title: All Nations Breath of Life: A Randomized Trial of Smoking Cessation for American Indians.
abstract: American Indians have the highest cigarette smoking prevalence of any racial/ethnic group in the U.S. There is currently no effective empirically based smoking-cessation program for American Indians. The purpose of this study was to determine if a culturally tailored smoking-cessation program, All Nations Breath of Life (ANBL), is more effective than a non-tailored cessation program among American Indian smokers.
  
  
  
  A multisite RCT was conducted from September 2009 to July 2014; analysis was conducted in 2015.
  
  
  
  Participants were rural or reservation-based American Indian smokers aged ≥18 years.
  
  
  
  Smokers were group randomized to either the culturally tailored ANBL or non-tailored current best practices (CBP) for a total enrolled sample size of 463 (ANBL, n=243; CBP, n=220).
  
  
  
  The primary outcome of interest was salivary cotinine-verified 7-day point prevalence smoking abstinence at 6 months. Results for both responder-only and intent-to-treat analyses for self-reported and cotinine-verified abstinence are presented.
  
  
  
  Intention-to-treat, imputing all non-responses as smokers, the self-reported point prevalence abstinence rates at 12 weeks were 27.9% in the ANBL arm and 17.4% in the CBP arm (p=0.028). There was a statistically significant difference in self-reported 6-month intent-to-treat point prevalence abstinence rates between ANBL (20.1%) and CBP (12.0%) arms (p=0.029). None of the cotinine-verified results were statistically significant.
  
  
  
  The culturally tailored smoking-cessation program ANBL may or may not be an effective program in promoting cessation at 12 weeks and 6 months. Participants in the culturally tailored ANBL program were approximately twice as likely to quit smoking at 6 months compared with the CBP program, using self-reported abstinence.
authors.affiliation: Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, Kansas; Center for American Indian Community Health, University of Kansas Medical Center, Kansas City, Kansas. Electronic address: wchoi@kumc.edu.
authors.forename: Won S
authors.initials: WS
authors.lastname: Choi
authors.affiliation: Department of Biostatistics and Epidemiology, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma.
authors.forename: Laura A
authors.initials: LA
authors.lastname: Beebe
authors.affiliation: Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, Kansas; Center for American Indian Community Health, University of Kansas Medical Center, Kansas City, Kansas.
authors.forename: Niaman
authors.initials: N
authors.lastname: Nazir
authors.affiliation: Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, Kansas; Center for American Indian Community Health, University of Kansas Medical Center, Kansas City, Kansas.
authors.forename: Baljit
authors.initials: B
authors.lastname: Kaur
authors.affiliation: Department of Biostatistics and Epidemiology, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma.
authors.forename: Michelle
authors.initials: M
authors.lastname: Hopkins
authors.affiliation: Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, Kansas; Center for American Indian Community Health, University of Kansas Medical Center, Kansas City, Kansas; Department of Biostatistics and Epidemiology, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma.
authors.forename: Myrietta
authors.initials: M
authors.lastname: Talawyma
authors.affiliation: School of Public Health, Brown University, Providence, Rhode Island.
authors.forename: Theresa I
authors.initials: TI
authors.lastname: Shireman
authors.affiliation: Center for American Indian Community Health, University of Kansas Medical Center, Kansas City, Kansas; Department of Biostatistics, University of Kansas Medical Center, Kansas City, Kansas.
authors.forename: Hung-Wen
authors.initials: HW
authors.lastname: Yeh
authors.affiliation: Center for American Indian Community Health, University of Kansas Medical Center, Kansas City, Kansas; Department of Biostatistics and Epidemiology, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma; Department of Family Medicine, University of Kansas Medical Center, Kansas City, Kansas.
authors.forename: K Allen
authors.initials: KA
authors.lastname: Greiner
authors.affiliation: Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, Kansas; Center for American Indian Community Health, University of Kansas Medical Center, Kansas City, Kansas; Department of Family Medicine, University of Kansas Medical Center, Kansas City, Kansas; American Indian Health Research and Education Alliance, Inc., Kansas City, Kansas.
authors.forename: Christine M
authors.initials: CM
authors.lastname: Daley
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D016540:Smoking Cessation / Q000208:ethnology* / Q000706:statistics & numerical data