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WATCH NOW: Medication, culturally based counseling combo improves quitting success for Black smokers

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Wisconsin has the nation’s largest disparity in smoking rates between Black and white individuals, but a culturally based treatment program offers promise for closing the gap.

A new editorial published by JAMA, with corresponding author Timothy Baker of the UW Center for Tobacco Research and Intervention (UW-CTRI), UW-Madison School of Medicine and Public Health, looked at a combination smoking cessation plan for Black tobacco users.

Overall smoking rates have declined from 20.9% in 2005 to 12.5% in 2020, per the CDC. However, 18.3% of Black individuals are smokers, according to the UCSF Smoking Cessation Leadership Center. And in Wisconsin, the rate for Black people is even higher at 30%, versus 12% for white people, the Behavioral Risk Factor Surveillance System says. Black individuals are also 11 times more likely to smoke menthol cigarettes, the manufacture and sale of which the FDA is looking at banning.

The UCSF Smoking Cessation Leadership Center states Black individuals have a harder time quitting smoking, with 59.1% trying to do so every year and only 3.3% succeeding, half the success rate of white individuals. The study cited in the JAMA editorial found the pairing of culturally appropriate counseling, paired with the smoking cessation medication varenicline — commonly known by the brand name Chantix — more than doubled success in quitting for the study group of 500 Black individuals. Using the program, 15.7% were still abstaining from smoking six months later, versus 6.5% for those using a placebo and undergoing counseling.

“What’s especially exciting is that these treatments aren’t rare,” said Dr. Michael Fiore, co-author and director of (UW-CTRI). “They’re widely available. They’re covered by Medicaid and many insurance plans.”

Noted co-author Dr. Tim Baker, associate director of UW-CTRI, “This shows the potential value and the absolute importance that clinicians attempt to intervene with all of their patients who smoke.”

Per the UCSF Smoking Cessation Leadership Center, Black individuals are lighter smokers, and co-author Dr. Jessica Burris of University of Kentucky, points to research that shows clinicians are less likely to suggest or offer treatment medications for those who smoke less.

“This may play a role in why Black patients tend to have low use of medications we know can help them quit smoking,” Burris said. “This is an incredible opportunity for clinicians to step up and help all patients quit. For African Americans in particular, prescribing varenicline and providing counseling that is sensitive to the unique experiences, strengths and stressors of the Black community is an effective approach.”

Medical centers can further assist smokers in quitting by identifying smokers using electronic health records and talking to them about treatment options.

For more information on quitting smoking, visit


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