Nicotine patch and group support may be the best combination for helping women in public housing to stop smoking

Feb 20 2006

Former smokers from the community, a nicotine patch and group support may be the best combination for helping women in public housing to stop smoking, researchers have found.

This strategy helped nearly 50 percent of women smokers in an Augusta public housing unit quit smoking by the end of a six-week program while less than 8 percent of women in a comparison group had kicked the habit, says Dr. Jeanette Andrews, nursing professor at the Medical College of Georgia and principal investigator.

Six months after they quit, 27.5 percent of the women in the treatment neighborhood hadn't resumed smoking. In the comparison group, only 5.7 percent were still smoke-free.

Researchers studied 103 women smokers, about half of whom lived in Barton Village - the treatment neighborhood - and half of whom lived in Underwood Homes - the comparison group. The program was named Sister to Sister because women were encouraged to quit with other female relatives and quickly formed a sisterhood with each other.

Women in public housing were an important target group because they report higher rates of smoking than women in the general population and they were interested in quitting smoking, according to Dr. Andrews.

"African-American women in (these) public housing communities reported a smoking prevalence of 40 percent, with at least two-thirds of households having at least one smoker in the residence," she says. An estimated 40-60 percent of African-Americans in public housing smoke, compared to 20-22 percent in the general population, she adds.

Women in Barton Village received the nicotine patch, nurse-led behavioral treatment and support from community health workers - former smokers familiar with the physical and social environments of public housing units. They also participated in small, weekly group sessions for six weeks that included empowerment counseling and group prayer. Two community health workers attended meetings and contacted women individually each week to provide more support.

Women in Underwood Homes attended nurse-led educational meetings about health topics including hypertension, nutrition, exercise and self-esteem. They also received smoking-cessation materials. "Having the community members involved not only in the planning and implementation of the project, but also the evaluation was instrumental to empowering women to strengthen and promote behavioral changes in their communities," says Dr. Andrews. "These early results clearly show that a community health worker-led intervention holds promise for promoting awareness and outreach of the program, promoting trust in the community and ensuring cultural appropriateness of the intervention."

The initial study was funded by the National Institute of Nursing Research and the American Legacy Foundation - a non-profit organization funded by the historic Master Settlement Agreement between a coalition of attorneys general in 46 states and five U.S. territories and the tobacco industry.

The current Sister to Sister study, funded by the American Legacy Foundation and the Georgia Cancer Coalition, has enrolled 150 women from four Augusta public housing neighborhoods - Underwood Homes, Delta Manor, Dogwood Terrace and Cherry Tree Crossing.

The intervention strategy now includes a permanent community health worker, Stacey Crawford, who leads group meetings in treatment neighborhoods. Nicotine patches also are provided to women in both comparison and treatment neighborhoods, but only treatment neighborhoods feature group sessions with a community health worker.