Sun S. Kim1, Jin Ye Yeo2
1University of Massachusetts Boston, Donna and Robert Manning College of Nursing and Health Sciences, Boston, MA, USA; 2JPHE Editorial Office, AME Publishing Company
Correspondence to: Jin Ye Yeo. JPHE Editorial Office, AME Publishing Company. Email: jphe@amegroups.com
Expert introduction
Dr. Sun S. Kim (Figure 1) is a Professor of Nursing at the University of Massachusetts Boston. Dr. Kim has expertise in developing gender- and culture-specific smoking cessation interventions for ethnic and racial minorities in the United States. She has a track record of successfully conducting numerous smoking cessation interventions while tailoring intervention strategies to the specific needs of study groups. Dr. Kim is also a board-certified clinical nurse specialist in psychiatric mental health with prescription privilege. She operates an adult mental health clinic for medication management.
Figure 1 Dr. Sun S. Kim
Interview
JPHE: What inspired you to dedicate your research towards mental health and specialize in developing smoking cessation interventions, especially in underserved populations?
Dr. Kim: I am a psychiatric nurse practitioner. My interest in smoking cessation interventions started in the late 1990s when I noticed that Korean male immigrants smoked cigarettes at exceedingly higher rates than any other racial and ethnic groups in the United States (U.S.). As a nurse scientist, I wanted to help them quit smoking. Many of them had difficulty accessing tobacco treatment due to linguistic and cultural barriers. So, I developed a culturally tailored smoking cessation intervention for Korean Americans and then later for Vietnamese Americans. I also collaborated with Dr. DeMarco to develop a smoking cessation intervention for women living with human immunodeficiency virus (HIV) who smoke two to three times more than the general U.S. female population. Blacks (i.e., African Americans) are the majority group of women living with HIV in the U.S.
JPHE: How has the landscape of smoking cessation interventions evolved over the years? Could you provide a brief overview of the current strategies for smoking cessation?
Dr. Kim: Cultural adaptation has been a long-standing approach to behavioral change for racial and ethnic minorities. To learn the sociocultural context of Korean men’s smoking behavior, I conducted a series of smoking cessation studies with Korean immigrants in the U.S. From these studies, I learned that family coaching is an effective intervention strategy for smoking cessation in Korean Americans. In addition, the ethnic group is geographically spread around the U.S. So, I developed a smoking cessation intervention that can be delivered remotely via videoconferencing. I also developed a digital storytelling intervention for women living with HIV. In the film, women living with HIV share their success in quitting smoking and urge the viewers to quit smoking for healthy and longer lives.
JPHE: Your team studied the predictors of nicotine replacement therapy (NRT) adherence and findings showed that negative attitudes are correlated to reduced usage of NRT products (1). In your opinion, what are some strategies counselors can adopt to address these attitudes?
Dr. Kim: Negative attitudes largely stem from misinformation about the safety and effectiveness of NRT. Counselors should thoroughly assess what has contributed to the negative attitudes and proactively address the issue by providing tailored health communication messages before providing NRT products. The US Food and Drug Administration (FDA) in 2013 made a public announcement that NRT products should be used alone without any other nicotine-containing products, including cigarettes. The FDA released new guidance in 2023 recommending the use of NRT along with smoking cigarettes before quitting and the use of more than one NRT product. Educating the public about this change is crucial to address their negative attitudes. Another strategy is explaining the underlying drug mechanism of NRT products. They were made to deliver nicotine, unlike smoking a cigarette. Although smoke inhalation is very effective in decreasing nicotine craving, its immediate relief is the cause of addiction. Educating people that NRT products are designed not to have this addictive nature. Another strategy is comparing the side effects of NRT products with those of smoking cigarettes. Although NRT products may have some side effects, they are much safer than cigarettes.
JPHE: Apart from counselors, do you think there should be a greater role for other stakeholders at the state and institutional levels to improve attitudes towards NRT adherence and smoking cessation in general? If yes, what are some approaches that these stakeholders can consider adopting?
Dr. Kim: When NRT products became available, they were highly publicized not to be used while smoking. Yet, there is no public announcement about the safety of the products when they are used while smoking. Stakeholders at various levels should run public educational campaigns that NRT products are safe to use in combination with and even with smoking. Stakeholders should also consider making NRT products available at no cost.
JPHE: In your opinion, what are some significant research gaps that remain in the field of smoking addiction and smoking cessation interventions? Moving forward, what do you think should be the research direction to bridge these gaps?
Dr. Kim: Smoking cessation interventions should be gender specific. There is a plethora of empirical findings reporting gender differences in nicotine metabolism and responses to tobacco treatment. For example, women are less likely to quit smoking with NRT alone than men. However, there is a lack of smoking cessation interventions tailored to gender-specific needs. More recently, researchers started to investigate the effects of genetic predisposition on the onset of nicotine addiction and the outcome of various tobacco treatment approaches. The future direction of tobacco treatment research should be centered around developing person-specific smoking interventions that incorporate technological innovation and biopsychosocial information.
JPHE: What is the most challenging aspect of research on underserved populations? What advice do you have for researchers who wish to pursue the same field?
Dr. Kim: Limited resources in finance and personnel are the most challenging aspects of research on underserved populations. If the underserved population you are interested in is a very small part of the country, you may experience barriers in securing research funding or finding a research collaborator.
JPHE: As an Editorial Board Member, what are your expectations for JPHE?
Dr. Kim: I wish for JPHE to be indexed by PubMed.
Reference
- Kim SS, Prasad A, Nayak MM, et al. Predictors of Nicotine Replacement Therapy Adherence: Mixed-Methods Research with a Convergent Parallel Design. Ann Behav Med. 2024;58(4):275-285. doi:10.1093/abm/kaae006