Smoky cabarets, Humphrey Bogart dragging a cigarette from his lips in “Casablanca” and the song “Smokin’ in the Boys Room” all tell people that smoking is cool.
While the imagery may be romantic, there’s nothing attractive about smoking, which, in addition to causing lung cancer, can lead to head, neck and oral cancer.
Through a new smoking cessation project at UAB, Isabel Scaranci, Ph.D., hopes to improve the health of young black men in Alabama’s poorest rural communities, who often begin smoking in their teens. A preliminary survey in the Black Belt shows that nearly 40 percent of African-American men between 15 and 30 years of age in rural counties smoke. Nationally, the prevalence of smoking among young black men is 20 percent.
Scaranci, Dr. William Carroll and Young-Il Kim, Ph.D., were recently awarded a grant through the National Institutes of Health, with the goal of helping young African-American men kick the deadly habit. That mission coincides with Oral, Head and Neck Cancer Awareness Week® April 8-15, led by the Head and Neck Cancer Alliance and supported by the American Academy of Otolaryngology – Head and Neck Surgery.
“Smoking is an addiction, and it’s very hard to change that behavior,” said Scaranci, associate director for Globalization and Cancer at UAB Comprehensive Cancer Center. “In the Black Belt and the Mississippi Delta, there are disparities in screening and treatment for cancer. These are very poor and isolated counties in Alabama. When you have the burden of disease, head and neck cancer is a horrible disease.”
Outreach to these economically disadvantaged populations has been difficult historically. Scaranci, who has made it her professional and personal mission to assist medically underserved communities, said it is important to begin understanding, early in young men’s lives, the patterns of tobacco use.
Carroll, a member of UAB’s Comprehensive Cancer Center, has seen an increase in head and neck cancers in African-American men caused by tobacco use.
“The biggest thing is that we kept seeing this devastating disease from the same communities,” said Carroll, professor and John S. Odess Endowed Chair, UAB Department of Otolaryngology. “That’s what motivated us to try to make a difference. We would like to interrupt this cycle in young people before the habits get too deeply engrained so that we might have a better chance of avoiding tobacco-related disease.”
Scaranci said that it’s necessary to take a different approach when assisting rural communities.
“We saw very high tobacco use there,” Scaranci said. “Now we need to develop an intervention tailored to this group. Care needs to be tailored to the reasons that people smoke. It’s not one size fits all. We need more attention on our rural populations.”
In many underserved neighborhoods, she said, “The tobacco stores target vulnerabilities. Tobacco products are really marketed to the population. And the thing is, many of these populations are isolated. Some people don’t have a car and can’t easily go to doctor appointments.”
Scaranci said that cognitive behavioral therapy and pharmacological management, such as nicotine replacement patches, are proven deterrents to smoking. UAB’s R21 grant will go toward training community health workers who will promote smoking cessation while receiving guidance and pharmacological management from UAB staff through telehealth.
Scaranci said the program is a creative way of reaching the population.
“We’re going to the ‘natural helpers’ in the community,” she said. “We will train lay people to be certified peer health educators, to promote behavioral change and do things that are sustainable in the local community. They will be UAB employees. People will have their own expert who they trust, who will work in tandem with us through telecommunication management.”
Scaranci said she is proud UAB strives to perform outreach in innovative ways of serving the community.
“These populations need the backup of a healthcare system,” she said.
Scaranci encourages people who need help to stop smoking to call Quit Now Alabama at 1-800-QuitNow (1-800-784-8669) to receive an assessment and free nicotine patches. The program provides four weeks of nicotine replacement therapy.