Because tobacco use and associated cancer rates among older adults are lower among Hispanics than other groups in Texas, very few efforts to reduce cigarette smoking have been carried out among young adult Spanish-speaking smokers across the state. Cessation service delivery is very sparse on the Texas-Mexico border, particularly from Laredo to Del Rio. In 2013 only two Spanish-speaking young adults (ages 18-29) from these border regions, and only one from San Antonio, used DSHS online or telephone cessation services. Only 43 young adults used these services in English. However, smoking rates are high in the young and fast-growing population in this part of South Texas, ranging from 23....

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Because tobacco use and associated cancer rates among older adults are lower among Hispanics than other groups in Texas, very few efforts to reduce cigarette smoking have been carried out among young adult Spanish-speaking smokers across the state. Cessation service delivery is very sparse on the Texas-Mexico border, particularly from Laredo to Del Rio. In 2013 only two Spanish-speaking young adults (ages 18-29) from these border regions, and only one from San Antonio, used DSHS online or telephone cessation services. Only 43 young adults used these services in English. However, smoking rates are high in the young and fast-growing population in this part of South Texas, ranging from 23.2% to 25.7%. Two in three of the young adult smokers in these areas are Latino and half speak mainly Spanish at home.

Telephone and online counseling, as well as text-messaging (SMS) applications, have been shown to roughly double successful quit rates, with even greater impact in younger age groups. Young adult Latinos are heavy users of mobile devices for texting and access to mobile media. We will overcome accessibility and cultural barriers to serving this population by using culturally and linguistically appropriate mobile communication channels and messages to recruit smokers to an evidence-based SMS cessation service designed specifically for the young adults in South Texas.

Following a six-month preparatory phase of work to finalize promotional plans and create evidence-based, culturally tailored Spanish and English SMS cessation services, we will carry out an intensive radio, social and mobile media promotional campaign to recruit young adult cigarette smokers to this service. Recruitment messages will combine elicitation of emotions of disgust toward smoking, portrayal of motivational interviewing dialogues and peer modeling to increase perceived self-efficacy for quitting. Responses to promotion, receipt of services and cessation outcomes will be tracked.

We aim to: (1) Reach 60,000 (50%) of an estimated 120,000 smokers ages 18-29 in Laredo, Eagle Pass, Del Rio, and San Antonio (and its surrounding media market areas) in South Texas with radio, social and mobile messages, encouraging text responses to enroll in the SMS cessation service; and (2) enroll 5% of all 120,000 young adult smokers (6,000 young service recipients) and 3% of all 330,000 adult smokers (10,000 service recipients) in these areas. Approximately 10% of these 10,000 service recipients in all age groups will achieve longer-term cessation, resulting in 1,000 successful quitters.

This project’s innovative features include attention to a population that has not been served with efforts to promote smoking cessation. We will employ an innovative mix of traditional media (radio) and new social media (Facebook, Instagram and YouTube) for outreach to young adults who smoke. We will also transform evidence-based SMS cessation assistance methods, that have previously been available only in English or with generic Spanish translation, to fit the language use and cultural milieu of young Spanish and English speakers. A preliminary focus group assessment revealed the need for using “Spanglish” and concentrating on the importance of family as a key cultural value among this group.

This project will greatly increase accessibility and utilization of evidence-based smoking cessation services among underserved young adults in South Texas, raising the number served from 46 (in 2013) to 6,000 over three years. By creating a San Antonio–based cessation service specifically for young adult smokers in South Texas, it represents a significant and nonduplicative systems change that will have an impact far beyond what is presently being accomplished here by Texas DSHS services. It will also provide a model that can be replicated by any organization or network interested in reaching this fast-growing demographic group in other parts of the state, establishing an SMS cessation service that can continue to assist young adult Latinos and smokers of other ethnicities in Spanish and English across Texas for less than $1 per person served. This highly replicable program has the potential to produce a public health impact by reducing future health service costs and smoking-related health disparities.

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