Acculturation predicts 7-day smoking cessation among treatment-seeking African-Americans in a group intervention.

BACKGROUND: African-Americans suffer disproportionately from tobacco-associated morbidity and mortality. Considering the relationship between cultural variables and cessation may be important for reducing disparities. PURPOSE: This study aimed to examine acculturation as a predictor of smoking cessation following a standard group intervention. METHODS: Treatment-seeking smokers (N = 140) participated in a group intervention for cessation plus transdermal nicotine patch therapy and completed the African American Acculturation Scale-Revised at baseline. The primary outcome was self-reported 7-day point prevalence abstinence at the end-of-counseling and 3 and 6 months postintervention. RESULTS: Adjusted logistic regression analyses found that acculturation predicted end-of-counseling and 3-month 7-day point prevalence abstinence; traditional African-Americans (i.e., less acculturated) were less likely to quit smoking. Cultural superstitions, religious beliefs and practices, and interracial attitudes were predictive of smoking cessation. CONCLUSIONS: Acculturation was associated with cessation following a group-based intervention. Culturally specific adaptations to established interventions might improve outcomes for traditional smokers.

Cognitive-behavioral therapy to promote smoking cessation among African American smokers: a randomized clinical trial.

OBJECTIVE: The health consequences of tobacco smoking disproportionately affect African Americans, but research on whether efficacious interventions can be generalized to this population is limited. This study examined the efficacy of group-based cognitive-behavioral therapy (CBT) for smoking cessation among African Americans. METHOD: Participants (N = 154; 65% female, M = 44 years old, mean cigarettes/day = 13) were randomly assigned to either (a) group CBT or (b) group general health education (GHE). Participants in both conditions received 6 sessions of counseling and 8 weeks of transdermal nicotine patches. The primary outcome variable was 7-day point prevalence abstinence (ppa), assessed at the end of counseling (2 weeks) and at 3- and 6-month follow-ups. Secondary outcomes included 24-hr ppa and 28-day continuous abstinence (assessed at 3 and 6 months). RESULTS: Intent-to-treat analyses demonstrated the hypothesized effects, such that 7-day ppa was significantly greater in the CBT than the GHE condition at the end of counseling (51% vs. 27%), at 3 months (34% vs. 20%), and at 6 months (31% vs. 14%). Results of a generalized linear mixed model demonstrated a significant effect of CBT versus GHE on 7-day ppa (odds ratio = 2.57, 95% CI [1.40, 4.71] and also an effect of time (p < .002). The Condition x Time interaction was not significant. Similar patterns of results emerged for 24-hour ppa and 28-day continuous abstinence. Results from per protocol analyses (i.e., participants who completed all aspects of the study) corroborate the intent-to-treat findings. CONCLUSIONS: These results demonstrate that intensive, group CBT smoking cessation interventions are efficacious among African American smokers.