Differences in smoking and quitting experiences by levels of smoking among African Americans

Background: Despite smoking fewer cigarettes per day than their White counterparts, African Americans have higher tobacco-related morbidity and mortality. Since most tobacco control efforts have focused on heavy smokers, little is known about smoking and quitting experiences of African-American occasional and light smokers. Methods: We conducted a survey of 484 African-American smokers, which included: 104 occasional (smoked in ≤25 of last 30 days), 176 light [smoked 1-10 cigarettes per day (cpd)], 69 moderate (11-19 cpd), and 135 heavy (≥20 cpd) attending an inner-city clinic. The survey assessed their sociodemographic characteristics, smoking characteristics, and cessation experiences. Results: Compared with moderate and heavy smokers, occasional and light smokers were, on average, younger, more likely to be female, and more likely to initiate regular smoking at an older age. Forty percent of occasional smokers used other tobacco products compared to 23.3%, 24.6%, and 27.4% for light, moderate, and heavy smokers, respectively. Motivation and confidence to quit were higher among occasional and light smokers. Interest in participating in a formal cessation program was equally high in all 4 groups (mean ranged from 7.6-8.0 on a scale of 1-10). The use of pharmacotherapy for smoking cessation was similar, and generally low, among all 4 groups. Conclusions: High levels of motivation for smoking cessation exist among African-American occasional and light smokers. The interest of these lighter smokers in smoking cessation represents a window of opportunity to design programs for a group that has been excluded from most cessation interventions.