
During the 12-week period of our intervention, we observed high engagement of Latino smokers with an average of 29.1 sent text-messages vs. other populations that average 8.6 messages.
Based on the feedback from participants, we concluded the program needed to be more culturally adapted to our Latino community. We decided to tailor the text-message program with the help of a Community and Communication Advisory Board (CCAB) and focus groups with Latino smokers, ex-smokers, and their relatives. Through this process Patéalo was created.
We would like to acknowledge the CCAB for the amazing work they did in bringing different areas of expertise together in the adaptation of the text-message library.
We would also like to recognize our co-investigators: Dr. Edward Ellerbeck and Dr. Lisa Sanderson Cox. This work would not have been possible without their help.