Proactive Tobacco Cessation Outreach to Smokers of Low Socioeconomic Status

Haas, Jennifer S.; Linder, Jeffrey A.; Park, Elyse Richelle; Gonzalez, Irina; Rigotti, Nancy A.; Klinger, Elissa V.; Kontos, Emily Z.; Zaslavsky, Alan M.; Brawarsky, Phyllis; Marinacci, Lucas; Hubert, Stella St; Fleegler, Eric W.; Williams, David R.

doi:10.1001/jamainternmed.2014.6674

Cited by 127 publications

(144 citation statements)

References 37 publications

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“…In the general population, use of FDA-approved cessation medications is associated with better cessation outcomes [18]. However, use of nicotine replacement therapy was not associated with increased quitting when compared to controls in a recent randomized controlled trial with low-income smokers [19]. Many factors may influence the use of cessation aids, including access to medications as well as perceived efficacy of these medications during a quit attempt [16,[19][20][21].…”

Section: Discussionmentioning

confidence: 99%

Interest in Smoking Cessation Related to a Smoke-Free Policy Among Homeless Adults

Vijayaraghavan,

Pierce

2015

J Community Health

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Homeless adults have among the highest rates of cigarette smoking. Few studies have explored the potential of smoke-free policies as facilitators of smoking cessation or harm reduction among sheltered homeless adults. We focused on clients of a homeless shelter in San Diego, California. The facility prohibited smoking indoors and outdoors within five blocks of the building, and permitted smoking during four smoking breaks during the day in designated smoking zones away from the building. Current and former smokers who were residents of the facility were interviewed on smoking behaviors and attitudes toward these policies. Of the 170 ever smokers, 75.3 % were current smokers. The average daily cigarette consumption was 6.6 cigarettes per day (SD 4.3). More than half of the participants (57.8 %) attempted to quit smoking in the past year. Of the current smokers, threefourths agreed that the facility policies were associated with their reduced consumption, and about half agreed that the policies were associated with either making a quit attempt or getting ready to quit completely. Sixty percent agreed that further restrictions on smoking, beyond the current policies, would be associated with increased interest in quitting smoking completely. Less than 10 % agreed that they were unhappy to stay in the facility because of the policies. Findings suggest that smoke-free policies may not influence occupancy rates in shelters serving clientele with high rates of cigarette smoking. Smoke-free policies in homeless service settings present an important and un-tapped opportunity to reduce smoking behaviors among homeless adults.

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Section: Discussionmentioning

confidence: 99%

Interest in Smoking Cessation Related to a Smoke-Free Policy Among Homeless Adults

Vijayaraghavan,

Pierce

2015

J Community Health

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“…Complementary programs implemented in conjunction with tax increases need to be concurrent, as there is a limited window of time within which complementary programs can be effective (Keller et al, 2015). These complementary programs should consider using media that encourages quit attempts (e.g., the “TIPS” campaign; see McAfee et al, 2013), as well as provide resources and access to cessation services (Keller et al, 2015; Slater et al, 2016; Haas et al, 2015). Programs could also attempt to alter multilevel and social processes that influence tobacco-related disparities (Twyman et al, 2014), as well as harness processes that are inherent in the quitting process such as social support and social contexts that provide pro-change mechanisms (Parks et al, 2016; Kingsbury et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

Behavioral change in response to a statewide tobacco tax increase and differences across socioeconomic status

Parks

Kingsbury

Boyle

et al. 2017

Addictive Behaviors

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Background Tobacco use is a leading behavioral risk factor for morbidity and mortality, and the tobacco epidemic disproportionately affects low-socioeconomic status (SES) populations. Taxation is effective for reducing cigarette use, and it is an effective population-based policy for reducing SES-related tobacco disparities. However, progress in implementing cigarette excise taxes has stalled across the United States, and there is a dearth of research on the full spectrum of behavioral shifts that result from taxes, particularly among low-SES populations. This project documents the impact of Minnesota’s $1.75 cigarette tax increase implemented in 2013. Methods Data come from the 2014 Minnesota Adult Tobacco Survey. Descriptive analyses and Latent Class Analysis (LCA) were used to provide a typology of the tax impact. Results From the LCA, six classes were identified, and 42% of respondents were classified as reporting action-oriented behavioral change related to the tax—8% reported sustained smoking abstinence. We found differential behavior change across levels of SES. Low-SES and medium/high-SES individuals were equally likely to report complete tobacco cessation, but the prevalence of daily smokers who reported action-oriented behavior without sustained cessation was nearly double for low-SES individuals. Conclusions Smokers report a range of behavioral changes in response to cigarette taxes, with differences across SES. The majority of smokers, and particularly low-SES smokers, report behavioral steps toward quitting or achieving sustained tobacco cessation in response to cigarette taxes. Complementary population-based programs geared toward assisting individuals, especially low-SES individuals, to achieve continuous tobacco cessation could increase the reach and effectiveness of cigarette taxes.

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“…We may have been underpowered to detect a meaningful difference in abstinence rates between those who did and did not use NRT, highlighting a need for studies that explore the efficacy of NRT for smoking cessation in this population. Other factors may influence the efficacy of NRT for smoking cessation in the homeless population including intensity of smoking, 49,50 use of concurrent tobacco products, frequency of use of NRT, and access to other treatments for cessation; these factors merit further exploration. Examining access to smoke-free living environments, identifying messages to convey smoking-related health effects, and identifying perceptions of current tobacco control strategies may provide additional insights into developing effective interventions for smoking cessation among this population.…”

Section: Discussionmentioning

confidence: 99%

Tobacco Cessation Behaviors Among Older Homeless Adults: Results From the HOPE HOME Study

Vijayaraghavan¹,

Tieu²,

Ponath³

et al. 2016

NICTOB

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Introduction: Tobacco-attributable deaths contribute significantly to the increased mortality observed among homeless adults aged 50 years or more. Little is known about the epidemiology of tobacco use among older homeless individuals. This longitudinal cohort study examines smoking behaviors and factors associated with smoking cessation among homeless individuals aged 50 years or more. Methods: We recruited a prospective cohort of 350 homeless individuals sampled from the community in Oakland, California. At 6 months follow-up, participants reported their cigarette quit attempts and 30-day abstinence. We used multivariable logistic regression to examine factors associated with making a quit attempt at follow-up, hypothesizing that heavier smokers would be less likely to make a quit attempt. Results: Of the 272 ever-smokers, 229 (84.2%) were current smokers (quit ratio 15.8). Among current smokers at enrollment who had a follow-up interview at 6 months, 43.6% (n = 71) reported making a quit attempt during the follow-up. Of those who reported making a quit attempt, 14.3% (n = 10) reported 30-day abstinence at follow-up. Among those who had reported making a quit attempt at follow-up, 22.5% had used nicotine replacement therapy (NRT). Staying in shelters (adjusted odds ratio [AOR] = 2.5, 95% confidence interval [CI] = 1.0-5.8) was associated with higher odds of making a quit attempt at follow-up. Higher cigarette consumption was associated with lower odds of making a quit attempt (AOR = 0.9, 95% CI = 0.8-0.9). Conclusions: In this study of tobacco use in older homeless adults, rates of quit attempts were similar to that observed in the general population, but successful quitting was lower. Implications: The current study is among the first studies to focus specifically on tobacco use and cessation behaviors among older homeless adults. The high prevalence of smoking and the low rates of successful quitting highlight numerous opportunities to intervene to increase quitting rates among this population. Among these, increasing access to smoke-free living environments and identifying effective cessation therapies will be critical to reducing tobacco-related disease burden among older homeless adults.

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Proactive Tobacco Cessation Outreach to Smokers of Low Socioeconomic Status

Cited by 127 publications

References 37 publications

Interest in Smoking Cessation Related to a Smoke-Free Policy Among Homeless Adults

Interest in Smoking Cessation Related to a Smoke-Free Policy Among Homeless Adults

Behavioral change in response to a statewide tobacco tax increase and differences across socioeconomic status

Tobacco Cessation Behaviors Among Older Homeless Adults: Results From the HOPE HOME Study

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