Declaration of Interests None declared. Supplementary Material Supplementary Data: Click here to view. Acknowledgments We would like to thank Nora Volkow, M.D., Director of the National Institute on selleck inhibitor Drug Abuse at the National Institutes of Health, and colleagues at the Clinical Trials Network for support and encouragement in exploring acceptability and sustainability of innovation in approaches to tobacco cessation.
Tobacco smoking continues to be the leading cause of preventable disease in the United States (Centers for Disease Control [CDC], 2011). Although there have been considerable reductions in overall smoking rates in the United States, in 2010, 19.3% of all adults in the United States were regular smokers (CDC, 2011).

National prevalence estimates of smoking among adults (ages 18 and older) are similar for Blacks (or African Americans, we use these terms interchangeably; 20.6%) and Whites (21.0%), higher for American Indian/Alaska Native adults (31.4%), and markedly lower among Hispanics (12.5%) and Asian Americans (9.2%). However, national averages by race obscure dramatically higher rates of smoking for certain subgroups, including low-income individuals (CDC, 2011) and urban racial/ethnic minorities (Dell, Whitman, Shah, Silva, & Ansell, 2005; Delva et al., 2005). For example, in a recent study of Chicago��s North Lawndale community (almost entirely African American, with 45% living below the poverty line), 39% of adults reported smoking regularly (Dell et al., 2005). Similarly, a community-based area probability sample of low-income Blacks in Detroit reported a smoking prevalence of 41.

8% (Delva et al., 2005). High rates of smoking within urban Black communities is of great concern, given that Blacks experience disproportionately higher rates of tobacco-related health consequences than other racial/ethnic groups (Haiman et al., 2006). Research is needed on factors associated with smoking among urban Blacks in order to reduce disparities in tobacco use and the national prevalence of smoking. Psychosocial stressors, defined as social or environmental exposures or demands that place a burden on adaptive capacities of an individual (Cohen, Janicki-Deverts, & Miller, 2007), are important to consider. A substantial amount of research has documented that psychosocial stress is a significant risk factor for smoking (Webb & Carey, 2008) and predicts difficulty with smoking cessation (Berg et al., 2010). Smoking is more common among individuals who report higher levels of work strain (Ayyagari & Sindelar, 2010), financial strain (Siahpush, Spittal, & Singh, 2007), relationship stress (Stein Brefeldin_A et al., 2008), discrimination (Williams & Mohammed, 2009), and stressful life events (McKee, Maciejewski, Falba, & Mazure, 2003).