Racial/Ethnic Disparities in the Use of Nicotine Replacement Therapy and Quit Ratios in Lifetime Smokers Ages 25 to 44 Years

Abstract

We examined racial/ethnic variations in the use of nicotine replacement therapy (NRT) and quit ratios among Caucasian, African American, Asian, and Latino lifetime smokers ages 25 to 44 years. We conducted cross-sectional analyses using data from individuals (n = 27,031) screened for enrollment in the Collaborative Study of the Genetics of Nicotine Dependence. Participants were randomly sampled from three Midwestern metropolitan areas using Health Maintenance Organization membership lists in Detroit, MI and Minneapolis, MN and a driver's license registry in St. Louis, MO from March 2003 to August 2005. A telephone survey collected information on smoking history, previous quit attempts, and sociodemographic characteristics. Among lifetime smokers (n = 9,216), univariate analysis indicated that African Americans (22%) and Latinos (22%) were significantly less likely to report having ever used NRT for smoking cessation than Caucasians (31%).Asians (22%) also reported lower rates of using NRT than Caucasians, but this difference was marginally significant (P = 0.06). These disparities persisted in multivariate analysis for African Americans [adjusted odds ratio (OR), 0.76; 95% confidence interval (95% CI), 0.63-0.91; P < 0.01] but not for Latinos (adjusted OR, 0.76; 95% CI, 0.54-1.06; P = 0.11) or Asians (adjusted OR, 0.98; 95% CI, 0.60-1.60; P = 0.95). As measured by the quit ratio, African Americans (35%) were less likely to have quit smoking than Caucasians (52%). This disparity persisted in multivariate logistic regression (adjusted OR, 0.66; 95% CI, 0.56-0.78; P < 0.001). Asian and Latino smokers were as likely as Caucasians to report smoking cessation. Future prospective studies are needed to assess whether lower utilization of cessation treatments such as NRT contribute to the observed disparity in quit ratios for African Americans. (Cancer Epidemiol

Evaluating the Effect of Access to Free Medication to Quit Smoking: A Clinical Trial Testing the Role of Motivation

“…Expanding the reach of our sampling-based intervention to racial and ethnic minority smokers of low socioeconomic status is important given that tobacco-related health disparities persist and are partly driven by the low rates of use of cessation medication (Fu et al, 2008;Houston, Scarinci, Person, & Greene, 2005;Levinson, Pérez-Stable, Espinoza, Flores, & Byers, 2004). Similarly, applying this intervention to smokers with cooccurring psychiatric disorders and/or chronic illnesses holds great promise.…”

Sex differences in TTC12/ANKK1 haplotype associations with daily tobacco smoking in Black and White Americans

“…The recruitment and survey techniques and population-based sampling methods and participant characteristics of the W3 and W4 samples, as well as the methods of biospecimen and DNA preparation from this sample and the participant characteristics of those who provided biospecimens, are described in detail elsewhere (Eaton et al, 2007;Fu, Kodl, et al, 2008;Mezuk et al, 2008;Regier et al, 1984). We note that the original 1981 sample was weighted heavily with elderly (age ≥65 years) residents due to deliberate oversampling for research on late-life disorders (1,086 elderly among 3,481 participants); by 2005, many of the elderly had died.…”

“…Biospecimen collection procedures-involving primarily phlebotomy for whole blood and buccal samples from those participants unable or unwilling to undergo phlebotomy-and DNA preparation and quantification are described elsewhere (Fu, Kodl, et al, 2008;Mezuk et al, 2008). Separate consent forms were used for the survey, the collection of blood samples, and collection of buccal samples (Mezuk et al).…”

“…Among the many nongenetic factors that may contribute to observed differences in smoking prevalence between Blacks and Whites are differences in menthol cigarette consumption, tobacco industry marketing practices, and access to smoking prevention and cessation services (CDC, 1998;Fu, Burgess, et al, 2008;Fu, Kodl, et al, 2008;Kendzor et al, 2008;Primack, Bost, Land, & Fine, 2007).…”

Personalized Medicine and Tobacco-Related Health Disparities: Is There a Role for Genetics?

“…Smokers in the United States with less education and lower socioeconomic status (SES) are just as likely to try quitting-40% to 50% of smokers regardless of SES made an attempt in 2000-but they are substantially less likely to succeed. 49,50 Important reasons for this disparity include differences in the reach of community-based measures and in access to proven aids to quitting, such as counseling and medications, 51 as well as certain market forces and community norms that undermine efforts which might otherwise be effective in this population. For example, illegal street sales of less-expensive, untaxed tobacco products rose in lowincome neighborhoods in New York City after excise tax increases, and low-SES smokers have been found to be less responsive to media campaigns promoting smoking cessation than smokers of higher SES.…”