Minority Smokers Less Likely to Try Nicotine Patch, Gum

Quitting Smoking and Race

Hispanic and African-American smokers are less likely than white smokers to try nicotine replacement therapies when they want to quit smoking, according to a new study of men receiving care from the Veterans Health Administration. The VA system provided a unique venue for the study, because enrollees receive medical care and prescription drugs at little or no cost.

"We can be a little more confident that the ethnic differences we observed are less likely to be related to health insurance and cost," said lead author Steven Fu, M.D., of the Veterans Affairs Medical Center in Minneapolis.

The study also ruled out demographic, physical, psychological and facility differences that might have accounted for the lower use of quitting aids such as the nicotine patch or gum. Use of such medications can double long-term quit rates.

"Infrequent use of NRT by ethnic minority smokers represents a missed opportunity to achieve successful smoking cessation," note the authors. Minorities suffer disproportionately from tobacco use and tobacco-related illness and death, according to the study.

The study, in the November-December issue of the American Journal of Health Promotion, included 1,606 male smokers treated by the VA in New Mexico, Arizona, Nevada, Texas and California.

While 50 percent of white participants reported that they had tried nicotine replacement therapy when trying to kick the habit, only 34 percent of African-Americans and 26 percent of Hispanics said the same. There were not enough members of other ethnic groups to gather meaningful data on their behavior, say the authors.

Fu and colleagues point out that the study relied on smokers' own reports of their quit attempts, which may not always be accurate. Also, the focus on male veterans means that the study findings may not apply to women and the general population.

The study points to a need for further research on why ethnic minority smokers are less likely to use tobacco treatments, says Fu. "It could be patient-level factors, provider-level factors or system-level factors. There are a lot more questions than answers on how to tailor smoking-cessation programs for diverse groups."

Another key area for future research is in relapse prevention, according to Arnold Levinson, a specialist in smoking prevention and control at the University of Colorado.
Patches and gum only help smokers through the first few months of nicotine withdrawal, he says.

"The lifestyle of a smoker is entwined with smoking in many more ways than nicotine," Levinson said. "The research that's going on now around relapse prevention is critical."