This systematic review of the literature identified five trials that recruited nonindigenous and indigenous participants in tobacco control interventions – three interventions tested the effectiveness of enhanced Quitline protocols with cessation products over usual Quitline care, and two trialled a culturally adapted cessation counselling intervention using mobile phones. Three studies did not demonstrate a significant effect of the intervention for both indigenous and nonindigenous participants; two were pharmacotherapy studies using nicotine replacement therapy and the third was a trial of a multimedia phone intervention. The fourth study found a significant effect of a behavioural intervention using text messaging for indigenous and nonindigenous participants. The final study found a significant effect in favour of very low nicotine cigarettes compared with usual care; results were similar across ethnic groups.
A great review on ‘what works’ to help indigenous peoples quit smoking. I agree with the authors’ recommendations that any study of cessation products or support must over-sample Māori, for as Māori participants have indicated, they are more likely to consider quitting even when they just participate in smoking cessation research. Importantly, a focus on developing a ‘culturally appropriate’ service may miss the point. Evidence shows that NZ Europeans are more likely to be prescribed NRT than other ethnicities. This gap increases after adjusting for smoking prevalence. Research to address inequities in clinical practice may therefore be more important.
Independent commentary by Dr. Matire Hardwood
Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.
Research Review publications are intended for New Zealand health professionals.
Disclaimer: This publication is not intended as a replacement for regular medical education but to assist in the process. The reviews are a summarised interpretation of the published study and reflect the opinion of the writer rather than those of the research group or scientific journal. It is suggested readers review the full trial data before forming a final conclusion on its merits.
