Tobacco cessation among low-income smokers: Motivational enhancement and nicotine patch treatment

Beth C. Bock, George D. Papandonatos, Marcel A. De Dios, David Abrams, Munawar M. Azam, Mark Fagan, Patrick J. Sweeney, Michael D. Stein, Raymond Niaura

Research output: Contribution to journalArticle

Abstract

Introduction: Despite decades of tobacco use decline among the general population in the United States, tobacco use among low-income populations continues to be a major public health concern. Smoking rates are higher among individuals with less than a high school education, those with no health insurance, and among individuals living below the federal poverty level. Despite these disparities, smoking cessation treatments for low-income populations have not been extensively tested. In the current study, the efficacy of 2 adjunctive smoking cessation interventions was evaluated among low-income smokers who were seen in a primary care setting. Methods: A total of 846 participants were randomly assigned either to motivational enhancement treatment plus brief physician advice and 8 weeks of nicotine replacement therapy (NRT) or to standard care, which consisted of brief physician advice and 8 weeks of NRT. Tobacco smoking abstinence was at 1, 2, 6, and 12 months following baseline. Results: The use of the nicotine patch, telephone counseling, and positive decisional balance were predictive of increased abstinence rates, and elevated stress levels and temptation to smoke in both social/habit and negative affect situations decreased abstinence rates across time. Analyses showed intervention effects on smoking temptations, length of patch use, and number of telephone contacts. Direct intervention effects on abstinence rates were not significant, after adjusting for model predictors and selection bias due to perirandomization attrition. Conclusions: Integrating therapeutic approaches that promote use of and adherence to medications for quitting smoking and that target stress management and reducing negative affect may enhance smoking cessation among low-income smokers.

Original languageEnglish (US)
Article numberntt166
Pages (from-to)413-422
Number of pages10
JournalNicotine and Tobacco Research
Volume16
Issue number4
DOIs
StatePublished - 2014

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Tobacco Use Cessation
Tobacco Use Cessation Products
Smoking Cessation
Poverty
Smoking
Tobacco Use
Nicotine
Telephone
Physicians
Withholding Treatment
Medication Adherence
Selection Bias
Therapeutics
Health Insurance
Smoke
Habits
Counseling
Primary Health Care
Public Health
Education

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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Tobacco cessation among low-income smokers : Motivational enhancement and nicotine patch treatment. / Bock, Beth C.; Papandonatos, George D.; De Dios, Marcel A.; Abrams, David; Azam, Munawar M.; Fagan, Mark; Sweeney, Patrick J.; Stein, Michael D.; Niaura, Raymond.

In: Nicotine and Tobacco Research, Vol. 16, No. 4, ntt166, 2014, p. 413-422.

Research output: Contribution to journalArticle

Bock, BC, Papandonatos, GD, De Dios, MA, Abrams, D, Azam, MM, Fagan, M, Sweeney, PJ, Stein, MD & Niaura, R 2014, 'Tobacco cessation among low-income smokers: Motivational enhancement and nicotine patch treatment', Nicotine and Tobacco Research, vol. 16, no. 4, ntt166, pp. 413-422. https://doi.org/10.1093/ntr/ntt166
Bock, Beth C. ; Papandonatos, George D. ; De Dios, Marcel A. ; Abrams, David ; Azam, Munawar M. ; Fagan, Mark ; Sweeney, Patrick J. ; Stein, Michael D. ; Niaura, Raymond. / Tobacco cessation among low-income smokers : Motivational enhancement and nicotine patch treatment. In: Nicotine and Tobacco Research. 2014 ; Vol. 16, No. 4. pp. 413-422.
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