Smoking cessation among inner-city African Americans using the nicotine transdermal patch.

OBJECTIVE

To determine the efficacy of the transdermal nicotine patch for smoking cessation in inner-city African Americans.

DESIGN

Double-blind, placebo-controlled, randomized trial.

SETTING

Outpatient in an inner-city hospital.

PATIENTS AND PARTICIPANTS

A computer-generated random numbers table with a block size set at 20 was used to randomize 410 patients to one of two study arms.

INTERVENTIONS

The transdermal nicotine patch for 10 weeks as an adjunct to brief counseling.

MEASUREMENTS AND MAIN RESULTS

Of the 410 patients randomized, mean age was 48 years, 65% were female, 41% had less than a high school education, 51% had an annual household income of less than $8,000, and the average number of cigarettes smoked per day was 20. Quit rates at 10 weeks were 21.5% (44/205) with the nicotine patch, and 13.7% (28/205) with the placebo patch (p = .03). At 6 months, quit rates were 17.1% (35/205) with the nicotine patch, and 11.7% (24/205) with the placebo patch (p = .08). After adjusting for baseline differences in age and educational attainment, differences remained significant at 10 weeks (p = .04), but were not significant at 6 months (p = .14). Compliance rates for return visits were 83%, 78%, 55%, and 52%, at 1, 2, 6, and 10 weeks, respectively.

CONCLUSIONS

The nicotine patch significantly improves short-term quit rates in inner-city African Americans who are interested in trying to quit smoking. Efforts should be made to reach underserved populations through smoking cessation programs, and to assist in maintaining abstinence.