The negative impact of smoking is disproportionately affecting African-American smokers.
Although smoking is a prevalent health concern in the larger U.S. population, commercial tobacco use has disproportionately affected the African-American community in particular. The CDC’s report on smoking rates notes that tobacco has led to health inequities for African-American smokers, mainly due to tobacco companies targeting and exploiting this demographic. While African-Americans start smoking at an older age than other racial and ethnic groups, they are unfortunately more likely to experience premature death and disease.
Among these smoking-related diseases is high blood pressure or hypertension, with a previous post reporting that hypertension occurs among African-Americans at an earlier age and often with greater severity. However, many African-American adult smokers fail to address smoking as a risk factor for health problems through quitting and transforming their lifestyles. Fortunately, the rise of the following tailored cessation interventions has contributed greatly to reducing smoking-related disease and mortality in African-American populations.
Culturally tailored behavioural strategies
The previously linked report by the CDC also points out that although the majority of African-American smokers who reported that they want to quit, they usually encounter systemic barriers when accessing cessation services. These barriers include not receiving clinical advice to quit smoking and lacking health insurance to cover evidence-based cessation treatment. Meanwhile, the national network of state quit lines available through 1-800-QUIT-NOW remains underutilized by African-American smokers because it does not address their distinctive smoking patterns, quitting motives, and cultural values.
In light of this need for tailored, culturally appropriate behavioural interventions, the National Cancer Institute developed the Self-Help Intervention for African-American Smokers. It promotes quit-smoking strategies through a Pathways to Freedom cessation guide combined with telephone counselling to establish participants’ personalized quitting and maintenance plans. The intervention has been linked to higher quit attempts and higher rates of maintaining seven-day smoking abstinence among African-American young adults, adults, and seniors who smoke.
In addition to behavioural interventions, African-Americans can also utilize pharmacotherapy for smoking cessation. This comes in the form of prescription medicines that interfere with the nicotine receptors in the brain or nicotine replacement therapy (NRT) that relieves cravings and withdrawal symptoms by supplying fixed nicotine doses into the body. A JAMA Network Open article found that using the prescription drug Chantix with NicoDerm nicotine patches can help African-American adults achieve later abstinence, as long as they combine the pharmacotherapy adaptations within the first two weeks of treatment.
However, since prescription quit-smoking medications can be challenging to access due to cost and access to health providers, African-American adult smokers also have the option to combine transdermal patches with other over-the-counter NRTs, such as pouches that provide an oral nicotine delivery. Among the best-selling oral NRTs in the U.S. are nicotine pouches due to how they replicate popular tobacco products. For instance, Prilla sells ZYN spearmint nicotine pouches that have a similar flavor profile to menthol cigarettes. As per a report on a National Survey on Drug Use and Health, 85 percent of African-American smokers preferred menthol cigarettes. Aside from a satisfying nicotine experience that’s not as strong as peppermint or cool mint, these pouches encourage long-term abstinence with their discreet, tobacco-free properties.
Lastly, the rise of mobile health (mHealth) technology has also boosted the uptake of cessation services among African-American smokers, especially those from low-income backgrounds. Since mHealth tools like the iQuit Mindfully text messaging program are free and automated, users can easily access mindfulness-based cessation strategies and reminders when needed. They can also set their preferred frequency, timing, and message content to address common cessation barriers such as intense cravings, stress, and slip-ups. Overall, text messages from the iQuit Mindfully program allow low-income African-American smokers to receive continuous support and motivation throughout their cessation journey.
With the wide range of cessation options exemplified above, health experts recommend complementing behavioural approaches like therapy and counselling with pharmacotherapy for improved chances of success. State governments and health departments must also continue to make greater efforts in increasing African-American communities’ awareness of and access to said services to better encourage them to quit and live smoke-free lifestyles.