title: Race and Medication Adherence Moderate Cessation Outcomes in Criminal Justice Smokers.
abstract: BACKGROUND
  Smokers in the criminal justice system represent some of the most disadvantaged smokers in the U.S., as they have high rates of smoking (70%-80%) and are primarily uninsured, with low access to medical interventions. Few studies have examined smoking-cessation interventions in racially diverse smokers, and none have examined these characteristics among individuals supervised in the community. The purpose of this study is to determine if four sessions of standard behavioral counseling for smoking cessation would differentially aid smoking cessation for African American versus non-Hispanic white smokers under community corrections supervision.
  
  
  METHODS
  An RCT.
  
  
  METHODS
  Five hundred smokers under community corrections supervision were recruited between 2009 and 2013 via flyers posted at the community corrections offices.
  
  
  METHODS
  All participants received 12 weeks of bupropion plus brief physician advice to quit smoking. Half of the participants received four sessions of 20-30 minutes of smoking-cessation counseling following tobacco treatment guidelines, whereas half received no additional counseling.
  
  
  METHODS
  Generalized estimating equations were used to determine factors associated with smoking abstinence across time. Analyses were conducted in 2014.
  
  
  RESULTS
  The end-of-treatment abstinence rate across groups was 9.4%, with no significant main effects indicating group differences. However, behavioral counseling had a differential effect on cessation: whites who received counseling had higher quit rates than whites who did not receive counseling. Conversely, African Americans who did not receive counseling had higher average cessation rates than African Americans who received counseling. Overall, medication-adherent African American smokers had higher abstinence rates relative to other smokers.
  
  
  CONCLUSIONS
  Racial disparities in smoking cessation are not evident among those who are adherent to medication. More research is needed to better understand the differential effect that behavioral counseling might have on treatment outcomes between white and African American smokers under community corrections supervision.
authors.affiliation: Department of Psychiatry. Electronic address: kcropsey@uab.edu.
authors.forename: Karen L
authors.initials: KL
authors.lastname: Cropsey
authors.affiliation: Department of Psychiatry.
authors.forename: C Brendan
authors.initials: CB
authors.lastname: Clark
authors.affiliation: Samuel Oschin Comprehensive Cancer Institute at Cedars-Sinai, West Hollywood, California;
authors.forename: Xiao
authors.initials: X
authors.lastname: Zhang
authors.affiliation: School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Peter S
authors.initials: PS
authors.lastname: Hendricks
authors.affiliation: Division of Psychiatry, Roper St. Francis Hospital, Charleston, South Carolina.
authors.forename: Bianca F
authors.initials: BF
authors.lastname: Jardin
authors.affiliation: Department of Psychiatry.
authors.forename: Adrienne C
authors.initials: AC
authors.lastname: Lahti
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D016642:Bupropion / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003376:Counseling / Q000379:methods*; D057237:Criminals; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000208:ethnology; D008875:Middle Aged; D016540:Smoking Cessation / Q000208:ethnology / Q000379:methods*; D000074606:Smoking Prevention; D016896:Treatment Outcome; D014481:United States; D044465:White People / Q000706:statistics & numerical data; D016903:Drug Monitoring
chemical_list: D016642:Bupropion