A Pilot Randomized Clinical Trial of Brief Interventions to Encourage Quit Attempts in Smokers From Socioeconomic Disadvantage

Abstract

Introduction Cigarette smoking disproportionately affects communities of low socioeconomic status where greater smoking prevalence and poorer cessation rates have been observed. Utilizing brief evidence-based interventions to increase cessation attempts may be an effective and easily disseminable means by which to mitigate undue burden in this population. Aims and Methods The current intervention randomized daily smokers (N = 57) recruited from a local community soup kitchen to receive either Brief (eg, 30 m) Motivational Interviewing, Nicotine Replacement Therapy (NRT) sampling, or a Referral-Only intervention. Approximately half of participants (50.9%) reported not completing high school and many reported either just (41.4%) or not (40.4%) meeting basic expenses. Follow-up was completed approximately 1-month postintervention. Results Nonsignificant group differences indicated that participants randomized to the NRT sampling condition were more likely to make a quit attempt (moderate effect size). Approximately 40% of the sample reported making a serious quit attempt at follow-up. Significant differences in cigarettes per day at follow-up, controlling for baseline, were observed, with participants in the Motivational Interviewing condition, only, reporting significant reductions. Participants randomized to the NRT condition were significantly more likely to report using NRT patch and lozenge at follow-up (large effect). There were no differences between groups with respect to seeking behavioral support. Finally, we found that subjective financial strain moderated the effect of condition on change in cigarette consumption where NRT sampling was more effective for participants reporting less financial strain. Conclusions Findings provide initial evidence for personalizing brief interventions to promote quit attempts in low-income smokers. Implications While most clinical research on tobacco use and dependence focuses on successful sustained abstinence, the current study is novel because it examined three brief interventions designed to increase the number of quit attempts made by a nontreatment-seeking group suffering from health disparities (ie, smokers from socioeconomic disadvantage). These data suggest that nontreatment-seeking smokers from socioeconomic disadvantage can be influenced by Brief MIs and these interventions should be used to motivate smokers from socioeconomic disadvantage to make a quit attempt. Future studies should examine combined MIs including pharmacological and behavioral interventions.

A Systematic Review of the Effectiveness of Brief Health Behaviour Change Interventions on Service Users Accessing the Third and Social Economy Sector

“…Characteristics and fndings of the eight included studies [52][53][54][55][56][57][58][59] are displayed in Table 3. Seventy-fve percent of the included studies measured smoking behaviour [52][53][54][55][56][57], and the remaining two studies measured factors related to diet [58,59] and exercise [58]. Te included studies were a mixture of TSE settings [54,[57][58][59] and TSE service providers [52,53,55,56,58].…”

“…Seventy-fve percent of the included studies measured smoking behaviour [52][53][54][55][56][57], and the remaining two studies measured factors related to diet [58,59] and exercise [58]. Te included studies were a mixture of TSE settings [54,[57][58][59] and TSE service providers [52,53,55,56,58]. TSE settings ranged from churches [58,59], homeless shelters [54], and a food bank [57], and TSE service providers were often peers such as fellow veterans [52] or church attenders [58], although some were volunteers from voluntary organisations [55,56] such as girl guides [53].…”

“…For service providers from TSEs, training in brief intervention ranged from one [52] to 16 hours [58]. For the remaining studies, providers ranged from trained counsellors [54] to clinical psychology PhD students [57] and to study authors [59]. Concerning study samples, sample size at the beginning of the study ranged from 64 [57] to 1,226 [55] and were mostly male.…”

Efficacy of Motivational Interviewing and Brief Interventions on tobacco use among healthy adults: A systematic review of randomized controlled trials

“…All studies used a randomized controlled trials design with one or another trial feature, including allocation concealment and blinding. Of the 12 studies, 3 studies used brief intervention or brief advise, (30,32,35,38,41) 6 studies used motivational interviews, (15,30,33,34,37,40) and one study used brief counseling on harm to self and harm to others (39) and quit immediately award model based on brief intervention approach. Seven of the 12 studies (58.3%) reported a beneficial effect of brief advice or motivational interview on reducing tobacco use (Table 2).…”

“…However, the same study reported increased cessation of medication use, motivation, and confidence to quit compared to brief advice, which further indicates the effectiveness of MI in behavior changes to quit smoking. In a study (34) at a Northeastern US State, daily smokers attended brief motivational interviewing and significantly reduced cigarette use. Likewise, motivational interviewing effectively improved quitting smoking among nurses over brief advice in a study conducted in Spain.…”