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.