Predictors of adherence to nicotine gum and counseling among African-American light smokers.
BACKGROUND
A high proportion of African-American smokers are light smokers, and they experience low smoking cessation rates and disproportionately high tobacco-related morbidity; yet no studies have examined tobacco treatment adherence in this group.


OBJECTIVE
To determine the predictors of adherence to nicotine gum and counseling among African-American light smokers (defined as smoking < or =10 cigarettes/day), and the effects of adherence on smoking cessation.


METHODS
Data were from a 2 x 2 randomized, placebo-controlled smoking cessation trial of nicotine gum (2 mg versus placebo) and counseling (motivational interviewing versus health education).


METHODS
Seven hundred fifty-five African-American light smokers at a community-based clinic.


METHODS
Demographic and health-related information, smoking behaviors, psychosocial variables, adherence to nicotine gum and counseling, and cotinine-verified 7-day abstinence from smoking at week-26 follow-up.


RESULTS
A logistic regression model showed that having a higher body mass index (OR = 1.03, 95% CI = 1.01 to 1.05), more quit attempts in the past year (OR = 1.04, 95% CI = 1.01 to 1.07), higher baseline exhaled carbon monoxide (OR = 1.22, 95% CI = 1.01 to 1.48), and higher perceived stress (OR = 1.12, 95% CI = 1.03 to 1.22) increased the likelihood of adherence to nicotine gum. Being a high school graduate was a predictor of adherence to counseling (OR = 1.58, 95% CI = 1.02 to 2.44). Surprisingly, being adherent to nicotine gum significantly reduced the odds of smoking cessation (OR = 0.50, CI = 0.28 to 0.87). On the other hand, adherence to counseling dramatically increased the likelihood of smoking cessation (OR = 3.32, CI = 1.36 to 8.08).


CONCLUSIONS
Individual risk factors may influence adherence to nicotine gum and counseling. Improving psychological interventions and promoting adherence to counseling may increase overall smoking cessation success among African-American light smokers.
Okuyemi
Kolawole S
KS
Program in Health Disparities Research, University of Minnesota Medical School, Minneapolis, MN, USA. kokuyemi@umn.edu
Zheng
Hui
H
Guo
Hongfei
H
Ahluwalia
Jasjit S
JS
D000328:Adult; D001741:Black or African American; D001521:Behavior Therapy; D015992:Body Mass Index; D002638:Chewing Gum; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000208:ethnology*; D008875:Middle Aged; D009538:Nicotine / Q000627:therapeutic use*; D018722:Nicotinic Agonists / Q000627:therapeutic use*; D016017:Odds Ratio; D010919:Placebos; D012907:Smoking / Q000208:ethnology; D016540:Smoking Cessation / Q000208:ethnology* / Q000379:methods / Q000523:psychology; D000074606:Smoking Prevention; D017211:Treatment Failure
D002638:Chewing Gum; D018722:Nicotinic Agonists; D010919:Placebos; D009538:Nicotine