The U.S. government is dedicating $4.5 million to enhance a “linguistically and culturally appropriate” program to help Asians quit smoking. It is known as the national Asian language quitline and provides cessation counseling, nicotine replacement therapy (NRT), and in-language materials for tobacco users who speak Chinese, Korean, and Vietnamese (CKV). The cash will flow through a Centers for Disease Control (CDC) offshoot called Office on Smoking and Health. With an annual budget of nearly $10 billion, the CDC is the federal agency responsible for protecting public health. It operates under the Department of Health and Human Services (HHS) and claims to work around the clock to protect America from health, safety, and security threats whether diseases start at home or abroad.
In its grant announcement the agency writes that telephone-based quitlines increase quit rates among individuals who use commercial tobacco and are trying to stop. They are also effective in reaching and supporting diverse and low-income populations, according to the CDC. “Limited capacity to provide linguistically and culturally appropriate quitline services may create barriers that contribute to tobacco-related disparities, especially among various subgroups of Asians that speak Chinese (including Cantonese and Mandarin), Korean, and Vietnamese languages (CKV),” the agency writes in the recently published Notice of Funding Opportunity (NOFO), adding that less than half of Asians of CKV descent in the United States report speaking English “very well.”
That poses a public health challenge, the CDC claims, because limited English proficiency reduces access to evidence-based health services. “Since many CKV speakers in the United States come from countries with very high smoking rates among men (up to 50%), providing culturally and linguistically appropriate care is a step towards equitable and effective care,” according to the agency. The millions of American taxpayer dollars will go to one lucky organization that will “operate and promote a linguistically and culturally appropriate nationwide quitline service for individuals who use commercial tobacco products and who predominantly speak CKV languages,” the CDC reveals. The agency explains that it is more efficient to provide a national Asian language quitline rather than rely on states to provide the services.
It is not clear how the agency came to that conclusion considering that a national government-funded Asian Smokers’ Quitline (ASQ) that has served CKV-speaking populations since 2012 has enrolled just 19,000 callers in more than a decade. That information is embedded deep in the grant announcement which is more than 50 pages and states that the CDC will provide continued support for a national Asian language quitline. With the new multi-million-dollar allocation the agency expects better outcomes such as increased use and reach of evidence-based and culturally appropriate quit support services among CKV-speaking people. That includes counseling, medications approved by the Food and Drug Administration (FDA), and digital technologies. The agency also expects “increased successful cessation at greater than 6 months among CKV-speaking people who use commercial tobacco,” according to the grant document.
Tobacco-related disparities are created by a complex mix of factors including social determinants of health, tobacco industry influence and environmental conditions, the CDC writes. Social determinants of health are the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks. The disparities can affect populations based on factors such as race, ethnicity, sexual orientation and gender identity, income, and employment status.
In the last few years, the government has spent vast amounts of taxpayer dollars to provide culturally and linguistically appropriate services to a variety of groups. Recent examples include $66.5 million to strengthen COVID-19 vaccine confidence among racial and ethnic minority groups by providing culturally appropriate information, education and outreach involving the shots. Uncle Sam also recently spent $125 million to provide illegal immigrant minors, known as Unaccompanied Alien Children (UAC), with a multitude of services in the private sector including medical care, special housing arrangements for delinquent, pregnant and gang-affiliated teens as well as long-term counseling. The services were guaranteed by the government to be “culturally and linguistically-appropriate to the unique need of each individual.”