“[Cessation] is a battle, a fight”: Factors influencing tobacco initiation and cessation patterns among African American males in Louisiana

Background: Few research studies have investigated why African-American men continue to have the highest rate of tobacco use in Louisiana and the lowest rate of quit line usage despite sustained tobacco control interventions and policies. This study used qualitative methods to identify social determinants associated with tobacco initiation and cessation among African American males in Louisiana in order to develop more targeted interventions and messaging.

Methods:  Twelve focus groups of low-income African American males were conducted in six cities in Louisiana. A semi-structured interview guide was used to elicit open-ended responses. Groups were stratified by whether participants were former smokers or current smokers interested in quitting in order to examine variation in responses.

Results: Differences in perceptions were more pronounced by smoking status than by region of the state. While participants believed that social determinants of health including relationships and community norms triggered their tobacco initiation and acted as barriers to cessation, they perceived internal motivation as being the most instrumental factor of their quitting success, more so than family, health, and faith. Although participants were aware of the quit line, few used it, and most were unaware of other cessation resources.

Conclusions: Findings from this study were used to develop a campaign and community events targeted at low-income African American males throughout Louisiana. Based on participant recommendations, cessation resources and methods should expand opportunities for personal interaction and outreach. Instead of focusing on reasons to quit, messaging needs to provide African American males internal motivation and readiness to quit.  

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Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Planning of health education strategies, interventions, and programs
Protection of the public in relation to communicable diseases including prevention or control
Public health or related public policy
Public health or related research
Social and behavioral sciences

Learning Objectives:
Identify potential social determinants that contribute to smoking initiation and tobacco use among low-income African American males. Assess health promotion and prevention messages and modalities of communication that work best with African American males. Discuss factors leading to cessation and describe the cessation methods that work best with low-income African American males.

Keyword(s): Tobacco Control, African American

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a qualitative research coordinator and consult with evaluation colleagues in my department. I am assisting with components of the focus group analysis. I currently work on other tobacco research studies for LPHI as well.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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