Community support may improve chances of African-American smokers quitting

Trusting neighbors and community may aid smoking cessation in African-American smokers, accordingly to a study published in the Annals of Behavioral Medicine, a publication of the Society of Behavioral Medicine.

MD Anderson researchers collected data from 397 African-Americans seeking treatment to quit smoking to determine if there was a significant relationship between social cohesion and smoking cessation. The study examined if social cohesion -- the self-reported connectedness and trust felt between neighbors -- was directly linked to smoking abstinence in African-American smokers actively trying to quit, and if psychosocial mediators played a role in those relations.

"We know from previous research that despite later smoking initiation and a lower rate of smoking, African-American smokers are more likely to develop smoking-related diseases and to die from them than are Caucasians," said Lorraine Reitzel, Ph.D., assistant professor in the Department of Health Disparities Research at MD Anderson Cancer Center. "Investigating factors that affect smoking cessation within this population is important to increase our understanding of how to reduce smoking-related health disparities among this group."

More than 45,000 African-Americans die in the United States from smoking related cancers per year.

Pre-quit, quit-day and post-quit

Participants were followed over a six-month period during three stages of the study: pre-quit, quit-day and post-quit. During the first stage, data was collected on demographics including educational level and employment status, as well as tobacco dependence, so that known effects of these things on smoking cessation could be controlled for in the data analyses.

Social cohesion was also assessed during the pre-quit stage. Participants were asked to share their personal belief about their neighbors' trustworthiness, community support and shared community values.

"Social cohesion is thought to provide a protective influence on health and have a positive effect on health-related behaviors," said Reitzel.

During the second stage participants followed the plan to quit smoking on a specific date, with assistance that included the provision of self-help materials, brief cessation counseling sessions and nicotine replacement therapy. Then researchers investigated the connection between social cohesion and continuous smoking abstinence after the quit day, as well as the extent to which four l factors - social support, positive affect, negative affect and stress - accounted for this connection.

"There has been no research examining the relationship between social cohesion and smoking-cessation while the smokers were actively trying to quit," said Reitzel. "This is the first study working with this population group that examines these relations in the context of a specific quit attempt."

Quitting sticks when neighborly connections are strong

The study found that among African-American smokers trying to quit, stronger bonds with neighbors had positive effects on social support, stress and emotions, all factors that increase the likelihood of smoking cessation. The results indicated that smokers reporting greater social cohesion were more likely to successfully quit because they had more social support, more positive emotions, less stress, and fewer negative influences from the environment.

"This is an important finding because if smokers perceive their relations with their neighborhood and community to be poor, and this increases stress and other negative emotions while lowering the sense of social support they experience, they will be at higher risk for relapse, even when receiving cessation treatment," said Reitzel.

The results of this study provide a gateway for researchers to develop tailored interventions for African-American smokers who report low social cohesiveness, such neighborhood-based cessation programs or church programs, to provide an opportunity for increased community interaction and development of better personal connections.

Reitzel says African-Americans experience many barriers to quitting smoking and these results represent a first step for researchers to better understand how the neighborhood can contribute to the failure or success of smokers who are trying to quit.