By AMERICAN HEART ASSOCIATION NEWS

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Beatrice smoked her first cigarette when she was 7 years old. By 13, she was a regular smoker.

The mother of two quit smoking in her late 30s, inspired by her sons.

“When my son was 11, he wrote me a letter and in it he asked me to quit smoking,” Beatrice said. “And when I was going through the process of quitting, that letter was very motivating for me. I want to be here for my family.”

Beatrice, who tells her story in a government video urging Hispanics and Latinos to quit, typifies the trend in that ethnic group, experts say.

Most efforts to get people to quit smoking carry a simple yet powerful message: Stop because it can kill you.

That tough message may change some minds, but experts say Hispanic and Latino smokers may succeed more with different messages. In short, addressing cultural differences and the importance of family can be more helpful, they say.

“That’s key: understand the culture, more than language,” said Hernán Tagliani, founder and president of The Group Advertising in Orlando, Florida, whose work has focused on U.S. Hispanics and Latinos for over a decade.

Quitting is critical for all people because smoking damages blood vessels and may lead to heart disease and stroke. It’s responsible for one in five deaths in the United States and is a leading cause of preventable deaths, experts say.

To help Hispanics and Latinos quit, it’s key to understand that smoking rates vary significantly by ethnicity. Similarly, idioms and slang terms can vary wildly from one country to the next in a way that could make some messages less effective. For example, Puerto Ricans have the highest smoking rate among Hispanics in the United States but may listen to messages differently than Venezuelans or Mexicans.

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And so simply translating standard messages into Spanish doesn’t always work – especially because second-, third- and fourth-generation Hispanics and Latinos may speak only English, Tagliani said.

In Puerto Rico’s health department, Antonio Cases and his staff over the years have sometimes chose not to use the ads from the Centers for Disease Control and Prevention because the messages and people in the ads didn’t fit the island’s population.

But the Spanish-language materials provided in recent years to promote the CDC’s Tips From Former Smokers include Hispanics and Latinos, and the Spanish-language messages are well done, said Cases, director of the department’s tobacco control and oral health division.

“In terms promoting the harm cigarettes do, as well as the promotion of the quit line, it’s very important that they are adapted to our [Puerto Rican] population,” he said.

In general, a successful campaign targeted to Hispanic and Latino adults taps into their deep-rooted sense of family, said Carla Eboli, chief reputation officer for Dieste, a Dallas-based agency that concentrates on Hispanic and Latino consumers.

Hispanic and Latino smokers have said in focus groups that love and support of family has motivated them to quit, Eboli said.

“The family aspect of health care is very, very important for the Hispanic community,” Eboli said.

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Hispanics and Latinos represent about 17 percent of the U.S. population, according to U.S. Census data. But not all are looking for Spanish-language information.

About 43 percent who primarily speak Spanish get their news from Spanish-language sources, but almost two-thirds of bilingual Hispanics and Latinos get their news from outlets in both languages, according to a 2013 report from the Pew Research Center.

“Thus, it’s not just a good idea to have our information available in Spanish — it’s critical,” said Michelle Johns, a health communications specialist at the CDC.

Johns’ colleagues at the Office on Smoking and Health knew it was important to create materials in both English and Spanish, she said. Its Tips From Former Smokers campaign was designed to reach the more than 3.5 million Hispanics and Latinos who smoke.

The Spanish-language Tips From Former Smokers includes links to smoking-cessation resources, short audio stories from former smokers and a list of diseases that may be linked to smoking. In addition, there are video testimonials.

Most stories center on how smokers’ bad habit worsened their health. They talk candidly about their open-heart surgery, losing teeth to gum disease linked to smoking, losing their legs and lungs. Some have died.

The National Cancer Institute also has a campaign to encourage people to quit.

The English-language website includes articles on how to manage emotions and how to transition into a smoke-free routine. The Spanish-language companion website also has information to help smokers quit – and a clear message.

The phrase at the top of the page says, in Spanish: “My family, my health, my life.”