# Addressing Health Equity in Tobacco Cessation Treatment for Historically Underrepresented Veterans

> **NIH VA IK2** · MICHAEL E DEBAKEY VA MEDICAL CENTER · 2024 · —

## Abstract

Background: Tobacco inflicts a tremendous health burden on its users. Veterans use tobacco products at a
higher rate than seen in the US adult population. Nearly 16% of African American Veterans and 11% of
Hispanic Veterans smoke, compared to 12% of White Veterans. Risk of developing tobacco-related disease is
highest for African American Veterans, with higher use of menthol cigarettes than other Veterans increasing
burden. Hispanic Veterans are also at elevated risk for developing tobacco-related disease. However, both
African American and Hispanic Veterans’ use of evidence-based tobacco cessation treatment in the Veterans
Health Administration (VHA) is low, despite the 2019 VHA Directive 1056 updated requirements for increasing
access to evidence-based tobacco cessation to Veterans. African American and Hispanic Veterans who use
tobacco report greater readiness to quit and are more motivated to quit than White Veterans. High levels of
motivation, desire to quit, and acceptability of treatment options should result in high levels of treatment
initiation. However, low initiation of treatment may reflect cultural barriers to treatment and the need for tailored
strategies to increase use.
Significance/Impact: The project aims to improve the health of African American and Hispanic Veterans by
addressing health equity and evaluating social determinants of health associated with accessing tobacco
cessation treatment use, combining two important HSR&D research priorities. Increasing the proportion of
African American and Hispanic Veterans that use tobacco cessation treatment in the VHA would greatly
diminish disease burden, prevent mortality, and increase functioning in this underserved population. That, in
turn, would decrease the healthcare burden on VHA, as well as the $2.7 billion dollars spent annually on
tobacco-related care. Lastly, the project aligns with ORD-wide research priorities to expand historically
underrepresented Veterans’ access to quality clinical trials and promotion of equity.
Innovation: Project innovations include: 1) focusing on vulnerable and underrepresented African American
Veteran and Hispanic population, 2) addressing under-researched health equity in tobacco cessation treatment
in VHA, 3) novel use of the population-specific, health communication research methods, and 4) obtaining
input from both Veterans and national stakeholders.
Specific Aims: The project has 3 aims. Aim 1: Identify barriers and facilitators impacting delivery of tobacco
cessation treatment to African American and Hispanic Veterans across facilities within VISN 16. Aim 2:
Develop the Engagement, Navigation, and Transmission Intervention for Cessation Efficiency (ENTICE)
intervention to increase African American and Hispanic Veteran initiation of tobacco cessation treatment. Aim
3: Conduct a pilot trial of ENTICE for African American and Hispanic Veterans at the Houston VAMC.
Methodology: For Aim 1, a mixed-methods evaluation (interviews and VA administ...

## Key facts

- **NIH application ID:** 10864197
- **Project number:** 1IK2HX003697-01A2
- **Recipient organization:** MICHAEL E DEBAKEY VA MEDICAL CENTER
- **Principal Investigator:** Darius B. Dawson
- **Activity code:** IK2 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2024-01-01 → 2028-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10864197

## Citation

> US National Institutes of Health, RePORTER application 10864197, Addressing Health Equity in Tobacco Cessation Treatment for Historically Underrepresented Veterans (1IK2HX003697-01A2). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10864197. Licensed CC0.

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