man holding cigarettes

Experts agree: Giving up cigarettes is the single most important health decision smokers can make. It’s also notoriously difficult to do – and African Americans may face unique obstacles to successfully kicking the habit, according to clinical health psychologist Monica Webb Hooper, PhD.

“We know, based on documents that have been released, that the tobacco industry has specifically targeted African Americans through sponsorships, marketing, and advertising” – especially when it comes to menthol cigarettes, Webb Hooper said. “The tobacco industry knew, and we now know, that menthol cigarettes are harder to quit.” Studies have found that among African American smokers, more than 80% smoke menthol cigarettes, compared with fewer than 30% of white smokers.

In collaboration with the National African American Tobacco Prevention Network, Webb Hooper helped develop a quit-smoking DVD called Pathways to Freedom: Leading the Way to a Smoke-Free Community. It’s based, in part, on the Center for Disease Control’s written smoking-cessation guide, Pathways to Freedom: Winning the Fight Against Tobacco. (Both are designed to help African American smokers quit.) A pilot study found the Pathways to Freedom DVD was more effective in this population than a smoking-cessation DVD from the American Medical Association.

Now, with funding from an American Cancer Society grant, Webb Hooper will investigate the effectiveness of her DVD when used in conjunction with quitlines, including the American Cancer Society’s, which offer smoking-cessation coaching. Though underutilized by the overall population, quitlines are well utilized by African Americans, Webb Hooper said.

Culturally Specific Content

Why might this DVD be more effective than the many quit-smoking programs that are currently available?

“Pew surveys show that [many] African Americans would prefer to have something they can watch, like a video where someone is talking to them, versus having to read,” Webb Hooper said. And what they see in this 60-minute DVD are the various roles tobacco has played in black history and culture in the US. For example, there’s a section about the history of slaves cultivating tobacco.

The DVD also identifies and provides solutions for coping with “unique stressors that [many] African Americans have faced over time and still face, like housing, employment, underemployment, and health problems. Smoking is used to self-medicate when they’re faced with any of a multitude of really significant things,” Webb Hooper said.

Looking Ahead

Research shows that a form of psychotherapy called cognitive behavioral therapy (CBT) is highly effective for smoking cessation. But many smokers have neither the money nor the inclination to see a mental health professional for help kicking the habit. That’s one reason why Webb Hooper believes this DVD, which incorporates CBT, can have a far-reaching, successful impact.

It offers advice on how to quit, lays out the steps to do so, and helps prevent smokers from relapsing. “Those are the areas where we talk about cognitive behavioral strategies and coping mechanisms,” she said.

With her Society grant funding, she will also explore a new venue for the video: a dedicated website. If successful, the intervention could potentially reach even more smokers – those who want to watch video on a cell phone or computer. However, Webb Hooper stands by the DVD as a mainstay of the program. “People who smoke tend to be in a lower socioeconomic group and many don’t have stable internet access. With the DVD they have something tangible,” she said.

FOR RESEARCHERS: Learn how to apply for a research grant from the American Cancer Society.

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