Purpose: To explore why some African-American smokers choose not to use nicotine replacement therapy (NRT) when attempting smoking cessation.
Design and setting: Semistructured audiotaped qualitative telephone interviews.
Participants: Thirty-three participants who were enrolled in a five-week cessation program were offered free NRT. Participants were asked to share their experiences and perceptions about trying to quit smoking.
Procedures: Data related to NRT perceptions were analyzed using an interpretive approach.
Findings: Participant comments suggested two issues that may help explain why some African-American smokers do not use NRT when attempting cessation. First, many participants expressed concerns about the nicotine dose in NRT and worried that using it would increase nicotine dependence. Second, there was considerable discussion about NRT's ambiguous status as a "drug" (along with sometimes-unrealistic expectations for its efficacy independent of human effort) and concern about lack of control over drug delivery and absorption. For many participants, NRT contrasted unfavorably with cigarettes and was seen as unfamiliar and worrisome.
Conclusions: Differences in how cigarettes and NRT products are marketed convey different (and highly inaccurate) social messages about their social value and relative risks of harming consumers. Better positioning NRT as a social object through innovative marketing, improved delineation of relative risks and facilitating strategic discussions about ways to tailor NRT use may decrease obstacles to African Americans' use of NRT.