Proactive Tobacco Cessation Outreach to Smokers of Low Socioeconomic Status

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Abstract
Although tobacco use in the United States has declined,1 substantial socioeconomic and racial and/or ethnic disparities in smoking prevalence, risk of addiction, and tobacco-related disease remain.2,3 Despite relatively similar rates of tobacco use, blacks experience a higher burden of tobacco-related disease, particularly lung cancer, than whites.3 Importantly, smokers of low socioeconomic status (SES) and/or of a racial or ethnic minority also have more difficulty quitting for several reasons, including more limited access to treatment,4-7 misinformation about risks and benefits of nicotine replacement therapy (NRT),8 lack of social support,9 neighborhood disadvantage,10 discrimination,11 and other life stressors.12,13 Widening socioeconomic disparities in mortality in the United States are largely explained by slower declines in tobacco use among low-SES smokers than among higher-SES smokers.14,15

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