How effective is the combination of clinic-based adult cessation for commercial tobacco with environmental prevention strategies to reduce availability of and exposure to commercial nicotine products for youth? This study aims to address this question in nine rural reservation-based California Indian Tribes served by a Tribal clinic.
In service of community-level environmental prevention, the project will conduct a Reward and Reminder program to encourage reservation area tobacco retailers to comply with State of California standards prohibiting sales of nicotine and commercial tobacco products to youth under 21.
At the individual level, the study will (1) consistently screen adult clinic patients for commercial tobacco use and dependence, and exposure to commercial tobacco use; (2) train clinic staff in smoking cessation counseling and nicotine-replacement therapy (NRT); and (3) assess the effectiveness of these strategies in reducing tobacco use and dependence in a sample of adults.
Finally, the project will convene youth advisory councils to conduct a youth participatory action research component to identify and develop culturally- and age-appropriate program implementation and encourage Tribal resolutions in support of smoke-free Tribal homes and service facilities. We will evaluate the effectiveness of our translational strategies through assessment of reward and reminder outcomes in stores, adoption of smoke-free policies by local tribes, and both enrollment and quit rates from the smoking cessation program.