The effects of nicotine gum and counseling among African American light smokers: A 2 x 2 factorial design

Jasjit S. Ahluwalia, Kolawole Okuyemi, Nicole Nollen, Won S. Choi, Harsohena Kaur, Kim Pulvers, Matthew S. Mayo

Research output: Contribution to journalArticlepeer-review

148 Scopus citations


Aim: Approximately 50% of African American smokers are light smokers (smoke ≤ 10 cigarettes a day). The prevalence of light smoking in the United States is increasing, yet there has not been a single smoking cessation clinical trial targeting light smokers. The purpose of this 2 × 2 factorial, randomized clinical trial was to evaluate the efficacy of nicotine gum (2 mg versus placebo) and counseling (motivational interviewing versus health education) for African American light smokers. Design: Participants were assigned randomly to one of four study arms: 2 mg nicotine gum plus health education (HE); 2 mg nicotine gum plus motivational interviewing (MI); placebo gum plus HE; and placebo gum plus MI. Participants and setting: A total of 755 African American light smokers (66% female, mean age = 45) were enrolled at a community health center over a 16-month period. Intervention and measurements: Participants received an 8-week supply of nicotine gum and six counseling sessions during the course of the 26-week study. Biochemical measures included expired carbon monoxide (CO) and serum and salivary cotinine. Findings: Seven-day quit rates for nicotine gum were no better than for the placebo group (14.2% versus 11.1%, P = 0.232) at 6 months. However, a counseling effect emerged, with HE performing significantly better than MI (16.7% versus 8.5%, P < 0.001). These results were consistent across outcome time-points (weeks 1, 8, and 26). Conclusions: Results highlight the potential positive impact of directive information and advice-oriented counseling on smoking cessation. Studies are needed to assess other interventions that may further improve quit rates among African American light smokers who are motivated to quit.

Original languageEnglish (US)
Pages (from-to)883-891
Number of pages9
Issue number6
StatePublished - Jun 2006


  • African American
  • Health education
  • Motivational interviewing
  • Nicotine replacement
  • Smoking


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