title: The Be Our Ally Beat Smoking (BOABS) study, a randomised controlled trial of an intensive smoking cessation intervention in a remote aboriginal Australian health care setting.
abstract: BACKGROUND
  Australian Aboriginal and Torres Strait Islander peoples (Indigenous Australians) smoke at much higher rates than non-Indigenous people and smoking is an important contributor to increased disease, hospital admissions and deaths in Indigenous Australian populations. Smoking cessation programs in Australia have not had the same impact on Indigenous smokers as on non-Indigenous smokers. This paper describes the outcome of a study that aimed to test the efficacy of a locally-tailored, intensive, multidimensional smoking cessation program.
  
  
  METHODS
  A randomised controlled trial of Aboriginal researcher delivered tailored smoking cessation counselling during face-to-face visits, aiming for weekly for the first four weeks, monthly to six months and two monthly to 12 months. The control ("usual care") group received routine care relating to smoking cessation at their local primary health care service. Data collection occurred at enrolment, six and 12 months. The primary outcome was self-reported smoking cessation with urinary cotinine confirmation at final follow-up (median 13 (interquartile range 12-15) months after enrolment).
  
  
  RESULTS
  Participants in the intervention (n = 55) and usual care (n = 108) groups were similar in baseline characteristics, except the intervention group was slightly older. At final follow-up the smoking cessation rate for participants assigned to the intervention group (n = 6; 11%), while not statistically significant, was double that of usual care (n = 5; 5%; p = 0.131). A meta-analysis of these findings and a similarly underpowered but comparable study of pregnant Indigenous Australian women showed that Indigenous Australian participants assigned to the intervention groups were 2.4 times (95% CI, 1.01-5.5) as likely to quit as participants assigned to usual care.
  
  
  CONCLUSIONS
  Culturally appropriate, multi-dimensional Indigenous quit smoking programs can be successfully implemented in remote primary health care. Intensive one-on-one interventions with substantial involvement from Aboriginal and Torres Strait Islander workers are likely to be effective in these settings.
  
  
  BACKGROUND
  Australian New Zealand Clinical Trials Registry (ACTRN12608000604303).
authors.affiliation: The Rural Clinical School of Western Australia, The University of Western Australia, 12 Napier Terrace, PO Box 1377, Broome, WA 6725, Australia. Julia.Marley@rcswa.edu.au.
authors.forename: Julia V
authors.initials: JV
authors.lastname: Marley
authors.forename: David
authors.initials: D
authors.lastname: Atkinson
authors.forename: Tracey
authors.initials: T
authors.lastname: Kitaura
authors.forename: Carmel
authors.initials: C
authors.lastname: Nelson
authors.forename: Dennis
authors.initials: D
authors.lastname: Gray
authors.forename: Sue
authors.initials: S
authors.lastname: Metcalf
authors.forename: Graeme P
authors.initials: GP
authors.lastname: Maguire
mesh_terms: D000328:Adult; D001315:Australia; D003367:Cotinine / Q000652:urine; D003376:Counseling; D005260:Female; D006303:Health Services, Indigenous; D006801:Humans; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D011247:Pregnancy; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention; D016896:Treatment Outcome; D000095283:Australian Aboriginal and Torres Strait Islander Peoples
chemical_list: D003367:Cotinine