New research published in the American Journal of Health Promotion shows that population-based approaches to smoking cessation -- including mass media campaigns and smoking quit lines -- can positively impact quitting behaviors among racial/ethnic minority and low socioeconomic status (SES) smokers, with varying effects across these groups (May/June 2011, Vol. 25:sp5, pp. S1-S4).
As part of a special issue entitled "Tobacco Control Among Diverse Populations," the journal published 15 papers that provide insight into how to effectively reduce tobacco's impact on diverse populations who are disproportionately affected by tobacco use. Researchers looked at the use and efficacy of various evidence-based interventions among diverse populations, including African Americans and Hispanics.
"We still have a lot to learn about how to reduce tobacco's impact on diverse populations in the U.S.," said Pebbles Fagan, PhD, MPH, health scientist in the Tobacco Control Research Branch of National Cancer Institute. "This research serves to identify ways in which public health can successfully reach out to racial/ethnic minorities and low SES populations who are more burdened with smoking-related diseases and death."
Socioeconomic differences, historical factors, and cultural practices, as well as aggressive marketing by the tobacco industry, have all contributed to a higher rate of tobacco use and related disease in certain populations, the researchers noted. For example, African Americans experience higher rates of lung cancer although they tend to smoke fewer cigarettes per day than other groups. Those with less than a high school education have higher smoking rates and lower quit rates than smokers with a high school degree or higher.
One study in the special issue confirmed that exposure to a national cessation campaign, EX, developed by Legacy, increased cessation-related attitudes among Hispanics and smokers with less than a high school education. Furthermore, exposure to EX was associated with increased quit attempts among African Americans and smokers with less than a high school education. The data indicates that mass media campaigns, when designed for racial/ethnic minorities and low SES groups, can help facilitate quitting.
"The data are extremely useful for planning national cessation campaigns like EX, as well as other population-based tobacco interventions. We want to be sure we can reach as many smokers as possible with evidence-based methods, especially those who are most at risk for tobacco-related health consequences," said Donna Vallone, PhD, MPH, senior vice president for research and evaluation at Legacy.
Another study in the special issue examined 18 years of data from the California Smokers' Helpline. That study found that African-American adult smokers had higher quit line utilization rates as compared with white adult smokers in California.
"Telephone counseling is free and convenient, provides a degree of anonymity for participants, and can encourage program utilization among those who would not normally seek help," said Shu Hong Zhu, PhD, a professor in the department of family and prevention medicine at the University of California, San Diego.
This study also found that, compared with whites, African Americans who called the quit line reported higher rates of awareness of the quit line from mass media campaigns.
"The papers in this special issue further reinforce the importance of appreciating within group, as well as between group differences in smoking and cessation patterns," said Kenneth Resnicow, PhD, a professor at the University of Michigan School of Public Health. "For example, Asian and Hispanic-American ethnic groups have unique smoking and quitting patterns based on country of origin and acculturation. Accounting for within group differences can better inform future prevention and cessation efforts in sociodemographic and cultural subgroups."
