Minority Smokers Had Less Success Than Whites With Same Quit Smoking Regimen

February 22, 2008

Evidence Points to Need for Targeted Cessation Methods

NEW YORK – (Feb. 22, 2008) Minority smokers had lower rates of response to the same smoking cessation treatments than White smokers in a large scale study designed to assess whether there were differences in effective stop smoking treatments for African-Americans, Hispanics and Whites. The study, published in the winter issue of the journal Ethnicity & Disease, shows the need for continued research into why these disparities continue to persist. Individuals from non-White racial and ethnic groups have been shown in previous research to have higher rates of tobacco-related diseases.

Lirio Covey, Ph.D. “We evaluated a large number of minorities in this trial,” said the study’s lead author Lirio Covey, Ph.D., associate professor of clinical psychology (in Psychiatry) at Columbia University Medical Center and director of the Smoking Cessation Program at the New York State Psychiatric Institute. “Our analysis implies that the burden of tobacco related illness may continue to fall disproportionately on minority racial and ethic groups; it also challenges current assumptions that the same approaches can be applied to all smokers. In order for successful smoking cessation to occur, treatment must be tailored to specific population groups based on better knowledge of these groups.”

In this study, 559 smokers (126 African-Americans, 73 Hispanics and 360 Whites) received eight weeks of treatment with established smoking cessation aids: buproprion, nicotine patch, and individual counseling. Bupropion was initially approved by the U.S. Food and Drug Administration for treating depression (brand name Wellbutrin); and subsequently FDA- approved for smoking cessation (brand name Zyban). Approximately 60 percent of Whites achieved the end goal of four weeks of continuous abstinence during the last four weeks of treatment, while 38 percent of African-Americans were successful and 41 percent of Hispanics were successful.

Exact mechanisms for these differences in treatment outcomes were not able to be pinpointed in this study. However, study investigators did identify factors specific to ethnic differences that could serve as guides for tailored interventions. In African-Americans, quitting occurred less frequently among participants with lower body mass index and a household member who smoked. Interventions aimed at educating this population with accurate information about weight and weight gain as related to stopping smoking and at restricting smoking within the household may be effective strategies in this population. For Hispanics, age was a significant predictor in that those who were older were more successful at quitting, a possible indicator of cohort-related differences in attitudes towards smoking. Interventions with specific messages for different age groups within the Hispanic population may be relevant. Early quitting was a strong predictor of success in all races and ethnicities measured, underscoring the need for smokers to get help in quitting with efficacious treatment methods such as those used in this study as soon as possible.

“Our hope is that this study will be an important piece of empirical evidence showing that individuals from different racial and ethnic groups may not respond uniformly to tobacco cessation treatments,” said Dr. Covey. “These results call for targeted treatment programs for specific populations, so that disease and deaths from smoking related illnesses are prevented in all racial and ethnic groups.”

Study medications were donated by GlaxoSmithKlne, Inc. This study was supported by the National Institute on Drug Abuse (NIDA). - ### -

Columbia University Medical Center provides international leadership in basic, pre-clinical and clinical research, in medical and health sciences education, and in patient care. The medical center trains future health care leaders at the College of Physicians & Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. Established in 1767, Columbia’s College of Physicians & Surgeons was the first in the country to grant the M.D. degree. CUMC is home to the largest medical research enterprise in New York state and one of the largest in the United States. Visit www.cumc.columbia.edu.

Columbia Psychiatry is ranked among the best departments and psychiatric research facilities in the nation and has contributed greatly to the understanding of and current treatment for psychiatric disorders including depression, suicide, schizophrenia, bipolar and anxiety disorders, and childhood psychiatric disorders. Located at the New York State Psychiatric Institute on the NewYork-Presbyterian Hospital/Columbia University Medical Center campus in the Washington Heights community of Upper Manhattan, the department enjoys a collaborative relationship with physicians in various disciplines at Columbia University’s College of Physician and Surgeons. Visit http://columbiapsychiatry.org/.

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African Americans, FDA, Lirio Covey, Physicians Surgeons, Upper Manhattan