Researchers at The University of Kansas Cancer Center have received a five-year National Institutes of Health R0-1 grant to compare and evaluate the efficacy of optimized versus non-optimized tobacco cessation approaches for African American smokers.
African Americans suffer tremendous tobacco-related morbidity and mortality despite their tendency to smoke fewer cigarettes per day and begin smoking later in life. They are, however, less likely to quit smoking, exposing themselves to smoke for a longer period of life. Smoking is linked to about 80 to 90 percent of all lung cancer cases, and African Americans suffer from lung cancer more than any other population in the U.S.
Nikki Nollen, PhD, principal investigator for the study, is a member of KU Cancer Center's Cancer Control & Population Health research program, which was developed to identify better ways to bring cancer control efforts into high-risk and underserved communities, including African Americans.
Dr. Nollen was drawn to this research because she observed in both smoking cessation studies and in clinical practice, when smokers are provided a medication to help them quit, they are generally expected to continue that medication regardless of how well it is working.
"I've witnessed smokers in previous trials experience difficulties with their medications very early on, and the vast majority of these patients never fully quit. Asking a smoker to continue taking a medication not working for them seems counterintuitive to me," Dr. Nollen said. "Imagine if this was the approach to managing hypertension, diabetes or virtually any other chronic disease."
"What if," she asks, "the effectiveness of the tobacco cessation approach was monitored and then modified accordingly throughout treatment?"
To test this theory, nearly 400 African American smokers will be treated using one of two smoking cessation approaches. One group will receive an optimized therapy that is adjusted based on the smoker's success in abstaining from tobacco use. They will receive smoking cessation counseling, a nicotine patch and up to two pharmacotherapy medications based on verified smoking status at weeks two and six. Participants who effectively quit on the current medication will continue on that medication. Participants who are still smoking will be switched to a different medication.
The other group will receive the same smoking cessation counseling and a nicotine patch for the duration of the study.
"Our 12-week study will evaluate a major shift in the approach to tobacco dependence treatment and, if effective, could have broad treatment implications for the nearly six million African American adult smokers in the United States," Dr. Nollen said.