Tobacco Cessation Treatment for Alaska Native Adolescents: Group Randomized Pilot Trial
Mené en Alaska auprès de 80 adolescents indigènes ayant une pratique tabagique (âge : 12 à 17 ans), cet essai évalue, du point de vue du taux d'abstinence tabagique validé par dosage salivaire de la cotinine, l'efficacité d'un programme d'aide au sevrage tabagique d'une durée de 6 semaines, basé notamment sur le partage de conseils et d'activités récréationnelles
Introduction: Tobacco cessation treatments have not been evaluated among Alaska Native (AN) adolescents. This pilot study evaluated the feasibility and potential efficacy of a targeted cessation intervention for AN youth using a group randomized design. Methods: Eight villages in Western Alaska were randomly assigned to receive the intervention (n = 4 villages) or to a delayed treatment control condition (written materials only; n = 4 villages). Ten adolescents aged 12–17 years were targeted from each village with a planned enrollment of 80. The intervention was held over a weekend and youth traveled from their villages to quit tobacco use with other teens. The intervention comprised 8hr of group-based counseling. Talking circles, personal stories from elders, and recreational activities were included to enhance cultural acceptability and participation. Newsletters were mailed weekly for 5-weeks postprogram. Assessments were conducted at baseline, week 6 (end-of-treatment), and 6 months. Self-reported tobacco abstinence was confirmed with salivary cotinine. Results: Recruitment targets were met in the intervention (41 enrolled) but not in control villages (27 enrolled). All intervention participants attended the weekend program. Retention was high; 98% of intervention and 86% of control participants completed 6-month follow-up. The 7-day point-prevalence self-reported tobacco abstinence rates for intervention and control participants were 10% (4/41) and 0% (0/27) at both week 6 and 6 months (p = .15). Only 1 adolescent in the intervention condition was biochemically confirmed abstinent at week 6 and none at 6 months. Conclusion: The intensive, individual-focused intervention used in this study was feasible but not effective for tobacco cessation among AN youth. Alternative approaches are warranted.