Blank under the guidance of Thomas Eissenberg. Portions of this work were presented at the 12th Annual Meeting of the Society for Research on Nicotine and Tobacco, 15�C18 February 2006. All work was performed at Virginia Commonwealth University.
Smoking is one of the leading causes of premature mortality worldwide and remains the leading cause Tubacin side effects of preventable death in the United States (Centers for Disease Control and Prevention [CDC], 2002). It is a major risk factor for several diseases, including lung cancer (Pirozynski, 2006), coronary heart disease (Redfern, Ellis, Briffa, & Freedman, 2006), stroke (Hankey, 2005), and respiratory diseases (Frank, Morris, Hazell, Linehan, & Frank, 2006).

Smokers with chronic illnesses are at especially high risk for poor health outcomes, not just from the chronic illnesses themselves but also from the adverse outcomes associated with their smoking behavior. For example, smokers with diabetes are considered to have a risk for future coronary events that is equivalent to those who have already experienced one cardiac event. Apart from the burden of smoking on individuals, smoking costs society billions of dollars annually as measured by health care costs and mortality-related productivity losses (Bertakis & Azari, 2006; Bunn, Stave, Downs, Alvir, & Dirani, 2006; CDC, 2002). An estimated 20.9% (ca. 45 million) of U.S. adults currently smoke cigarettes (CDC, 2006). Smoking prevalence varies by racial group, age, gender, and education (Adams & Schoenborn, 2006; CDC, 2005, 2006). American Indian/Alaska Native adults (32.

9%) are most likely to be smokers, followed by White (22.2%), Black (20.9%), and Asian adults (11.6%). Smoking is most prevalent among adults aged 18�C44 years (25.0%) and is more prevalent among men than women. The deleterious effects of smoking on public health have lead to numerous behavioral (Brown et al., 2001; Hennrikus et al., 2005; Lancaster & Stead, 2005; Lichtenstein, Glasgow, Lando, Ossip-Klein, & Boles, 1996) and pharmacotherapeutic (Croghan et al., 2007; Lerman et al., 2004; Saules et al., 2004) smoking cessation interventions, which have had varying degrees of success. Behavioral programs have been implemented in a variety of settings (hospitals, workplace) and using different modalities (telephone counseling, Internet-based, group format, brief vs. multiple counseling).

Pharmacotherapeutic interventions have focused primarily on nicotine replacement agents (nicotine gum, patch, nasal Carfilzomib spray, and spray) and antidepressants such as bupropion. The effectiveness of these smoking cessation programs has been associated with several sociocultural factors. For example, being married (Madan et al., 2005; van Loon, Tijhuis, Surtees, & Ormel, 2005) and having a high level of motivation (Dotinga, Schrijvers, Voorham, & Mackenbach, 2005; Franks, Pienta, & Wray, 2002) have been associated with higher smoking cessation rates, whereas lower educational attainment (Wetter et al.