, 2005, 2007; Yerger et al., 2008). The finding that Black smokers discount the need for cessation treatment of any kind suggests that they hold different views on nicotine dependence, http://www.selleckchem.com/products/AZD2281(Olaparib).html including the value of comprehensive treatment for it. Thus, there seems to be an overall dismissal of any treatment need not just medication alone. This underscores a clear need for increased education on the challenges of quitting and the role of pharmacotherapy in that process. The need for heightened education is more apparent, given prior research that shows lower rates of health literacy among Blacks (Willey, Williams, & Boden-Albala, 2009) as well as the link between low health literacy and negative health outcomes (Williams, Davis, Parker, & Weiss, 2002).

Importantly, there is support for the efficacy of educational efforts to improve health care literacy among Blacks (Mabiso, Williams, Todem, & Templin, 2010; Yang et al., 2010). Contrary to our hypothesis, however, we did not find significant Race �� Attitude interactions as being predictive of pharmacotherapy use. That is, associations between use and attitudes were consistent across (not moderated by) racial group. This suggests that the attitudes that undermine pharmacotherapy usage are universal across race and possibly other demographics. Conversely, this may reflect limitations in power, incomplete assessment of attitudinal beliefs about pharmacotherapy, or both. Our data collection instrument was limited in its scope of pharmacotherapy attitudes.

We conceptualized attitudinal barriers as consisting primarily of safety concerns and doubts of efficacy, an approach based on prior research (Cummings et al., 2004; Fu et al., 2005, 2007; Shiffman, Ferguson, et al., 2008; Yerger et al., 2008). Other more detailed attitudes certainly exist, such as the comparative harm of pharmacotherapy to smoking. Nonetheless, the lack of significant Race �� Attitude interactions suggests that factors other than attitudes may undermine pharmacotherapy use among Blacks. Prior studies have documented a history of negative health care experiences among Black smokers (Browning, Ferketich, Salsberry, & Wewers, 2008; Chase, McMenamin, & Halpin, 2007; Franks, Fiscella, & Meldrum, 2005; Fu et al., 2007; Houston, Scarinci, Person, & Greene, 2005) and strong negative attitudes (i.e., mistrust) toward doctors (Fu et al., 2007).

Perceptions of discrimination and inequity within the health care system are related to medical care delays and nonadherence (Casagrande, Gary, LaVeist, Gaskin, & Cooper, 2007). Also, a number of studies have shown that Blacks are routinely less likely to receive adequate quit advice from health care providers than Whites (Browning et al., 2008; Chase et al., 2007; Franks Carfilzomib et al., 2005; Houston et al., 2005).