All ETDs from UAB

Advisory Committee Chair

Connie Kohler

Advisory Committee Members

Nataliya Ivankova

Jeroan Allison

Andrea Cherrington

Thomas Houston

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) School of Public Health


The purpose of this qualitative was to use data extracted from the narrative stories of African American patients to generate a grounded theory to explain the process and act of initiating and of quitting smoking among low income African American patients in the Deep South. This is important since African Americans are more likely to suffer from smoking-related illnesses, which are the leading cause of death among African Americans. Data were analyzed from interviews conducted in 2005 as part of the Stories Project and supplementary interviews conducted in 2011. Convenience sampling strategies guided participant recruitment for primary interviews and theoretical sampling strategies guided supplementary interviews. Inclusion criteria were: age 19 or older, African American race, current or former smoker, and absence of hearing, vision, or comprehension difficulties. Results were categorized according to whether participants were smokers or quitters at the time of the interview. The researcher asked open-ended questions regarding smoking initiation and quit experiences. Analysis was conducted using systematic design of grounded theory, which included open, axial and selective coding. Categories emerged during open coding and were connected during axial coding; categories were integrated to form a theory using selective coding. The core category was labeled "Cigarette Use." Both smokers and quitters had similar experiences in initiating smoking, specifically that they were encouraged to smoke by someone in close relationship with them. Both groups also had a common experience of continuing their smoking behavior after their initial smoking experience but some were eventually able to quit while others sustained their smoking. Both groups also relied on their faith in God to quit. However, a key difference was that although both quitters and smokers expressed a high level of self-efficacy in quitting, smokers experienced a much more difficult time in quitting and more frequently expressed that they were struggling to quit. Both groups also were resistant to using nicotine replacement therapy in quitting. Based on these findings, future intervention programs should assess barriers to using nicotine replacement therapy and try to increase uptake in order to improve smoking cessation rates.

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