DESCRIPTION (provided by applicant): Young adults and individuals in the lowest socioeconomic status (SES) categories report the highest rates of cigarette use and lowest rates of cessation. Although young adult smokers from backgrounds characterized by low SES are just as likely as their higher SES peers to attempt to quit smoking, they are less likely to use effective cessation treatments and less likely to actually quit. Individuals who occupy lower SES categories may not use effective cessation treatments due to lack of resources, assistance, and/or support. These individuals may also prefer to quit on their own, without the use of cessation aids. Web-based programs tailored to individual characteristics relevant to smoking cessation are one of the only types of cessation programs that are self-directed and can reach large numbers of smokers for very little cost. Yet, research examining smoking cessation using tailored web-based programs has focused almost exclusively on higher SES, White female smokers. The purpose of this study is to examine the feasibility of a tailored web-based cessation program for a racially/ethnically diverse sample of young adult smokers from lower SES backgrounds. Utilization and acceptability will be assessed by randomly assigning individuals either to a tailored web-based smoking cessation program based on social cognitive theory and studies of persuasive communications or to a control condition comprising a non-tailored web-based program providing evidence- based smoking cessation information. Both programs will be self-paced, allowing individuals to choose when and where they visit them. Participants will be smokers enrolled in post-secondary vocational/technical programs who want to quit smoking. The Specific Aims of the proposed project are to 1) Determine if young adult smokers from low SES backgrounds will use a tailored web-based cessation program and find it an acceptable means for quitting, 2) Identify the psychosocial variables relevant to young adult smokers from low SES backgrounds (e.g., financial stress, role overload, depressive symptoms) that contribute to variability in utilization and acceptability of the web-based program, and 3) Use individual interviews to determine how to increase utilization and acceptability of the tailored web-based program, and maximize its appeal to young adult smokers from low SES backgrounds. If successful, this project will lead to a multi-year R01 proposal testing the efficacy of a tailored web-based smoking cessation program in a larger randomized controlled trial. Results from Specific Aims 2 and 3 will be used to modify the existing web-based program to further tailor it to the needs of young adults occupying lower SES categories. The long-term goal of this research is to develop effective smoking cessation programs for young adults from low SES backgrounds that ultimately will decrease disparities in tobacco use and tobacco-related morbidity and mortality.
PUBLIC HEALTH RELEVANCE: Tobacco use remains the leading cause of preventable death in the United States. Young adults and individuals occupying the lowest socioeconomic status (SES) categories are disproportionately represented among smokers. Identifying low-cost smoking cessation programs that can reach, appeal to, and are effective for large numbers of smokers from low SES backgrounds, will have a major impact on decreasing disparities in smoking and smoking-related morbidity and mortality.
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