Mixed methods research to increase engagement and smoking abstinence among African Americans enrolled in Quitline text messaging services

Project Summary/Abstract
Cigarettes are used by over 34 million U.S. adults and cause more than 480,000 deaths annually due to
smoking and smoke exposure. Despite smoking at similar rates and consuming less cigarettes per day, African
Americans are more likely to die from several tobacco-caused cancers compared to Whites. Quitting smoking
reduces the risk of premature death and adds years to life expectancy; however, a disparity exists in annual
quit rates between African Americans and Whites (4.9% vs. 7.1%). This disparity is due to several social
determinants. Thus, it is critical to investigate scalable, evidence-based strategies to increase smoking
cessation among African Americans. African Americans are twice as likely to use quitlines compared to
Whites. However, little is known about the impact of mHealth interventions among African Americans using
quitlines. In preliminary studies conducted by Penn State investigators, we found that automated text
messaging was feasible for monitoring smoking status and providing smoking cessation support. However,
these studies were not designed to assess the impact of interventions in minority populations. A recent study
compared engagement and abstinence rates between Black and White smokers in a national texting cessation
program and found that Blacks were just as likely as Whites to enroll and remain in the program; yet Blacks
were less likely to respond to abstinence assessments and report cessation. Few studies have focused on the
behaviors and perceptions of quitline texting services among African Americans. The current project proposes
to assess data from the Pennsylvania quitline to inform a tailored mHealth smoking cessation intervention. The
overall goal of this Mentored Career Development Award (K01) is to build on the candidate’s advanced
postdoctoral training by developing her expertise to investigate and alleviate disparities in tobacco-related
disease for racial minorities through the use of technology interventions. Career development objectives are to
develop expertise in: 1) mHealth applications for smoking cessation, 2) qualitative data analysis, and 3) clinical
research skills in ecological momentary assessment. The central hypothesis is that social determinants will
explain differences in smoking abstinence between African Americans and White smokers using technology as
a cessation aid. The specific aims for this study will be to 1) conduct a secondary analysis of the PA quitline
texting program data and provide an overview of service engagement and smoking rates during enrollment and
at 6-month follow-up; 2) to conduct qualitative interviews with African Americans who enrolled in the PA quitline
texting program to better understand the factors that serve as barriers to engagement and abstinence; 3) To
conduct a pilot EMA study to inform a tailored mHealth smoking cessation intervention for African Americans.
The research environment is an academic medical center with the facilities, technology, resources, and
advanced equipment to support the research and training proposed in this award.

Grant Number: 5K01DA053410-04
NIH Institute/Center: NIH
Principal Investigator: Sophia Allen