Smoking cessation



Can quit rates improve among low-income smokers by addressing their unmet basic needs and offering more targeted, specialized quitline services?


Low-income Americans smoke more and quit less than other groups. Even proven cessation methods don’t work as well among low-income smokers. One reason is that smokers living in poverty face daily hardships that supersede or interfere with quitting. Standard quit smoking programs don’t address these unmet basic needs or the unique life contexts of very low income smokers.  Smoking-related cancers disproportionately affect the poor, uninsured, and those with less than a high school education and it is increasingly clear that low-income smokers and their families suffer greater financial hardship because of tobacco use.  Tobacco quitlines are highly effective, but scant research has investigated quit success by important socio-demographic factors.  Research is needed to maximize the use and effectiveness of tobacco quitlines in low-income populations.

This study tests the effects of a re-imagined approach to helping low-income smokers quit using a Specialized Quitline and Basic Needs navigators.  This study addresses cancer disparities, and increases access to and use of evidence-based cancer prevention.


In our previous research, we significantly increased calls to a tobacco quitline from low-income smokers, yet standard quitline services were no more effective than a no-intervention control condition in reducing smoking in this sample.  We have also demonstrated that low-income smokers with multiple unmet basic needs – e.g., housing, food, safety or necessities – are less likely to contact a quitline or even remember receiving referrals for smoking cessation.  However, when their basic needs were resolved, the odds of contacting a referral increased by 47%, and nearly three-fold when participants received supportive calls from a navigator.  Specialized Quitline services designed for low-income smokers and supplemental assistance to help them resolve unmet Basic Needs may improve cessation rates in this vulnerable population.


This study partners with United Way 2-1-1 Missouri, the Missouri Tobacco Quitline and Optum Inc. – the nation’s largest quitline service provider.

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