African Americans, particularly men, have high rates of smoking and concomitantly high rates of smoking-related cancers. Recent developments in the identification of genetic markers of susceptibility to tobacco related cancers provide exciting opportunities for developing innovative health education strategies that personalize risk and enhance motivation for smoking cessation. The proposed study is a five year randomized trial to evaluate the incremental improvement of providing biomarker feedback to state-of-the-science smoking cessation interventions to increase motivation and likelihood of cessation among African American smokers. Three intervention conditions will be tested in an additive study design. Patients who receive care at a community health clinic that serves a predominantly African American population will be screened for smoking status in the waiting rooms to identify current smokers. Smokers who agree to provide a breath and blood sample and take part in the smoking cessation intervention (n=620) will be randomized t one of three intervention conditions (1) Self-help guide plus motivational telephone counseling (Enhanced al care, n-160); (2) Self-help guide plus motivational tailored feedback that includes expired carbon monoxide (CO) results plus motivational telephone counseling (Exposure biomarker feedback, n=160); (3) Self-help guide plus tailored feedback that includes test results for CO and the presence of genetic biomarkers of susceptibility to lung cancer plus motivational telephone counseling (Susceptibility biomarker feedback, n-300). Data collection will include an in-person baseline survey, telephone follow-up surveys at 6,12, and 18 months, and collection of saliva samples to validate self-reported abstinence. The primary outcomes of interest will be motivation to quit smoking, point prevalence, and sustained abstinence at each follow-up. The proposed study is integrally linked to the overall project theme, """"""""Improving Cancer Risk Communications."""""""" The framework for the CPRU enables us to assemble a multidisciplinary team that brings the best and brightest together to develop our communication approaches. The economics of scale inherent in the CPRU Cores will permit us to include cost effectiveness analysis and a solid biostatistical resource at modest cost.
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