S. Department of Health and Human Services [U.S. DHHS], 1998). Compared with non-Hispanic White smokers, they endure a higher incidence of and mortality from both tobacco-related CHIR99021 side effects cardiovascular disease (American Heart Association, 2002; Centers for Disease Control and Prevention, 2002) and cancer (Abidoye, Ferguson, & Salgia, 2007; American Cancer Society, 2007; Kosary et al., 1995; U.S. DHHS, 1998). However, despite evidence to suggest that greater than 70% of Black smokers report wanting to quit smoking (U.S. DHHS, 1998) and additional data showing that Blacks are more likely to make a quit attempt than non-Hispanic Whites (Fiore et al., 1989; Fu et al., 2005; Giovino et al., 1994; U.S. DHHS, 1998), they are less likely to achieve abstinence (Giovino, 2002).

The quit ratio (proportion of ever-smokers who have quit) remains consistently lower among Black smokers (King, Polednak, Bendel, Vilsaint, & Nahata, 2004). There are extensive empirical data documenting the clinical significance of pharmacotherapy for smoking cessation (Fiore et al., 2008; Silagy, Lancaster, Stead, Mant, & Fowler, 2004). Nicotine replacement therapy (NRT) in particular has over a decade of research documenting its efficacy estimated to double a smoker’s chance of quitting. NRT has been shown to be equally effective for both Black and White smokers (Fu, Burgess, et al., 2008; Robles, Singh-Franco, & Ghin, 2008). Despite this evidence, the population impact of pharmacotherapy has been modest (Pierce & Gilpin, 2002), and the majority of smokers report having never tried any form of NRT.

For example, data from the National Health Interview Survey demonstrate that 78% of the 4,000 smokers surveyed reported never using pharmacotherapy (Cokkinides, Ward, Jemal, & Thun, 2005). Importantly, minority smokers are even less likely to use medications than Caucasians (Cokkinides, Halpern, Barbeau, Ward, & Thun, 2008; Fu et al., 2008; Shiffman, Brockwell, Pillitteri, & Gitchell, 2008; Zhu, Melcer, Sun, Rosbrook, & Pierce, 2000). For example, results of a recent population survey found rates of pharmacotherapy use (including NRT and prescription bupropion) for the most recent quit attempt to be Cilengitide significantly lower among Black smokers (17%) compared with White smokers (29%; Shiffman, Brockwell, et al., 2008). Results of another recent population survey found rates of use of any cessation quit aid (inclusive of both pharmacotherapy and behavioral support) for a quit attempt in the past year to be significantly lower among Black smokers (22%) compared with White smokers (34%; Stahre, Okuyemi, Joseph, & Fu, 2010). Discrepancies in use of pharmacotherapy hold even within an equal-access health care system, where cost barriers are removed.