**BYLINE:** Kristi Birch
Smoking is a leading cause of health disparities between Black adults and non-Hispanic white adults. Black adults who smoke cigarettes have more hospitalizations, cancer diagnoses, stroke, heart disease and deaths. But there is little research examining the effectiveness of smoking-cessation treatment specifically in Black people.
The University of Kansas Medical Center is partnering with the University of Wisconsin Center for Tobacco Research and Intervention to determine what treatments work best to help Black people to quit smoking. Their research is funded with a $10 million award from the Patient-Centered Outcomes Research Institute. [PCORI](https://www.pcori.org/) is an independent, nonprofit organization authorized by Congress that funds research providing patients, their caregivers and clinicians with the evidence-based information they need to make better-informed health care decisions.
“Despite smoking fewer cigarettes per day on fewer days per month, Black adults are more likely to get sick and die from tobacco-related causes,” said Nikki Nollen, Ph.D., professor of population health at KU Medical Center, co-leader of The University of Kansas Cancer Center's Cancer Prevention and Control research program and a co-investigator on the study. “In addition, due to targeted tobacco industry marketing, over 84% of Black adults who smoke in the United States use mentholated cigarettes, which are more addictive, more harmful and harder to quit.”
This study will examine the effects of three treatment packages for Black adults who want to quit smoking as part of a five-state study (in Arizona, Indiana, Kansas, Virginia and Wisconsin). Participants will be recruited from five metropolitan areas in those states with elevated smoking rates among Black residents: Bloomington, Indiana; Kansas City, Kansas; Milwaukee, Wisconsin; Phoenix, Arizona and Richmond, Virginia. These 1,500 participants will be randomized to one of the three treatment packages: standard, intensive or Intensive incentivized intervention:
* The standard intervention will provide four counseling sessions and two weeks of nicotine patches, similar to a typical state-run quitline.
* The intensive intervention will provide eight weeks of nicotine patches, eight culturally specific counseling sessions (participants can choose whether to have in-person group counseling or individual phone counseling) and access to the Pathways to Freedom video (a video designed to help Black adults quit smoking) on the study website.
* The intensive incentivized intervention will be the same as the Intensive Intervention and will also provide up to $50 in incentives for participants to attend counseling sessions.
These three treatment packages were selected because the individual components have been shown to be effective among Black adults trying to quit smoking and because the study’s Community Advisory Board (CAB), with feedback from focus groups of Black adults who smoke, deemed them to be acceptable and feasible.
“This multisite trial will be the largest comparative effectiveness study, to-date, of smoking cessation treatments for Black adults who smoke. The thoughtful consideration that went into selecting treatments that can be accessed in non-clinical settings at no or minimal cost enhances the ability to translate the study’s findings into ‘real-world’ settings,” said Nollen.
The goal of this research is to determine whether the culturally specific interventions being tested in this study will increase quit rates relative to the standard evidence-based intervention. These treatments will not be provided in clinical settings, but rather in the participants’ everyday lives. The study also will investigate the best ways to engage Black adults in these low-barrier treatments.
“Being Black in America is associated with significant smoking-related health inequities,” said Megan Piper, Ph.D., co-director of research at the University of Wisconsin Center for Tobacco Research and Intervention and a principal investigator on the study.
“This project was selected for PCORI funding not only for its scientific merit and commitment to engaging patients and other health care stakeholders, but also for its conduct in real-world settings,” said PCORI Executive Director Nakela Cook, M.D., MPH. “It has the potential to answer an important question about what treatments work best to empower Black people to quit smoking and fill a crucial evidence gap.”