Beta-testing the feasibility of a family-based financial incentives smoking cessation intervention with Alaska Native families: Phase 2 of the Aniqsaaq (to breathe) Study

Abstract

Background: Alaska Native and American Indian (ANAI) communities in Alaska have disproportionately high commercial tobacco smoking rates and face barriers to accessing cessation treatment. We beta-tested the feasibility of a remotely delivered, ANAI family-based financial incentive cessation intervention.

Methods: We enrolled 10 "dyads" (i.e., one adult ANAI person who smokes [PWS] and one adult family member of their choice) across Alaska into a culturally tailored 6-month intervention (NCT05209451). PWS completed expired carbon monoxide, salivary cotinine, and self-reported abstinence measures at home during six smoking status check-ins. Both dyad members received financial incentives in escalating amounts for confirmed PWS abstinence. Participants completed baseline and end-of-study surveys.

Results: Eight of the 10 PWS were women, their average age was 45 years (range = 34-57), and mean daily cigarettes smoked was 13 (range = 3-20). Five of the 10 family members were women, and four currently also smoked. Of the 60 check-ins possible among PWS participants, 41 (68 %) were completed; five (50 %) completed all check-ins. Despite minor difficulties with PWS internet connection, lost test kits, and delayed payment receipt, all participants were able to complete check-ins and received payments earned. Five PWS were abstinent at the final 6-month check-in, and two PWS were abstinent at all check-ins. Five PWS completed the end-of-study survey; four reported the intervention was helpful and would recommend it to others.

Conclusion: A family-based financial incentive intervention for smoking cessation with ANAI families appears feasible. Next, a randomized controlled trial will be conducted statewide to evaluate effectiveness and inform future implementation needs.

Keywords: Alaska native; American indian; Cessation; Family-based; Health disparities; Tobacco; Treatment and intervention.

Fig. 1

Phase 2 beta-test engagement and abstinence rates Legend: Completion and abstinence rates for all 10 PWS participants. Alt text: Bar graph showing the completion and abstinence rates for all 10 PWS participants.

Fig. 2

Smoking status results for each assessment type at all check-ins Legend: Carbon monoxide (CO) parts per million (PPM) results are shown for all 10 PWS participants. The black line at 6 PPM represents the cutoff for smoking abstinence results. Alere iScreen results are shown for all 10 PWS participants. Self-reported smoking response results are shown for all 10 PWS participants. Alt text: The first bar graph shows carbon monoxide parts per million (PPM) results for all 10 PWS participants. A black line depicts the 6 PPM cutoff for smoking abstinence results. The second bar graph shows Alere iScreen saliva swab test results, reported as positive or negative, for all 10 PWS participants. The third bar graph shows self-reported smoking response results, reported as yes or no, for all 10 PWS participants.