Black Americans face a disproportionate burden of cancer incidence and death from tobacco smoking.1 Among other tobacco-related disparities, Blacks have less success achieving abstinence from tobacco than Whites even though they are more likely to attempt to quit.2,3 Identifying factors that contribute to racial differences in abstinence rates will contribute to effective interventions to reduce cancer morbidity and mortality among Blacks. Increased cue reactivity to smoking-related cues might be one important mechanism that explains Blacks increased difficulty maintaining abstinence from tobacco use. Although little research to date has examined racial differences in the cognitive processing and physiological processes of tobacco-related stimuli, several studies suggest that Blacks experience several aspects of tobacco smoking differently than Whites. Nonetheless, many questions remain unanswered about the nature, quantity, and quality of these differences. Psychophysiological data are a rich source of information that is likely to elucidate these differences. Racial differences in cue reactivity and attentional processes related to tobacco disparities would suggest specific targets for the development of interventions for treatment and/or prevention programs with the goal of optimizing interventions to more effectively assist Blacks achieve long-term abstinence and/or prevent initial use. The goal of this pilot study is to examine racial differences in in psychophysiological cue reactivity that are likely to contribute to tobacco-related disparities. Findings from this pilot study will inform the development of a larger examination of racial differences in the cognitive processing of smoking-related cues and cue reactivity. White and Black Smokers will complete a classic cue reactivity flanker task while psychophysiological indicators of cognitive processing and behavioral measures are collected. Primary outcome measures include the P300 event-related potential (ERP), brain wave amplitude, skin conductance reactivity (SCR), and reaction time. Differences between Black and White smokers reactivity to smoking-related versus non-smoking related stimuli will be examined. We hypothesize that alterations in cue reactivity develop early in cue processing and that this finding will be heightened in Blacks compared to Whites, explaining heightened craving levels in response to smoking-related cues and less successful quit attempts in Blacks.
Aim 1 : To examine psychophysiological and behavioral differences in cue reactivity between Black and White smokers. We anticipate that Black smokers will: H1: Exhibit larger P300 (ERP) response to smoking related cues than White smokers;H2: Exhibit a larger SCR response to smoking related cues than White smokers;H3: Exhibit longer reaction times to smoking related cues than White smokers;and H4: Will report greater craving levels than White smokers before and after the experimental sessions. Cue reactivity is a well-established and theoretically grounded construct strongly associated with the craving, tobacco consumption, and relapse to smoking. This study applies a well-established construct to the study of racial differences.
Significant health and cessation disparities exist between Black and White tobacco smokers, with Black smokers experiencing higher craving, lower cessation rates, and increased health complications related to tobacco use. The aim of this project is to examine racial differences in reactions to smoking related imagery that may explain this disparity. Our long term goal is to inform and optimize potential treatment and prevention interventions for Black smokers.
|Smith, Philip H; Bessette, Andrew J; Weinberger, Andrea H et al. (2016) Sex/gender differences in smoking cessation: A review. Prev Med 92:135-140|