This is an accordion element with a series of buttons that open and close related content panels.
Understanding the strengths of the patient populations most affected by tobacco in your community can inform your program planning. You can work with community stakeholders to identify options to leverage strengths to overcome barriers and enhance the impact of your tobacco program.
For example, effective tobacco prevention and treatment campaigns for American- Indian communities focus on keeping tobacco sacred and reclaiming traditional practices from commercial tobacco companies in an effort to promote health and preserve culture simultaneously. See more from the National Native Network, CDC, and Minnesota Blue Cross Blue Shield Center for Prevention.
In addition, some effective tobacco control messaging programs highlight the history of targeting, exploitation, and cultural appropriation of African-American/Black communities by tobacco companies. See more from the truth initiative and Public Health Law Center.
Universal Proactive Outreach and Treatment
Prompting care teams to offer or deliver tobacco treatment to all patients appears to reduce disparities among historically underserved groups, including minoritized individuals and Medicaid-eligible persons (Baker et al., 2021; Creswell et al., 2022; McCarthy et al., 2022). This is important as disparities in tobacco use prevalence, and its consequences in terms of cancer, have grown as tobacco use rates have declined overall (Irvin Vidrine et al., 2009; Simmons et al., 2016). Such disparities are prominent in usual care conditions in which the onus is on individual patients or clinicians to request or initiate tobacco treatment (Babb et al., 2017).
Targeted and Culturally Specific Approaches
Targeting tobacco treatment and education to underserved populations and those disproportionately affected by tobacco use can also improve health equity. Interventions that are culturally specific have been shown to improve knowledge, health behaviors, and health outcomes, especially when tailored at the patient level (Williams et al., 2016).
Examples of such programs include:
- Quitline services that provide culturally specific and intensified cessation services to clients who identify as American Indian or Alaska Native
- A video-and-text-based intervention that increases confirmed abstinence rates among socioeconomically disadvantaged African American adults, when compared against SmokefreeTXT (Webb Hooper et al., 2021)
- A self-help intervention for African American adults who smoke
- Strategies recommended in the American Lung Association guide Addressing Tobacco Use in Black Communities
- An Asian smoking quitline for people who identify as Asian or Asian American, with services available in Cantonese, Mandarin, Korean, Vietnamese, and English
- CDC-recommended strategies to overcome barriers reported by LGBTQ+ communities in stopping tobacco use and American Lung Association-recommended strategies to provide culturally specific tobacco treatment in LGBTQ+ communities and counter tobacco industry targeted marketing
- SmokefreeTXT programs for specific populations (veterans, Spanish speakers, women, teens, people aged 60 or older)
- Texting, telehealth, and in-home support for disadvantaged pregnant and post-partum persons
- Interventions for behavioral health and substance use treatment clients
Based on demographic, diagnostic, and social determinants of health information you collect from patients, you could design system changes that match patients from underserved populations to specialized publicly available resources.
Assess and Enhance Equity through Quality Improvement and Community Engagement
Interventions designed for individuals (i.e., patients), providers, health care organizations and systems, and communities offer viable options for addressing health disparities through personalized behavior change, education, and policy (Williams et al., 2016). A diverse group of stakeholders should be engaged in designing your program to ensure various types of health disparities are addressed and the program results in improved tobacco treatment reach and effectiveness. Consider engaging:
- Representatives from the populations of interest (i.e., follow guidance from advocates for health equity who advise “nothing about us without us”)
- Community advisory or advocacy boards
- Diversity, equity, and inclusion leaders in your system
- Front-line staff with experience and knowledge working with underserved groups
- Community advisory or advocacy boards
- Quality improvement and business analytics experts who can help you design methods (e.g., dashboards or automated reports) to monitor equity
This team can help you build a program that will enhance health equity and cancer control in vulnerable populations. See these strategies for inclusive leadership and ways to enhance diversity and inclusion in the healthcare workforce.