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Introduction: 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.Design: A multisite RCT was conducted from September 2009 to July 2014; analysis was conducted in 2015.Setting/participants: Participants were rural or reservation-based American Indian smokers aged ≥18 years.Intervention: 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).Main Outcome Measures: 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.Results: 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.Conclusions: 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. [ABSTRACT FROM AUTHOR]

Background: Recent studies have shown that tobacco advertising leads to the onset of smoking among adolescents. However, much more still remains to be learned about the impact of tobacco advertising in the later transitions, mainly from experimentation to established smoking. In this study, we focused on the influence of tobacco advertising and promotions on the transition from experimentation to established smoking.Methods: Data were derived from a longitudinal survey of adolescents in California. Adolescents who were classified as experimenters at baseline were included in the analyses (N=965). Receptivity to tobacco advertising and promotions refers to the development of a positive affective response to the communication (e.g., having a favorite tobacco advertisement or being willing to use a promotional item).Results: Approximately 32% of adolescents who were experimenters at baseline in 1993, progressed to established smoking by follow-up in 1996. Progression was higher among Caucasian (37.3%) than Hispanic (21.9%) or African-American (17.6%) adolescents. Adolescents who perceived that most of their peers smoked, had poor relationships with family members, and were exposed to smoking friends and family members were more likely to progress to established smoking at follow-up in 1996. In addition, adolescents who were receptive to advertising and believed that they could quit anytime were more likely to progress to established smoking than those who did not think they could quit anytime. Adolescents who were willing to use a promotional item and who believed that they could quit anytime had the highest rate of progression to established smoking (52%).Conclusions: This study provides evidence that receptivity to tobacco advertising and promotions is an important factor in progressing from experimentation to established smoking among adolescents. Because perceived ability to quit made adolescents more likely to progress, counter-tobacco marketing campaigns should incorporate messages about addiction and difficulties associated with quitting. [ABSTRACT FROM AUTHOR]

Introduction: National data indicate a higher prevalence of obesity among American Indian (AI) populations and greater disparity of morbidity and mortality among younger age groups compared with other ethnicities. Diet and physical activity are important obesity preventive behaviors, but no published data exist that describe these behaviors in relation to obesity in AI young adults at tribal colleges. Study purposes were to: (1) identify fruit and vegetable intake and physical activity practices of AI young adults from three U.S. tribal colleges according to BMI categories; (2) identify the accuracy of body weight perceptions; and (3) identify predictor variables for weight misperception.Methods: In this observational study during 2011-2014, a total of 1,256 participants were recruited from three participating U.S. tribal colleges to complete an online survey addressing issues related to diet, physical activity, and weight perception. Reported height and weight were used to calculate BMI categories, and differences between BMI categories were examined. Gender differences related to accuracy of weight perception by BMI categories were also examined. Analyses were conducted in 2016.Results: Based on self-reported height and weight, 68% of the sample was overweight or obese (BMI ≥25) and mean BMI was 28.9 (SD=6.9). Most did not meet recommendations for fruit intake (78.7%), vegetable intake (96.6%), or physical activity (65.6%). More than half (53.7%%) who were overweight/obese underestimated their weight category. Men more often underestimated their weight category (54.2%) than women (35.1%).Conclusions: Interventions are needed to improve weight-related lifestyle behaviors of AI tribal college students. [ABSTRACT FROM AUTHOR]