1. Cognitive Behavioral Therapy Versus General Health Education for Smoking Cessation: A Randomized Controlled Trial Among Diverse Treatment Seekers.
- Author
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Hooper, Monica Webb, Lee, David J., Simmons, Vani Nath, Brandon, Karen O., Antoni, Michael H., Asfar, Taghrid, Koru-Sengul, Tulay, and Brandon, Thomas H.
- Abstract
Objective: Racial and ethnic disparities in smoking cessation persist. This randomized controlled trial compared the efficacy of group cognitive behavioral therapy (CBT) for cessation among African American/Black, Latino/Hispanic, and White adults. Method: African American/Black (39%), Latino/Hispanic (29%), and White (32%) adults (N = 347) were randomly assigned to eight group sessions of CBT or general health education (GHE), both including nicotine patch therapy. Biochemically confirmed 7-day point prevalence abstinence (7-day ppa) was measured at the end-of-therapy, and at 3-, 6-, and 12-month followups. Generalized linear mixed models and logistic regressions tested abstinence rates by condition, stratified by race and ethnicity, and interaction effects. Results: CBT led to greater abstinence than GHE across 12-months of follow-up (AOR = 1.84, 95% CI [1.59, 2.13]) overall [12-month follow-up: CBT = 54% vs. GHE = 38%] and within racial and ethnic groups [12-months: African American/Black (CBT = 52%, GHE = 29%), Latino/Hispanic (CBT = 57%, GHE = 47%), and White (CBT = 54%, GHE = 41%)]. African American participants were less likely than White participants to quit irrespective of condition, as were persons with lower education and income. Socioeconomic status indicators positively predicted abstinence among racial and ethnic minority participants, but not White participants. Conclusions: Group CBT was efficacious compared with GHE. However, cessation patterns suggested that intensive group interventions were less beneficial over the longer term among lower socioeconomic African American and Latino individuals, compared with White participants. Tobacco interventions should target racial and ethnic and socioeconomic differences, via culturally specific approaches and other means. Public Health Significance Statement When treating individuals who wish to quit smoking, this study demonstrated that cognitive behavioral therapy (CBT) delivered in a group format is efficacious across racial and ethnic groups. An intersectional look within racial and ethnic groups, revealed that CBT worked equally well among White persons irrespective of their socioeconomic status (SES), yet was more effective among higher SES racial and ethnic minority persons. Within group diversity is an important consideration when "gold-standard" interventions are recommended universally. To address cessation disparities particularly among racial and ethnic minority individuals with less privileged socioeconomic status, the implementation of culturally specific approaches may be beneficial. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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