Improving smoking cessation outcomes in the African American community through extended treatment: Addressing social vulnerability to advance treatment of menthol users

PROJECT SUMMARY / ABSTRACT African Americans remain disproportionately burdened by tobacco, experiencing among the highest rates of tobacco-attributable disease. Approximately 85% of African American adults who smoke use menthol cigarettes. Which contribute to persistent tobacco use. African Americans and many groups of menthol users

experience excessive socioeconomic disadvantage; individuals with socioeconomic disadvantage are at greater risk for smoking and less likely to stop. Addressing unmet social needs may offer a critical inroad to supporting smoking abstinence. Evidence suggests addressing unmet needs can improve healthcare

outcomes, yet the impact of addressing unmet social needs within the context of tobacco treatment has not been established. This revision application will exist within our ongoing parent study, the Kick It at Swope (KIS- V) clinical trial, evaluating extended pharmacotherapy in 500 African American daily smokers (expecting 425

menthol and 75 non-menthol users), with the goal of increasing treatment efficacy. The objective of this revision application is to characterize unmet social needs of African American menthol users by assessing community-level neighborhood disadvantage and individual-level social needs and persistence or resolution of

those needs among 300 participants (255 menthol, 55 non-menthol), estimating over 200 enrolled prior to the start of this revision and 100 enrolled within the first five months of this award. Our specific aims are to evaluate individual-level social vulnerability and community-level social disadvantage among African American

menthol smokers, and to assess and describe the resolution of participant needs during the 6 months of tobacco use treatment. These aims will be completed during the one-year of this award. The infrastructure put in place will further support the long-term aim of evaluating community-level disadvantage, individual

vulnerability and social need, and resolution of needs in relation to smoking abstinence following treatment following completion of the parent trial. Importantly, these findings from one of the largest samples of menthol smokers within a clinical trial will produce strong evidence to inform individual- and system-level approaches to

enhancing treatment of menthol smokers. Findings will advance our understanding of the interrelationship of key socioecological factors to smoking abstinence within treatment and will inform intervention for socioeconomically disadvantaged smokers. Supporting long-term abstinence would have major impact on

reducing tobacco-related disparities, morbidity, and mortality.