African Americans bear a disproportionate burden of tobacco-related disease. This proposal is prompted by the investigators' grim clinical experience with head and neck cancer in African Americans. Incidence rates of this disease are disproportionately high in the Black Belt counties of Alabama and mortality rates are doubled in African American (AA) men as compared to white men. Approximately 90% of the cases of this devastating disease would be eliminated by tobacco avoidance. This pilot project explores the use of """"""""alternative"""""""" tobacco products among young adult AA men in some of the Black Belt counties; a practice that may be a gateway to lifelong tobacco dependence. ? ? This proposal is submitted in response to RFA-CA-07-501 under the NCI Community Network Program. The parent grant for this pilot project is the Deep South Network for Cancer Control (DSN). The goals of the DSN are to improve access to and utilization of proven beneficial cancer interventions and to develop a cadre of well-trained researchers who will continue to address reduction and elimination of cancer disparities. Following the Community-Based Participatory Research (CBPR) principles, DSN developed a comprehensive """"""""Community Action Plan"""""""" (CAP) in collaboration with the targeted communities. The community members' priorities centered on healthy lifestyle changes (including nutrition, physical activity, and tobacco control), and cancer screening. However, they also concluded that further work is needed before culturally relevant programs focusing on tobacco control are developed, and recommended that pilot projects focus on this topic. Therefore, this pilot project is a result of a direct recommendation from the targeted communities, it addresses an issue outlined in their CAP, and it will be implemented in conjunction with the DSN community partners. This project will provide groundwork for a culturally relevant tobacco prevention or cessation intervention in the Black Belt counties. Compelling findings may also significantly impact future directions for the parent DSN program. ? ? ? ?
