Abstract

To help tobacco control research better include vulnerable populations, we sought to identify effective ways to recruit diverse smokers. In 2014–2015, we recruited 2149 adult cigarette smokers in California and North Carolina, United States, to participate in a randomized trial of pictorial cigarette pack warnings. The most effective means of recruiting smokers were the classified advertising website Craigslist (28% of participants), word of mouth (23%), Facebook (16%), and flyers or postcards (14%). Low-income and African American smokers were more likely to respond to interpersonal contact (including staff in-person recruitment and word of mouth) than were high-income and non-African American smokers (all p < 0.05). Hispanic and gay, lesbian, and bisexual smokers were more likely to be recruited by Craigslist than non-Hispanic and straight smokers (both p < 0.05). Of the recruitment methods requiring cost, the cheapest was Craigslist ($3–7 per smoker). The most expensive methods were newspaper ads in California ($375 per smoker) and staff in-person recruiting in North Carolina ($180 per smoker). Successfully recruiting diverse smokers requires using multiple methods including interpersonal, online, and other media. Craigslist and word of mouth are especially useful and low-cost ways to recruit diverse smokers.

Highlights

  • Despite recent declines in smoking, 17% of adults in the United States (US) smoke cigarettes, a behavior that causes over 480,000 deaths per year [1,2]

  • Low-income smokers were more likely than high-income smokers to be recruited by interpersonal methods and bus ads and less likely to be recruited by Craigslist and roadside signs

  • We found that similar approaches worked for recruiting African American and low-income smokers

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Summary

Introduction

Despite recent declines in smoking, 17% of adults in the United States (US) smoke cigarettes, a behavior that causes over 480,000 deaths per year [1,2]. Notable disparities in smoking rates exist in the US. Smoking is more common among the poor; gays, lesbians, and bisexuals (GLB); transgender people; and African Americans [2,3,4]. These groups are disproportionately burdened by smoking-related diseases [5,6,7]. Despite the high rates of smoking in these demographic groups, they are consistently underrepresented in clinical trials [8,9,10,11]. Recruiting smokers from underrepresented and vulnerable populations into tobacco control studies is important for understanding how interventions and policies can reduce smoking disparities

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