A community-based tobacco cessation program for individuals experiencing homelessness. (June 2022)

• Record Type: Journal Article
• Authors: Hartman-Filson, Marlena; Chen, Jennifer; Lee, Priscella; Phan, Megan; Apollonio, Dorie E.; Kroon, Lisa; Donald, Fiona; Vijayaraghavan, Maya
• Is Part Of: Addictive behaviors. Volume 129(2022)
• Publication Date: 2022-06
• Subjects: People experiencing homelessness -- Tobacco cessation -- Pharmacy-linked interventions; Substance abuse -- Periodicals; Alcoholism -- Periodicals; Drug addiction -- Periodicals; Nicotine addiction -- Periodicals; Smoking -- Periodicals; Gambling -- Psychological aspects -- Periodicals; Electronic journals; 362.29
• DOI: 10.1016/j.addbeh.2022.107282
• Languages: English
• ISSNs: 0306-4603

Abstract

Highlights: Tobacco use is common among people experiencing homelessness. Homeless shelters may be appropriate sites to deliver cessation interventions. Training shelter staff to deliver cessation counseling is feasible. Community pharmacists can be leveraged to expand smoking cessation services in homeless shelters. Such an intervention may reduce tobacco use among people experiencing homelessness. Abstract: Background: Tobacco use is common among persons experiencing homelessness (PEH), and interventions are needed. We conducted a community-based, single-arm uncontrolled trial of a pharmacy-linked intervention for smoking cessation for PEH. Methods: The intervention took place between September 2019 and June 2021 in homeless shelters in San Francisco, CA. We trained shelter staff on how to provide brief cessation counseling, then tested a program among PEH in two shelters that included one-time pharmacist-delivered cessation counseling and nicotine replacement therapy (NRT) for 3 months. We examined factors associated with cigarette consumption and quit attempts. Results: We trained 69 staff from 8 shelters and selected 2 of those shelters as pilot sites for the program. Of the 52 participants, 71% were male and 49% were Black. The majority of participants reported making a quit attempt (70%) and using NRT (84%). Having an encounter with staff in the past week was associated with a 40% reduction in weekly consumption (Incidence rate ratio (IRR) 0.61, 95% CI 0.57–0.67) and using medications in the past week was associated with a 23% reduction in weekly consumption (IRR 0.78, 95% CI 0.75–0.81). Using medications in the past week increased the odds of a quit attempt 2.89 times compared to not using medications (Adjusted odds ratio (AOR), 2.89, 95% CI 1.45–5.77). Conclusions: Our findings highlight a role for leveraging community-based pharmacists to expand smoking cessation services in homeless shelters to reduce tobacco use among PEH.