Changes in attitudes towards smoking during smoking cessation courses for Turkish- and Albanian-speaking migrants in Switzerland and its association with smoking behavior: A latent change score approach

INTRODUCTION: Migrant populations usually report higher smoking rates than locals. At the same time, people with a migration background have little or no access to regular smoking cessation treatment. In the last two decades, regular smoking cessation courses were adapted to reach out to Turkish- and Albanian-speaking migrants living in Switzerland. The main aims of the current study were (1) to analyze the effects of an adapted smoking cessation course for Turkish- and Albanian-speaking migrants in Switzerland on attitudes toward smoking and smoking behavior; and (2) to elucidate whether changes in attitudes toward smoking were associated to changes in smoking behavior in the short- and in the long-term. METHODS: A total of 59 smoking cessation courses (Turkish: 37; Albanian: 22) with 436 participants (T: 268; A: 168) held between 2014 and 2019 were evaluated. Attitudes toward smoking and cigarettes smoked per day were assessed at baseline and 3-months follow-up. One-year follow-up calls included assessment of cigarettes smoked per day. Data were analyzed by means of structural equation modeling with latent change scores. RESULTS: Participation in an adapted smoking cessation course led to a decrease of positive attitudes toward smoking (T: β = −0.65, p < 0.001; A: β = −0.68, p < 0.001) and a decrease of cigarettes smoked per day in the short-term (T: β = −0.58, p < 0.001; A: β = −0.43, p < 0.001) with only Turkish-speaking migrants further reducing their smoking in the long-term (T: β = −0.59, p < 0.001; A: β = −0.14, p = 0.57). Greater decreases in positive attitudes were associated with greater reductions of smoking in the short-term (T: r = 0.39, p < 0.001; A: r = 0.32, p = 0.03), but not in the long-term (T: r = −0.01, p = 0.88; A: r = −0.001, p = 0.99). CONCLUSION: The adapted smoking cessation courses fostered changes in positive attitudes toward smoking that were associated with intended behavior change in the short-term. The importance of socio-cognitive characteristics related to behavior change maintenance to further increase treatment effectiveness in the long-term is discussed.