Barriers to use of tobacco cessation services for lower SES and African-American tobacco users in the Arkansas Mississippi Delta?

Authors:
Christine E. Shaffer, S. Laney Brickman, Naomi Cottons and Mary Olsen

Presenter:
Christine E. Shaffer
Assistant Professor, University of Arkansas for Medical Sciences, USA

Abstract
Understanding the barriers to utilization of evidence-based tobacco cessation services for lower socioeconomic (SES) groups is important given higher prevalence of tobacco use in lower SES groups.

Method: Community-based participatory methods were used to collect qualitative and quantitative data in the Arkansas Mississippi Delta that addressed access and use of cessation services. Qualitative outcomes were used to develop a survey instrument,
which was administered to 799 Delta residents.

Results: Most residents were unaware of the available services and expressed distrust of the programs and their providers. Beliefs related to use of cessation programs included concerns about providing personal information; getting sick when they quit tobacco; and the stressful socio-economic context; as well as strong beliefs in the role of God and faith in the process of quitting. Few difference in the intensity of these beliefs between African-American and White tobacco users were found, but there were numerous differences between lower and higher SES groups.

Conclusions: Communications about the cessation services should be tailored to the concerns of lower SES groups by using trusted local community sources for disseminating information and acknowledging the challenging socio-economic context as well as the significant role of faith.

Source of funding: This is a pilot project funded by the Arkansas Center for Health Disparities (Exploratory National Research Center for Minority Health and Health Disparities 1 P20 MD002329-01).

Declaration of interest: none

About the presenter
Christine E. Sheffer, PhD is an Assistant Professor in the Department of Health Behavior and Health Education at the University of Arkansas for Medical Sciences. She is a clinical psychologist and has extensive experience training health care providers in the evidence-based treatment of tobacco use and dependence as well as implementing statewide programs that deliver brief and intensive treatment for tobacco dependence in several contexts and modalities. She is the current Vice President of the Association for the Treatment of Tobacco Use and Dependence (ATTUD) and recently spearheaded the development of a Tobacco Treatment Specialist Training Program Accreditation (attudaccred.org) program.