(PS1-84) Evaluating Black and Hispanic Cancer Patients’ Experiences in Virtual Tobacco Treatment

Introduction: Cancer patients often do not have access to evidence-based tobacco treatment, and reduced access may perpetuate health disparities among Black and Hispanic adults who smoke. The current study aimed to examine Black and Hispanic cancer patients’ experiences in evidence-based virtual tobacco treatment.

Methods: This is a secondary analysis of a multisite RCT comparing the effectiveness of two evidence-based tobacco treatments integrated into cancer care. Eligibility criteria were: 18+, newly diagnosed with cancer, smoked ≥1 cigarette in the past month, and spoke English or Spanish. The current analysis included participants who self-identified as White, Black, and/or Hispanic (N=296). Participants received either 1) four weekly motivational counseling telephone counseling sessions and information about cessation medication options or 2) four weekly motivational counseling telephone sessions, four biweekly telephone counseling sessions, and 3 monthly booster sessions that additionally integrated stress management and resiliency intervention content, plus 12 weeks of free FDA-approved smoking cessation medication. We examined sociodemographic information, smoking history, and cultural characteristics (e.g., racial/ethnic identity, acculturation, language, familism, religiosity, quitting self-efficacy) at baseline and smoking abstinence at 3- and 6-month follow-ups. Additionally, we conducted exit interviews with a randomly and purposively selected subset of the sample.

Results: White non-Hispanic participants were older (M=59.1, SD=9.7) than Black and Hispanic participants (M=55.1, SD=8.2; p=.007). Black and Hispanic patients smoked fewer cigarettes per day (10.5 vs. 14.7 cigarettes per day, p = .03) and reported higher levels of quitting self-efficacy compared to White patients (6.5 vs. 5.3, p = .006). Black and Hispanic patients had higher familism scores (2.4 vs. 2.2, p=.03) and were more likely to endorse greater religiosity and rate religion as important in making healthcare decisions/coping compared to White patients. Black and Hispanic patients were less likely than White patients to speak English only at home (72.5% vs. 91.2%, p< .001). There were no differences in treatment utilization (attendance, medication use) or biochemically confirmed smoking abstinence rates at 3 and 6-month follow-ups by race/ethnicity, controlling for treatment group. In exit interviews, Black and Hispanic patients reported that greater racial and linguistic representation in counseling could enhance the program.

Discussion: Findings suggest that virtual tobacco treatment was accessible and effective for Black and Hispanic cancer patients, regardless of critical sociodemographic and cultural differences. The tobacco cessation interventions used in the current study were flexible and individualizable while maintaining the structure and content of evidence-based tobacco treatment. Increasing the representation of Black and Hispanic tobacco treatment counselors and offering the treatment in additional languages could improve the acceptability and broader dissemination of tobacco treatment in this population.