Understanding Disparities in Quitting in African American and White Smokers

描述（由申请人提供）：吸烟的种族/民族差异有充分的记录；非裔美国人每天吸烟比白人少，但吸烟导致的发病率和死亡率却不成比例地高。有充分证据表明，在戒烟方面也存在差异，非洲裔美国人的戒烟率一直低于白人。然而，到目前为止，还没有对种族进行充分有力的分层研究，以严格的研究设计来证实这一发现，或了解非洲裔美国人相对于白人的戒烟率差异的机制。本应用程序的目的是：1)描述非裔美国人和白人吸烟者接受伐尼克兰治疗后在戒烟方面的差异；2)确定吸烟、心理社会、治疗过程和生物学因素，这些因素独立地解释了种族/民族与非裔美国人和白人吸烟者可替宁验证的7天戒烟之间的关系；3)通过吸烟水平检查伐尼克兰的副作用。这些目标将通过一项前瞻性队列干预研究来实现，该研究将448名参与者（224名非裔美国人，224名白人）按种族、年龄（< 40岁，40岁以上）和性别进行分层。所有参与者将接受3个月的伐尼克兰治疗，这是目前最有效的戒烟药物，标准的教育材料，以及6次戒烟咨询。这项研究具有创新性。这将是目前已知的第一个报道伐尼克兰在a类人群中使用的研究，第一个在轻度吸烟者（<10 cpd）和大范围吸烟水平（3-20 cpd）中检查伐尼克兰的研究，第一个按种族分层的头对头研究，旨在前瞻性地比较AA和白人的药物治疗，也是少数几个探索AA和白人吸烟者戒烟差异机制的研究之一。这些发现的影响将是相当大的，对治疗、临床实践和政策都有影响。将获得关于非裔美国人和白人在戒烟方面的差异的重要知识。研究结果有可能通过将该领域从对种族/民族的一般关注转向有针对性地关注与非裔美国人和白人最相关的可改变的吸烟、心理社会和治疗过程因素，来改善烟草使用治疗。

DESCRIPTION (provided by applicant): Racial/ethnic differences in smoking are well documented; African Americans smoke fewer cigarettes per day than Whites but experience disproportionately greater smoking attributable morbidity and mortality. Well documented disparities also exist in smoking cessation with African Americans consistently quitting at lower rates than Whites. However, to-date, no adequately powered study, stratified on race, has been conducted to confirm this finding using a rigorous study design or to understand the mechanisms accounting for differential quit rates in African Americans relative to Whites. The objectives of this application are to 1) describe the differences in smoking cessation among AA and White smokers treated with varenicline, 2) identify the smoking, psychosocial, treatment process, and biological factors that independently explain the relationship between race/ethnicity and cotinine-verified 7-day abstinence in African American and White smokers, and 3) examine the side effect profile of varenicline by smoking level. These aims will be accomplished through a prospective cohort intervention study, stratified on race, age (< 40, > 40), and gender among 448 participants (224 African American, 224 White). All participants will receive 3 months of varenicline, the most effective of currently available smoking cessation medications, standard educational materials, and six sessions of smoking cessation counseling. This study is innovative. It will be the first known study to report on the use of varenicline in As, the first to examine varenicline in light smokers (<10 cpd) and among a wide range of smoking levels (3-20 cpd), the first head-to-head study, stratified on race, designed to prospectively compare pharmacotherapy in AAs versus Whites, and one of a few to explore mechanisms underlying disparities in quitting between AA and White smokers. The impact of these findings will be considerable, having ramifications for treatment, clinical practice, and policy. Significan knowledge will be gained about African American-White differences in quitting. Findings have the potential to improve tobacco use treatment by moving the field away from a generic focus on race/ethnicity toward a targeted focus on modifiable smoking, psychosocial, and treatment process factors most relevant to African Americans and to Whites.