Limitations of the study include use of a convenience selleck chem sample of smokers enrolled in a smoking cessation trial. Thus, these findings may not generalize to smokers not seeking help quitting. Nonetheless, research with smokers who are motivated to quit is important because these are the people who are most amenable to change. Also, the study was cross-sectional in design, which precludes causal inferences. Longitudinal assessment of symptoms would allow discernment of the temporal ordering of these relationships. In addition, anxiety, coping, and emotional support are relevant factors that the present study did not assess. These measures should be included in future studies. Finally, the limitations of self-report data (e.g., social desirability, memory constraints) must be recognized.

Notwithstanding the limitations of this study, its findings can inform treatment plans for Black smokers interested in quitting. Treatments based on the biopsychosocial model aim not only to reduce symptoms but also to improve functioning across these domains (Aitken, 1987). Stress, depression, and alcohol use are modifiable factors that can be managed through established cognitive�Cbehavioral intervention techniques. Future research should test whether attending to these psychosocial factors in Black smokers reduces the prevalence of smoking-related physical symptoms. Funding National Cancer Institute (R03-CA126418). Declaration of Interests None declared. Supplementary Material [Article Summary] Click here to view.

Acknowledgments The authors thank the Syracuse Community Health Center, the Onondaga County Department of Health, and SUNY Upstate Medical University for their support of this work. Special thanks are extended to Maria Ippolitto and Mia Davidner Feldman for their assistance with coordinating the study.
A target sample of 60 support persons was based on the primary aim of examining feasibility. Recruitment occurred over a 5-month period from 2005 to 2006 and consisted of flyers displayed in the community that targeted family members or friends who wanted to help a smoker quit. Individuals were eligible for the study if they were at least 18 years of age, provided written informed consent, had never smoked or had not smoked in the past 6 months, wanted to help a current adult smoker (average of at least one cigarette smoked per day during the past 7 days), and had current and expected contact (face-to-face, telephone, or E-mail) with their smoker on at least 4 days/week for the 6-month study duration, and if their smoker provided written informed consent.

Individuals were excluded if another support person from the same household had enrolled, if another individual had enrolled to help the same smoker, or if the smoker was currently (in the past 30 days) receiving cessation treatment. The study was approved by the Mayo Clinic institutional review board. A total of 98 people expressed interest in the study; Batimastat 85 were reached for screening.