Skip to main content Accessibility help

Increasing access to smoking cessation treatment among Latino smokers using case management

  • Francisco Cartujano-Barrera (a1), Jaime Perales (a2), Evelyn Arana (a1), Lisa Sanderson Cox (a2), Hung-Wen Yeh (a3), Edward F. Ellerbeck (a2), Kimber P. Richter (a2) and Ana Paula Cupertino (a1)...



Disparities exist among Latino smokers with respect to knowledge and access to smoking cessation resources. This study tested the feasibility of using case management (CM) to increase access to pharmacotherapy and quitlines among Latino smokers.


Latino smokers were randomized to CM (n = 40) or standard care (SC, n = 40). All participants received educational materials describing how to utilize pharmacy assistance for cessation pharmacotherapy and connect with quitlines. CM participants received four phone calls from staff to encourage pharmacotherapy and quitline use. At 6-months follow-up, we assessed the utilization of pharmacotherapy and quitline. Additional outcomes included self-reported smoking status and approval for pharmacotherapy assistance.


Using intention-to-treat analysis, CM produced higher utilization than SC of both pharmacotherapy (15.0% versus 2.5%; P = 0.108) and quitlines (12.5% versus 5.0%; P = 0.432), although differences were not statistically significant. Approval for pharmacotherapy assistance programs (20.0% versus 0.0%; P = 0.0005) was significantly higher for CM than SC participants. Self-reported point-prevalence smoking abstinence at 6-months were 20.0% and 17.5% for CM and SC, respectively (P = 0.775).


CM holds promise as an effective intervention to connect Latino smokers to evidence-based cessation treatment.


Corresponding author

Author for correspondence: Francisco Cartujano-Barrera, E-mail:


Hide All
Abroms, L. C., Carroll, P., Boal, A. L., Mendel, J., & Carpenter, K. M. (2016). Integrated phone counselling and text messaging services at quitlines: An acceptability study. Journal of Smoking Cessation, 11(1), 511.
Babb, S. (2017). Quitting smoking among adults—United States, 2000–2015. Morbidity and Mortality Weekly Report, 65(52), 14571464.
Benefits of case management for chronic illness limited: Comparative Effectiveness. (2013). AHRQ, Rockville, MD. from
Boal, A. L., Abroms, L. C., Simmens, S., Graham, A. L., & Carpenter, K. M. (2016). Combined quitline counseling and text messaging for smoking cessation: A quasi-experimental evaluation. Research on Nicotine & Tobacco, 18(5), 10461053.
Bock, B. C., Niaura, R. S., Neighbors, C. J., Carmona-Barros, R., & Azam, M. (2005). Differences between Latino and non-Latino White smokers in cognitive and behavioral characteristics relevant to smoking cessation. Addictive Behaviors, 30(4), 711724.
Bringham and Women's Health. (2018). E-Visits and Virtual Visits in Primary Care. Retrieved January 15, 2019, from
Carpenter, M., Ford, M., Cartmell, K., & Alberg, A. (2011). Misperceptions of nicotine replacement therapy within racially and ethnically diverse smokers. Journal of the National Medical Association, 103(9–10), 885894.
Cupertino, A. P., Mahnken, J. D., Richter, K. P., Cox, L. S., Casey, G., Resnicow, K., & Ellerbeck, E. F. (2007). Long-term engagement in smoking cessation counseling among rural smokers. Journal of Health Care for the Poor and Underserved, 18(6), 3951.
DeNavas-Walt, C., Proctor, B., & Smith, J. (2012). Income, poverty, and health insurance coverage in the United States: 2011; current population reports. Washington, DC: U.S. Census Bureau.
Diverse Racial Ethnic Groups and Nations (DREGAN) Project Team. (2006). Tobacco use in Minnesota: Perspectives from Latino communities. Minnesota: Blue Cross and Blue Shield of Minnesota, Communidades Latinas Unidas en Servicio, Minnesota Partnership for Action Against Tobacco.
Fiore, M. (2000). Treating tobacco use and dependence: An introduction to the US Public Health Service Clinical Practice Guideline. Respiratory Care, 45(10), 11961199.
Fiore, M., Jaen, C. R., Baker, T. et al. (2008). Treating tobacco use and dependence: 2008 update.
Heatherton, T. F., Kozlowski, L. T., Frecker, R. C., & Fagerstrom, K.-O. (1991). The Fagerström test for nicotine dependence: a revision of the Fagerstrom Tolerance Questionnaire. British Journal of Addiction, 86(9), 11191127.
Hollis, J. F., McAfee, T. A., Fellows, J. L., Zbikowski, S. M., Stark, M., & Riedlinger, K. (2007). The effectiveness and cost effectiveness of telephone counselling and the nicotine patch in a state tobacco quitline. Tobacco Control, 16(Suppl 1), i53i59.
Joseph, A. M., Fu, S. S., Lindgren, B. et al. (2011). Chronic disease management for tobacco dependence: A randomized, controlled trial. Archives of Internal Medicine, 171(21), 18941900.
Levinson, A., Perez-Stable, E., Espinoza, P., Flores, E., & Byers, T. (2004). Latinos report less use of pharmaceutical aids when trying to quit smoking. American Journal of Preventive Medicine, 6(2), 105111.
Levinson, A., Borrayo, E., Espinoza, P., Flores, E., & Pérez-Stable, E. (2006). An exploration of Latino smokers and the use of pharmaceutical aids. American Journal of Preventive Medicine, 31(2), 167171.
Lewin, M. E., & Baxter, R. J. (2007). America's health care safety net: Revisiting the 2000 IOM report. Health Affairs(Project Hope), 26(5), 14901494.
Marin, G., Sabogal, F., Marin, B. V., Otero-Sabogal, R., & Perez-Stable, E. J. (1987). Development of a short acculturation scale for Hispanics. Hispanic Journal of Behavioral Sciences, 9(2), 183205.
Miller, W., & Rollnick, S. (2002). Motivational interviewing: Preparing people for change (2nd ed.). New York: Guilford Press.
Miller, K. D., Goding Sauer, A., Ortiz, A. P., Fedewa, S. A., Pinheiro, P. S., Tortolero-Luna, G., Martinez-Tyson, D., Jemal, A., & Siegel, R. L. (2018). Cancer statistics for Hispanics/Latinos, 2018. CA: A Cancer Journal, 68(6), 425445.
Mussulman, L., Ellerbeck, E., Cupertino, A. et al. (2014). Design and participant characteristics of a randomized-controlled trial of telemedicine for smoking cessation among rural smokers. Contemporary Clinical Trials, 38(2), 173181.
Odegard, P. S., & Gray, S. L. (2008). Barriers to medication adherence in poorly controlled diabetes mellitus. The Diabetes Educator, 34(4), 692697.
Philbin, E. F. (1999). Comprehensive multidisciplinary programs for the management of patients with congestive heart failure. Journal of General Internal Medicine, 14(2), 130135.
Piñeiro, B., Diaz, D. R., Monsalve, L. M. et al. (2018 a). Systematic transcreation of self-help smoking cessation materials for Hispanic/Latino smokers: Improving cultural relevance and acceptability. Journal of Health Communication, 23(4), 350359.
Piñeiro, B., Vidrine, D. J., Wetter, D. W., Hoover, D. S., Frank-Pearce, S. G., Nguyen, N., Zbikowski, S. M., & Vidrine, J. I. (2018 b). Implementation of ask-advise-connect in a safety net healthcare system: Quitline treatment engagement and smoking cessation outcomes. Translational Behavioral Medicine. doi: 10.1093/tbm/iby108.
Prochaska, J. O., Velicer, W. F., Rossi, J. S. et al. (1994). Stages of change and decisional balance for 12 problem behaviors. Health Psychology, 13, 3946.
Quality Payment Program. (2018). MIPS Overview. Retrieved January 15, 2019, from
Rich, M. W. (1999). Heart failure disease management: A critical review. Journal of Cardiac Failure, 5(1), 6475.
Rich, M. W. (2001). Heart failure disease management programs: Efficacy and limitations. American Journal of Medicine, 110(5), 410412.
Soto Mas, F. G., Papenfuss, R. L., Jacobson, H. E., Hsu, C. E., Urrutia-Rojas, X., & Kane, W. M. (2005). Hispanic physicians’ tobacco intervention practices: A cross-sectional survey study. BMC Public Health, 5, 120.
SRNT Subcommittee on Biochemical Verification. (2002). Biochemical verification of tobacco use and cessation. Nicotine & Tobacco Research, 4(2), 149159.
Swartz, S. H., Cowan, T. M., Klayman, J. E., Welton, M. T., & Leonard, B. A. (2005). Use and effectiveness of tobacco telephone counseling and nicotine therapy in Maine. American Journal of Preventive Medicine, 29(4), 288294.
Tinkelman, D., Wilson, S. M., Willett, J., & Sweeney, C. T. (2007). Offering free NRT through a tobacco quitline: Impact on utilisation and quit rates. Tobacco Control, 16(Suppl 1), i42-i46.
Wagner, E. H. (1998). Chronic disease management: What will it take to improve care for chronic illness? Effective Clinical Practice, 1(1), 24.
Wagner, E. H. (2000). The role of patient care teams in chronic disease management. BMJ (Clinical Research Ed ), 320(7234), 569.
Wagner, E. H., Davis, C., Schaefer, J., Von Korff, M., & Austin, B. (1999). A survey of leading chronic disease management programs: Are they consistent with the literature? Managed Care Quarterly, 7, 5666.
Webb Hooper, M., Payne, M., & Parkinson, K. A. (2017). Tobacco cessation pharmacotherapy use among racial/ethnic minorities in the United States: Considerations for primary care. Family Medicine and Community Health, 5(3), 193203.
Wetter, D. W., Mazas, C., Daza, P. et al. (2007). Reaching and treating Spanish-speaking smokers through the National Cancer Institute's Cancer Information Service. A randomized controlled trial. Cancer, 109(Suppl 2), 406413.
Whittaker, R., McRobbie, H., Bullen, C., Rodgers, A., & Gu, Y. (2016). Mobile phone-based interventions for smoking cessation. Cochrane Database of Systematic Reviews, 4, CD006611.



Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed