We propose to develop a replicable, mediated self-help smoking cessation intervention oriented toward Black smokers wanting to quit and to test its effectiveness among 2,400 Black individual policyholders of North Carolina Mutual Life Insurance Company (NC Mutual), the largest Black-owned business enterprise in the US. The intervention will feature a new, well-illustrated, easy-to-read quit-smoking manual, incorporating nicotine-fading, nonsmoking skills training, and materials to bolster natural support for quitting. The four-part manual will be presented in four home visits by NC Mutual sales agents, who will rceive a short, standadized training session to generate interest and promote participation. Compliance incentives and reinforcements will be employed. A trained quit-smoking counselor will be available by means of an 800-number at NC Mutual to provide needed professional assistance to quitters. We will first interview 1,200 policyholders to obtain essential information about smoking histories, motivation to quit, expectations of success, and anticipated supports and obstacles to quitting among Black smokers. We will then pilot test the interventions among NC Mutual employees and nearby policyholders. The formal evaluation will be carried out through a quasi-experimental comparison of prospective quitters in 18 intervention districts and 18 control districts. The agents will obtain questionnaire data at baseline and at 3, 6, and 12 months after intervention. Biochemical verification using salivary cotinine will be carried out on about half of self-reported quitters. We will assess the effect of the intervention and of other factors on quit attempts, quitting, and medium-term abstinence. Multivariate statistical models will be used to assess intervention, agent, and district effects, adjusting for potentially confounding factors. This study will yield a readable, soundly-based, quit-smoking manual, a replicable delivery mode, and a scientifically rigorous evaluation of their effects on medium-term abstinence. The intervention we develop could be adopted by churches and other organizations in the Black community.
| Orleans, C T; Schoenbach, V J; Salmon, M A et al. (1989) A survey of smoking and quitting patterns among black Americans. Am J Public Health 79:176-81 |
