title: Tobacco-Related Health Disparities Across the Cancer Care Continuum.
abstract: BACKGROUND
  Use of tobacco is the leading preventable cause of death in the United States. Racial/ethnic minorities and individuals of low socioeconomic status disproportionately experience tobacco-related disease and illness. Unique challenges and circumstances exist at each point in the cancer care continuum that may contribute to the greater cancer burden experienced by these groups.
  
  
  METHODS
  We reviewed tobacco-related disparities from cancer prevention to cancer survivorship. We also describe research that seeks to reduce tobacco-related disparities.
  
  
  RESULTS
  Racial/ethnic minorities and low-income individuals experience unique social and environmental contextual challenges such as greater environmental cues to smoke and greater levels of perceived stress and social discrimination. Clinical practice guidelines support the effectiveness of pharmacotherapy and behavioral counseling for racial and ethnic minorities, yet smoking cessation rates are lower in this group when compared with non-Hispanic whites. Superior efficacy for culturally adapted interventions has not yet been established.
  
  
  CONCLUSIONS
  To reduce health disparities in this population, a comprehensive strategy is needed with efforts directed at each point along the cancer care continuum. Strategies are needed to reduce the impact of contextual factors such as targeted tobacco marketing and social discrimination on smoking initiation and maintenance. Future efforts should focus on increasing the use of evidence-based cessation treatment methods and studying its effectiveness in these populations. Attention must also be focused on improving treatment outcomes by reducing smoking in diverse racial and ethnic patient populations.
authors.affiliation: Health Outcomes and Behavior Program, Moffitt Cancer Center, Tampa, FL, USA. Vani.Simmons@Moffitt.org.
authors.forename: Vani Nath
authors.initials: VN
authors.lastname: Simmons
authors.forename: Barbara
authors.initials: B
authors.lastname: Pineiro
authors.forename: Monica Webb
authors.initials: MW
authors.lastname: Hooper
authors.forename: Jhanelle E
authors.initials: JE
authors.lastname: Gray
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Brandon
mesh_terms: D003266:Continuity of Patient Care / Q000592:standards*; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000628:therapy*; D014026:Nicotiana