Predictors of smoking reduction among Blacks

Introduction: Blacks who smoke have increased tobacco-related health risks. Cessation decreases the likelihood of many health problems. Smoking reduction may be important in the cessation process and potentially reduce health risks. Methods: Because little is known about specific predictors of smoking reduction, we investigated factors predicting reduction among Black light smokers enrolled in a 26-week cessation trial. Specifically, we compared (a) reducers (reduced cigarettes per day [cpd] ≥50%) with nonreducers and (b) reducers with quitters. Baseline demographic, smoking-related, and psychosocial variables were collected, and Week 26 smoking status was assessed. Results: Among 539 participants, 41.0% (n = 221) reduced their smoking, 17.6% (n = 95) quit, and 41.4% (n = 223) did not reduce their smoking by ≥50%. In comparison with reducers, nonreducers were more likely to have their first cigarette within 30 min of waking (odds ratio [OR] = 2.4, 95% CI = 1.47-3.93), lower baseline cpd (OR = 0.84, 95% CI = 0.77-0.93), higher baseline cotinine levels (OR = 1.002, 95% CI = 1.000-1.003), lower perceived stress (OR = 0.86, 95% CI = 0.78-0.95), and higher Smoking Consequences Questionnaire (SCQ) negative social impression scores (OR = 1.04, 95% CI = 1.01-1.06), after controlling for treatment arm, gender, and age. Significant predictors of smoking cessation versus reduction included lower baseline cpd (OR = 0.85, 95% CI = 0.75-0.95), higher nicotine dependence (OR = 1.47, 95% CI = 1.09-1.98), lower baseline cotinine levels (OR = 0.996, 95% CI = 0.994-0.998), higher body mass index (OR = 1.05, 95% CI = 1.01-1.08), lower perceived stress (OR = 0.82, 95% CI = 0.72-0.95), and higher SCQ negative social impression scores (OR = 1.05, 95% CI = 1.01-1.08). Discussion: Distinct predictors are associated with different trajectories of smoking behavior change (i.e., reduction vs. cessation vs. no change).