Asian Language Quitline

A Multi-State Smokers' Quitline for Asian Language Speakers

PI: Jim Dearing, PhD, Institute for Health Research, KPCO

The first state-funded telephone counseling service to help smokers quit smoking in the U.S., referred to as a quitline, began in 1992. The effectiveness of the program was proven with a large randomized trial but, as is typical in the diffusion of innovations, it took a few years before another state adopted the idea of a state quitline. The pace of adoption quickened and by 2004, all 50 states plus Washington D.C. had quitlines that provided counseling free of charge to smokers in English (2). Most of these quitlines soon followed with direct counseling services in Spanish. The US Public Health Service's Clinical Practice Guidelines specifically recommend that clinicians and health care delivery systems ensure that all patients who smoke be provided with access to quitlines, and the US Department of Health and Human Services' Task Force on Community Preventive Services strongly recommends multicomponent telephone support.

Only one state, however, has added Asian language services to its quitline (in 1993), and little has changed since. Some states have tried to mitigate the obvious disparity in access to service by using a third-party translation service. However, counseling through an interpreter makes it difficult to establish rapport with clients, a critical ingredient in effective counseling. Moreover, a third-party set up makes people more reluctant to promote the service via mass media campaigns. This is because media promotion typically generates a large volume of calls in a very short period of time, which is difficult to handle when all calls have to go through a third party. The lack of media campaigns in Asian languages has lead to few calls to the quitline from Asian language speakers, which in turn has enhanced the inaccurate impression that Asian smokers will not use quitline services.

The present study is part of a project funded by the U.S. Centers for Disease Control and Prevention (CDC) to understand what has kept state health departments from adding Asian-language services to their quitlines and to develop methods to improve the adoption of Asian-language quitline service. The project is a collaboration of several academic groups and state health departments.

For more information on this project, please email us.