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African Americans: NRT or Alternative Medicine for Cessation

Institution: University of California, San Francisco
Investigator(s): Valerie Yerger, ND, MA
Award Cycle: 2006 (Cycle 15) Grant #: 15KT-0038H Award: $285,000
Subject Area: Tobacco-Use Prevention and Cessation
Award Type: New Investigator Awards

Initial Award Abstract
Health disparities represent a major problem for the United States, and smoking is a primary contributor to these disparities. Though the number of people smoking in the United States has reduced, the proportion of African Americans who smoke is greater than the proportion of whites who smoke. When compared to white smokers, African American smokers try to quit more often, say they feel more confident about being able to quit, and are more motivated to save money and reduce other smoking-related hassles. But despite all these reports, African Americans have a harder time quitting and are more likely to pick up their smoking again once they do quit than are white smokers who try to quit.

Drugs made to replace nicotine in the body, such as the nicotine patch, gum, lozenge, and nasal spray, have been used to help individuals quit smoking. These drugs, often referred to as nicotine replacement therapy (NRT), have been shown to significantly increase the number of people who are able to quit; however, African Americans are less likely to use these drugs than white smokers. To better understand why African Americans are not using these drugs at the same rate as white smokers, researchers have recommended that more research be done to see why. Recommendations include additional research on the acceptability of NRT and an assessment of what, if any, obstacles prevent African Americans from choosing to use these treatments.

This project not only addresses these recommendations, but also responds to a TRDRP priority to address smoking cessation in African Americans. We will address directly one of the possible causes of African Americans' lower smoking cessation rates by exploring perceived obstacles to the use of conventional nicotine replacement therapies such as the nicotine patch, gum, or lozenge and identifying any uses of alternative therapies such as home remedies, prayer and spiritual healing, or relaxation techniques to quit smoking. A number of studies have suggested that non-conventional therapies are effective in helping people quit smoking. There is also evidence that 71.3% of African Americans use some form of alternative medicine to manage their illnesses and symptoms. However, there have been no published studies on the use of alternative therapies by African American adults for smoking cessation.

This descriptive, exploratory study has two aims. The first aim is to get a sense of what may be influencing African Americans in their decision making regarding the use of NRT. We will conduct focus groups in several California communities to explore African Americans' percieved obstacles to the use of NRT and to identify any uses of alternative therapies to quit smoking. The second aim is to analyze the data from the focus groups to identify important issues and to develop questions for a culturally appropriate survey. The survey will then be used later in a larger study to measure African American adults' perceived obstacles to the use of NRT and their knowledge of, usage patterns, and perceived effectiveness of NRT and alternative therapies for smoking cessation.

Given the disproportionate burden of tobacco-related diseases that affect African Americans, exploring why they are less likely to use NRT may provide additional insight into the obstacles interfering with smoking cessation. Furthermore, exploring potential uses of alternative therapies may offer even more insight as to how we may better assist African Americans to quit smoking. This project directly addresses recommendations to research why African American smokers are less likely to use conventional tobacco cessation treatments. It will thereby contribute to our knowledge about what we may need to do to reduce the unequal burden of tobacco use and tobacco-related diseases among African Americans.

Tobacco industry knowledge of the role of menthol in chemosensory perception of tobacco smoke.
Periodical: Nicotine and Tobacco Research Index Medicus:
Authors: Krestlake, J., Yerger, V.B. (in press) ART
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