Commentary: Educational and Clinical Training Considerations for Addressing Tobacco-Related Cancer Health Disparities

Abstract

In the United States, tobacco use is a leading contributor to inequities in cancer health among individuals for many ethnic, racial, sexual minority, and other minority groups as well as individuals in lower socioeconomic groups and other underserved populations. Despite remarkable decreases in tobacco use prevalence rates in the United States over the past 50 years, the benefits of tobacco control efforts are not equitably distributed. Tobacco-related disparities include higher prevalence rates of smoking, lower rates of quitting, less robust responses to standard evidence-based treatments, substandard tobacco treatment delivery by health care providers, and an increased burden of tobacco-related cancers and other diseases. Among the multiple critical barriers to achieving progress in reducing tobacco treatment-related disparities, there are several educational barriers including a unidimensional or essentialist conceptualizations of the disparities; a tobacco treatment workforce unprepared to address the needs of tobacco users from underserved groups; and known research-to-practice gaps in understanding, assessing, and treating tobacco use among underserved groups. We propose the development of competency-based curricula that: 1) use intersectionality as an organizing framework for relevant knowledge; 2) teach interpersonal skills, such as expressing sociocultural respect, a lack of cultural superiority, and empathy as well as skills for developing other-oriented therapeutic relations; and 3) are grounded in the science of the evidence-based treatments for tobacco dependence. These curricula could be disseminated nationally in multiple venues and would represent significant progress toward addressing tobacco-related disparities.

Trauma exposure, PTSD symptoms, and tobacco use: Does church attendance buffer negative effects?

“…Tobacco use among African Americans differs from that of Whites in important ways: African Americans initiate tobacco use at older ages (Nelson et al, 2008), are more likely to use tobacco on an occasional or non-daily basis (Trinidad et al, 2009), use a greater variety of tobacco products (Kennedy, Caraballo, Rolle, & Rock, 2016), and have lower rates of cessation (Holford, Levy, & Meza, 2016;Kulak, Cornelius, Fong, & Giovino, 2016 et al, 2010). Our findings underscore the need for evidence-based, culturally informed, and patient-oriented interventions for African American tobacco users to reduce this health disparity (Cox, Okuyemi, Choi, & Ahluwalia, 2011;Liu et al, 2013;Sheffer, Hooper, & Ostroff, 2018).…”

Preventing Tobacco-Related Cancer Disparities: A Focus on Racial/Ethnic Minority Populations

“…Each seeks to enhance our collective understanding of potential targets for individual, systems-level, and policy interventions to prevent cancer disparities. Sheffer et al 12 14 did not find an association between menthol cigarette smoking and e-cigarette use overall. However, menthol smokers reported less e-cigarette knowledge and were interested in trying these products to quit smoking.…”

Health and Health Care Disparities in Cancer and Cardiovascular Diseases: Learning from One to Improve the Other

“…The articles address three areas of focus that are highly relevant for, and applicable to, cardiovascular disease: lifestyle behaviors, attitudes, knowledge and perceptions [12][13][14] ; promising interventions 15,16 ; and policies and training. 17,18 These are all areas where progress made in our understanding of cancer disparities and the design of effective interventions can have direct benefit for addressing cardiovascular disparities.…”

“…It is through this lens that cardiovascular specialists and health care professionals interested in cardiovascular disparities would Editorial: Cancer Disparities -Mensah use of technologies such as email and text messaging can inform communication technology-based interventions. 16 As emphasized in the article by Sheffer et al, 18 challenges in clinical training and workforce preparedness to address tobacco treatment-related disparities remain important barriers to achieving progress in reducing cancer disparities. These challenges have relevance for addressing cardiovascular disparities.…”

“…In fact, competency-based curricula that use intersectionality as an organizing framework proposed by Sheffer et al will be helpful in framing the approach to skills-building and continuing education in efforts to reduce cardiovascular disparities. 18 Although the articles in this issue of Ethnicity & Disease focus only on the important shared risk of tobacco, the research themes of lifestyle behaviors, attitudes, knowledge, perceptions, promising interventions, policies, and training all have relevance for the other shared risk factors important for cancer and cardiovascular disparities. The articles therefore provide an opportunity for us to learn from tobacco-related cancer disparities to inform research and the design of interventions for addressing cardiovascular disparities.…”