Predictors of adherence to nicotine gum and counseling among african-american light smokers

Kola Okuyemi, Hui Zheng, Hongfei Guo, Jasjit S Ahluwalia

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

Abstract

BACKGROUND: A high proportion of African-American smokers are light smokers, and they experience low smoking cessation rates and disproportionately high tobacco-related morbidity; yet no studies have examined tobacco treatment adherence in this group. OBJECTIVES: To determine the predictors of adherence to nicotine gum and counseling among African-American light smokers (defined as smoking ≤10 cigarettes/day), and the effects of adherence on smoking cessation. DESIGN: Data were from a 2 × 2 randomized, placebo-controlled smoking cessation trial of nicotine gum (2 mg versus placebo) and counseling (motivational interviewing versus health education). PARTICIPANTS: Seven hundred fifty-five African-American light smokers at a community-based clinic. MEASUREMENTS: Demographic and health-related information, smoking behaviors, psychosocial variables, adherence to nicotine gum and counseling, and cotinine-verified 7-day abstinence from smoking at week-26 follow-up. RESULTS: A logistic regression model showed that having a higher body mass index (OR = 1.03, 95% CI = 1.01 to 1.05), more quit attempts in the past year (OR = 1.04, 95% CI = 1.01 to 1.07), higher baseline exhaled carbon monoxide (OR = 1.22, 95% CI = 1.01 to 1.48), and higher perceived stress (OR = 1.12, 95% CI = 1.03 to 1.22) increased the likelihood of adherence to nicotine gum. Being a high school graduate was a predictor of adherence to counseling (OR = 1.58, 95% CI = 1.02 to 2.44). Surprisingly, being adherent to nicotine gum significantly reduced the odds of smoking cessation (OR = 0.50, CI = 0.28 to 0.87). On the other hand, adherence to counseling dramatically increased the likelihood of smoking cessation (OR = 3.32, CI = 1.36 to 8.08). CONCLUSIONS: Individual risk factors may influence adherence to nicotine gum and counseling. Improving psychological interventions and promoting adherence to counseling may increase overall smoking cessation success among African-American light smokers.

Original languageEnglish (US)
Pages (from-to)969-976
Number of pages8
JournalJournal of general internal medicine
Volume25
Issue number9
DOIs
StatePublished - Sep 1 2010

Keywords

  • African American
  • counseling
  • nicotine gum
  • smoking cessation

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