Predictors of Counseling Participation Among Low-Income People Offered an Integrated Intervention Targeting Financial Distress and Tobacco Use

Abstract

Introduction Although prevalence of smoking in the USA has been decreasing for decades, smoking rates among low-income individuals remain elevated. Theories from behavioral economics and prior research suggest that financial stress may contribute to the difficulty that low-income smokers face in quitting. The present work is a secondary analysis of a randomized controlled trial that incorporated financial coaching and social services referrals into smoking cessation treatment. Primary analyses showed that participants randomized to the intervention ( N = 208) were significantly more likely not to smoke, to have lower financial stress, and to be able to afford leisure activities ( p < .05) than were control participants ( N = 202). Methods This paper investigates subgroup discrepancies in attendance of intervention sessions and in uptake of various components of this intervention through exploratory analysis. Results Analysis using logistic regression indicated that decreased age, not having received higher education, and having income less than $1000 per month were predictive of decreased counseling attendance ( p < .05). Few demographic factors were predictive of uptake of counseling components among those who attended counseling. Conclusions These results can guide future efforts to increase participant engagement in the intervention. Trial Registration ClinicalTrials.gov Identifier: NCT03187730.