Gender, race, and education differences in abstinence rates among participants in two randomized smoking cessation trials

Abstract

Introduction: Smoking is the leading preventable cause of morbidity and mortality in the United States, but this burden is not distributed equally among smokers. Women, Blacks, and people with low socioeconomic status are especially vulnerable to the health risks of smoking and are less likely to quit.

Methods: This research examined cessation rates and treatment response among 2,850 participants (57.2% women, 11.7% Blacks, and 9.0% with less than a high school education) from two large cessation trials evaluating: nicotine patch, nicotine lozenge, bupropion, bupropion + lozenge, and nicotine patch + lozenge.

Results: Results revealed that women, Blacks, and smokers with less education were less likely to quit smoking successfully than men, Whites, and smokers with more education, respectively. Women did not appear to benefit more from bupropion than from nicotine replacement therapy, but women and smokers with less education benefited more from combination pharmacotherapy than from monotherapy.

Discussion: Women, Blacks, and smokers with less education are at elevated risk for cessation failure, and research is needed to understand this risk and develop pharmacological and psychosocial interventions to improve their long-term cessation rates.

Figure 1.

Six-month cessation outcome by treatment for men versus women smokers in the combined Efficacy/Effectiveness sample.

Figure 2.

Six-month cessation outcome by treatment for White versus Black smokers in the combined Efficacy/Effectiveness sample.

Figure 3.

Six-month cessation outcome by treatment by education status in the combined Efficacy/Effectiveness sample.