Yes You Can!
Groundbreaking Smoking Cessation Study for Hispanics
By Rachel Winters
Irma De La Fuente, 59, grew-up in Mexico surrounded by smokers. Smoking cigarettes was not just accepted in her community – it was part of it.
“In Mexico, smoking isn’t prohibited anywhere,” Irma says. “When I was growing-up, my entire family smoked, and as a very young girl, my mother would send me to light her cigarettes on the stove. I often felt like all of Mexico was smoking because I saw people doing it everywhere, even along the corridors in the hospitals.”
With a family of smokers and a community where the habit was a part of daily life, it is no surprise that Irma began smoking at age 15. Soon, she was smoking two packs of cigarettes a day. Irma smoked heavily until March 2008, when she kicked the habit for good by joining M. D. Anderson’s Si Se Puede, a smoking cessation study in the Houston area specifically designed for the Hispanic community.
Unique Study Targets Hispanic Community and Breaks Down Barriers
"Si Se Puede helps researchers understand how factors, such as cravings, support from friends or family, stress and coping skills, affect Spanish-speaking Hispanic smokers as they try to quit smoking or remain smoke-free,” says Carlos A. Mazas, Ph.D., an instructor in M. D. Anderson’s Department of Health Disparities Research and the study’s principal investigator. “The study also looks at the participant’s education level and ability to adjust to new cultures or environments to see if these factors also relate to quitting.”
Irma heard about Si Se Puede, which in English means “Yes You Can,” from a February 2008 radio ad. At the time, Irma and her husband had been living in the United States for six years. They left Mexico to join their four children (all of whom are smokers) and ten grandchildren due to what Irma describes as “empty nest syndrome.” Irma initially treated this syndrome with daily training sessions at a local bowling alley and by competing in international bowling competitions in Mexico, but her love for bowling couldn’t replace her love for her family.
“I was influenced by my grandchildren to join the study because none of them smoked, unlike my children, who all do,” Irma says. “I also decided to join because I was disappointed with myself for smoking. I was tired of smelling like smoke, and I wanted to feel better. I called the number on the ad and got an appointment right away.”
Lung cancer is now the number one cause of cancer death among Hispanics. In addition, three of the four leading causes of death for Hispanics (heart disease, cancer and stroke) are related to smoking, according to the Centers for Disease Control and Prevention. Even with these statistics, Hispanic smokers living in the U.S. don’t participate in smoking prevention research very often.
Understanding the Smoker’s Mind and Environment
Si Se Puede uses personal digital assistant (PDA) devices, which are hand-held computers, to collect data from participants. After completing a tutorial session, participants are given a PDA device that they use for three consecutive weeks. Participants use their PDA to complete questionnaires throughout the day to capture their experiences, thoughts and actions, including stress and anger, at the moment they most crave a cigarette. This method is called ecological momentary assessment and is particularly interesting because it records what is going on in the smoker’s environment and mind.
“The Si Se Puede study is one of the first studies in the United States to use hand-held computers to assess the experiences of Spanish-speaking smokers as they attempt to quit,” Mazas says.
Typically, participants are asked questions such as:
- How do you feel after smoking a cigarette?
- Were people smoking around you?
- Did you smoke any cigarette today that you haven’t entered in the computer?
“By identifying factors that contribute to a Hispanic person’s smoking behaviors and their ability/inability to quit, researchers will have a better understanding of how to design more successful smoking cessation programs for this population,” Mazas says. “This could lead to a decrease in smoking and cancer-related death.”
The Si Se Puede study began recruiting participants in March 2008 and will continue recruitment through September 2010. Each smoker participates in a seven week session. The next seven week session will begin in February 2009. Sessions are conducted in Spanish, which was especially helpful to Irma.
“Once I quit, I started to feel better almost instantly,” Irma says. “I felt cleaner, and I had more confidence when I hugged people. I wanted to hug my grandkids more. Living without cigarettes feels like running free on a beach somewhere.”
Enjoying the Benefits of Smoking Cessation
Irma is no longer a smoker, but she still lives among smokers and is hoping to get her husband enrolled in the program. Since quitting, Irma has begun to think more about herself, and in addition to working for an agency that wires money to countries like Mexico, she is now studying for her citizenship and trying to find enough free time to work on her bowling game. Irma also is looking forward to her trip to California – a trip paid for by saving the $10 a day she would have spent on cigarettes. When talking about her cigarette piggy bank, Irma is all smiles.
“Research study participants are the heart of cancer prevention,” says Erica Cantu, a research coordinator in M. D. Anderson’s Department of Health Disparities Research and Si Se Puede’s head research coordinator. “To effectively reduce the number of future cancer cases, researchers must first be able to identify the most important factors that cause cancer and determine how to avoid them. The only way for them to do this is through cancer prevention research studies.”
“Programs, like this one, reach and educate people,” Irma says. “There is no better medicine than prevention.”
Participants in the Si Se Puede research study receive counseling, nicotine patches and self-help materials at no charge. Eligible participants must be Hispanic and speak Spanish. They also must be current smokers between the ages of 21 and 65, with a home address and functional telephone number. It is important to know that many participants will not quit smoking during the study. For more information, contact the Si Se Puede study line at 713-745-0063.