Background: Tobacco dependence treatment efforts have focused on primary care physicians (PCPs), but evidence suggests that they are insufficient to help most smokers quit. Other health professionals also frequently encounter smokers, but their smoking prevalence, cessation practices, and beliefs are less well known. Methods: The study included 2,804 subjects from seven health professional groups: PCPs, emergency medicine physicians, psychiatrists, registered nurses, dentists, dental hygienists, and pharmacists. Outcomes included self-reported smoking status, smoking cessation practices, and beliefs. Multivariate regression was used to examine factors associated with health professionals (except pharmacists) self-reportedly performing the “5 A’s”: asking, advising, assessing, assisting, or arranging follow-up about tobacco. Results: Health professionals have a low smoking prevalence (<6%), except nurses (13%). Many health professionals report asking (87.3%–99.5%) and advising (65.6%–94.9%) about smoking but much less assessing smokers’ interest (38.7%–84.8%), assisting (16.4%–63.7%), and arranging follow-up (1.3%–23.1%). Controlling for health professional and practice demographics, factors positively associated in the multivariate analyses with self-reportedly performing multiple components of the 5 A’s include awareness of the Public Health Service guidelines, having had cessation training, and believing that treatment was an important professional responsibility. Negative associations include the health professional being a current smoker, not being a PCP, being uncomfortable asking patients if they smoke, believing counseling was not an appropriate service, and reporting competing priorities. Conclusion: U.S. health professionals report not fully performing the 5 A’s. The common barriers and facilitators identified may help inform strategies for increasing the involvement of all health professionals in conducting tobacco dependence treatments.

BACKGROUND: Asian Americans have lower colorectal cancer (CRC) screening rates than non‐Hispanic white individuals. Hmong Americans have limited socioeconomic resources and literacy. The current randomized controlled trial was conducted to determine whether bilingual/bicultural lay health educator (LHE) education could increase CRC screening among Hmong Americans.METHODS: A cluster randomized controlled trial was conducted among Hmong Americans in Sacramento, California. LHEs and recruited participants were randomized to intervention or control groups. The intervention group received CRC education over 3 months delivered by an LHE. The control group received education regarding nutrition and physical activity delivered by a health educator. The outcomes were changes in self‐reported ever‐screening and up‐to‐date CRC screening after 6 months.RESULTS: All 329 participants were foreign‐born with mostly no formal education, limited English proficiency, and no employment. The majority of the participants were insured and had a regular source of health care. The intervention group experienced greater changes after the intervention than the control group for ever‐screening (P = .068) and being up‐to‐date with screening (P<.0001). In multivariable regression analyses, the intervention group demonstrated a greater increase than the control group in reporting ever‐screening (adjusted odds ratio, 1.73; 95% confidence interval, 1.07‐2.79) and being up‐to‐date with screening (adjusted odds ratio, 1.71; 95% confidence interval, 1.26‐2.32). Individuals who had health insurance were found to have >4 times the odds of receiving screening, both ever‐screening and up‐to‐date screening. A higher CRC knowledge score mediated the intervention effect for both screening outcomes.CONCLUSIONS: A culturally and linguistically appropriate educational intervention delivered by trained LHEs was found to increase CRC screening in an immigrant population with low levels of education, employment, English proficiency, and literacy. Cancer 2017;98–106. © 2016 American Cancer Society.

BACKGROUND: Cancer is the leading cause of death for Asian Americans. The authors evaluated the status of cancer prevention for Chinese Americans in San Francisco, which has had years of cancer prevention efforts.METHODS: Through a community‐based clinic serving Chinese Americans, a randomized, controlled trial (n = 395) was conducted among participants who attended either a cancer prevention seminar or biospecimen education seminar. Changes in knowledge, attitudes, and screening completion/intent were measured across and between seminar groups.RESULTS: Participants were mostly women who had low acculturation and education levels. Over two‐thirds to almost all participants knew about modifiable risk factors for cancer and that screening tests were available, including for lung cancer. The majority of women had already completed mammography and Papanicolaou (Pap) tests. Approximately one‐half reported having completed colorectal cancer screening, prostate screening, or hepatitis B screening. Most were nonsmokers, but about one‐half “strongly agreed” that they would want a test for tobacco smoke exposure. After the cancer prevention seminar, significant increases within group were noted for knowledge (eating healthy foods, from 93.1% to 97.7% [P = .0002]; secondhand smoke causes cancer, from 66.3% to 74.8% [P = .04]) and for screening completion/intent (colorectal cancer, from 58.1% to 64.5% [P = .002] cervical cancer, from 72.9% to 75.5% [P = .04]) and there was a trend toward an increase for prostate cancer (from 50.0% to 61.1%; P = .10). There was a significant change between groups for eating healthy foods (P = .004).CONCLUSIONS: The current reports documents the gains in cancer prevention among Cantonese‐speaking Chinese Americans, fostered by academic, community, and public health efforts. A community‐based seminar demonstrated improvement in some cancer knowledge or screening intent and opportunities for continued efforts. Cancer 2018;124:1622‐30. © 2018 American Cancer Society.

Preoperative smoking cessation is associated with a reduction in postoperative pulmonary complications, especially after thoracic surgery.^1-3 A longer time of smoking cessation prior to an elective operation is associated with a lower risk of pulmonary complications.^4,5 Therefore, the period between the initial outpatient visit with a surgeon and the surgery date is a critical time to encourage smoking cessation to reduce the risk of postoperative complications and increase the chance of long-term smoking cessation. This sentiment is acknowledged by the International Association for the Study of Lung Cancer. Recognizing the critical importance of smoking cessation after cancer diagnosis, in September 2019, the International Association for the Study of Lung Cancer recommended for patients undergoing treatment for lung cancer that evidence-based tobacco cessation assistance should be routinely and integrally incorporated into multidisciplinary cancer care for the patients and their family members.⁶ Given this importance, clinicians must have effective smoking cessation resources to provide to their patients.

Vietnamese American men have smoking prevalence rates higher than the general population. We analyzed Vietnamese American smoking behavior by demographic and health-related factors, including some specific to Vietnamese, in the largest tobacco-specific survey yet targeting the Vietnamese population. Using a statewide surname probability sample and computer-assisted telephone interviewing, we surveyed 1,101 Vietnamese men and 1,078 Vietnamese women in California (63.5% participation among successfully contacted eligible individuals) in 2007–2008. We conducted multivariate regression models to analyze the association between Vietnamese male smoking status and demographic and health-related factors. Among women, <1% were current smokers and <2% were former smokers. Among men, 25% were current and 24% were former smokers. Regression models for Vietnamese men delineated factors associated with both current and former smoking (vs. never smoking): being married, being employed, having lower educational attainment, and consuming alcohol. Other factors associated with current smoking (vs. never smoking) were having no health insurance, having seen a Vietnamese doctor or no doctor visit in the past year, having Vietnamese military or Vietnamese reeducation camp experience, having less knowledge about the harms of smoking, and reporting higher depression symptoms. Increasing age and not being Buddhist were associated with former (vs. never) smoking. Smoking patterns of Vietnamese women and Vietnamese men are significantly different from the general California population. Tobacco control efforts targeting Vietnamese men should include community outreach since current smokers have low health care access, utilization, and knowledge.