Impact of individual- and neighborhood-level risk factors on brain responses to smoking cues among and across racial groups - Smoking is the leading cause of preventable deaths, with half a million occurring in the U.S.
However, this burden is not borne equally. For example, although African Americans (AAs) have
a comparable smoking prevalence to non-Hispanic Whites (NHWs), they are more likely to die
from smoking-related diseases. Further, AAs have lower smoking cessation rates than NHWs.
Consequently, AAs have greater lifetime exposure to tobacco smoke, which increases the risk
of tobacco-related disease. The reasons underlying these racial disparities in treatment efficacy
are not completely understood and appear even among clinical trials with equal treatments.
We currently understand smoking to be initiated and maintained through several
neurobiological processes, including enhancement of positive emotion, reduction of negative
emotion and/or stress, and avoidance of nicotine withdrawal. Thus, neurobiological assessment
might inform the development of more effective smoking cessation interventions. A promising
neurobiological metric, cue reactivity, is associated with addiction intensity and has been
shown to be predictive of cessation.
However, few studies have examined racial differences in cue reactivity. Thus, little is known
about neurobiological mechanisms that might underlie differences in smoking and/or cessation
success across racial/ethnic groups. Further no cue reactivity research has examined the
relationship between neighborhood-level correlates of tobacco disparities (e.g., neighborhood
poverty, crime) and cue reactivity. It is theorized that residents who are exposed to chronic
neighborhoods stressors, including disadvantage, violence, and crime, use nicotine as self-
medication against stress. Neighborhood disadvantage and its correlates are associated with
not only higher prevalence of smoking, but also decreased likelihood of quitting, and higher
likelihood of smoking initiation. Hence, it is possible that heightened and chronic exposure to
stressors at both the individual and neighborhood levels, which is disproportionately prevalent
among AAs, help shape the racial patterning of responses to smoking-related stimuli.
Using data of African American and non-Hispanic White smokers recruited from Houston,
Texas and Milwaukee, Wisconsin, this study will investigate the relationship between race,
individual factors, mentholated cigarette usage (given the disproportionate popularity of
mentholated cigarettes among AAs), and neighborhood-level stressors, including neighborhood
poverty and crime, and cue reactivity. Study results will help elucidate the key individual- and
neighborhood-level factors that predict and/or modify cue reactivity levels.
