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.


METHODS
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.
Webb
Monica S
MS
Department of Psychology.
de Ybarra
Denise Rodríguez
DR
Department of Psychology.
Baker
Elizabeth A
EA
Department of Psychology.
Reis
Isildinha M
IM
Department of Epidemiology and Public Health.
Carey
Michael P
MP
Department of Psychology.
D000279:Administration, Cutaneous; D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000368:Aged; D016009:Chi-Square Distribution; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006266:Health Education; D006801:Humans; D057194:Intention to Treat Analysis; D008297:Male; D008875:Middle Aged; D009538:Nicotine / Q000627:therapeutic use; D016017:Odds Ratio; D011615:Psychotherapy, Group / Q000379:methods; D016540:Smoking Cessation / Q000208:ethnology / Q000379:methods*; D011795:Surveys and Questionnaires; D014029:Tobacco Use Disorder / Q000208:ethnology / Q000628:therapy*; D016896:Treatment Outcome
D009538:Nicotine