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Health Educ Behav. 2014 Apr;41(2):186-96. doi: 10.1177/1090198113504415. Epub 2013 Nov 26.

Formative evaluation of a practice-based smoking cessation program for diverse populations.

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1Roswell Park Cancer Institute, Buffalo, NY, USA.



Smoking rates are higher among those living at or below poverty and among persons with lower levels of education. We report on a formative research project examining patient perceptions of tobacco cessation strategies among diverse, low socioeconomic, urban smokers cared for in community-based primary care medical offices.


We conducted 10 focus groups among low socioeconomic status participants recruited from urban primary care medical offices in Buffalo and Niagara Falls, New York. Participants included current or former smokers, who were stratified by age-group (18-39 years and 40+ years). The focus groups discussed perceptions of tobacco cessation strategies, previous quit attempts, and use/attitudes regarding technology and social media as potential platforms for cessation support.


Participants (n = 96) included predominantly African Americans (n = 62, 65%) and European Americans (n = 16, 16%); 56% were older than 40 years and 92% were low income. Most participants were supportive of cessation message delivery via phone; however, the age-groups varied in their attitudes on quitting smoking, desired frequency of phone contacts, and social media usage. Participants aged 18 to 39 years reported more Internet use, greater use of text messaging, and were more open to health information via social media.


Based on significant variation between younger and older smokers' perceptions of tobacco addiction and use of communication technologies, it appears reasonable to stratify the content and platform of health messaging by the target age-group.


evaluation; focus groups; formative evaluation; health behavior; health promotion; media; qualitative methods; smoking and tobacco use; social media

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