1034 JOURNAL OF THE NATIONAL MEDICAL ASSOCIATION VOL. 101, NO. 10, OCTOBER 2009 o r i g i n a l c o m m u n i c a t i o n IntroductIon W hile general population data indicate that smoking prevalence is 24.5% among white American women women, compared to 16.3% among African American women 1 , these statistics are misleading due to studies that reveal that (1) rates of smoking are higher for white American women than for African American women until the mid-30s, after which the data are reversed; 2 and (2) cigarette smoking estimates are higher for women living below the poverty level and/or with a GED or less, compared to women with an undergraduate college degree or higher and women living at or above the poverty level. 1 (African American women are overrepresented among the poor and less educated). 3 Although recent data indicate that the percentage of smokers who have quit smoking has increased signifi- cantly in the general population, statistics reveal that the smoking cessation gap appears to be widening between African American women compared to white American women. 4,5 For example, while the percentage of white American women who quit smoking in 1965 increased from 19.6% to 40.4% in 2006, the percentage of African American women who quit smoking in 1965 increased from 14.5% to 34.7% in 2006. 1,2 This disparity exists despite the fact that African American women express a strong desire to quit, confidence in their ability to quit, and are light to moderate smokers. 6-8 Quitting smoking is particularly imperative for Afri- can American women due to their disproportionate rates of smoking-related morbidity and mortality. For example, incidence of lung cancer is higher among African Ameri- can women than white American women, and the death rate due to lung cancer is 18% higher in African American women compared to white American women. 9,10 Studies reveal that African American women are less Author Affiliations: Department of Behavioral Science, College of Medicine (Dr Fernander, and Mss Goldsmith-Mason, White, and Obi) and Depart- ment of Biostatistics, College of Public Health, University of Kentucky (Dr Bush), Lexington, Kentucky. Funding/Support: This research was supported by the Kentucky Lung Cancer Research Program, grant 3048104060, Dr Fernander (principal investigator). Objective: Quitting smoking is particularly imperative for African American women due to their disproportionate rates of smoking-related morbidity and mortality. However, very few smoking cessation interventions have demon- strated successful quit rates for African American women. This study sought to examine the Breathe Free ™ for Women (BFFW) smoking cessation lifestyle program among African American female smokers. The primary objective of the pilot project was to examine end-of-treatment quit rates, and the secondary objective sought to obtain feedback from African American female participants on the acceptability of the intervention in this population. Methods: A total of 42 African American females were recruited to participate in 1 of 6 intervention cohorts. Each intervention cohort participated in 9 group sessions present- ed over a period of 4 weeks. Participants complete an inves- tigator developed survey assessing current smoking status as well as impressions of each intervention session. Results: An end-of-treatment quit rate of 19% was achieved with an average study retention rate of 70%. In addition, par- ticipants’ feedback indicated that the BFFW intervention offers a highly promising model for enhanced tailoring by incorporat- ing socioculturally relevant methods, materials, and content. Conclusions: Future research must address the critical public health need for socioculturally relevant adaptations of exist- ing and promising smoking cessation programs for African American women. Keywords: African Americans n women’s health n tobacco J Natl Med Assoc. 2009;101:1034-1040 End-of-Treatment Smoking Cessation Among African American Female Participants in the Breathe Free ™ for Women Smoking Cessation Program: Results of a Pilot Study Anita Fernander, PhD; Heather Bush, PhD; Shakira Goldsmith-Mason, MS; Pamela White; Brittaney Obi corresponding Author: Anita F. Fernander, PhD, 103 College of Medicine Office Building, Department of Behavioral Science, College of Medicine, University of Kentucky, Lexington, KY 40536-0086 (afern2@uky.edu).