Smoking cessation
2016-Present
KEY QUESTION
Can quit rates improve among low-income smokers by addressing their unmet basic needs and offering more targeted, specialized quitline services?
REACH
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.
EFFECTIVENESS
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.
CONNECTIONS
This study partners with United Way 2-1-1 Missouri, the Missouri Tobacco Quitline and Optum Inc. – the nation’s largest quitline service provider.
Related publications
Addressing social needs in health care settings: Evidence, challenges, and opportunities for public health
Kreuter MW, Thompson T, McQueen A, Garg R. Addressing social needs in health care settings: Evidence, challenges, and opportunities for public health. Annual Review of Public Health. 2021;42:329-344. doi: 10.1146/annurev-publhealth-090419-102204
Assessing the capacity of local social service agencies to respond to referrals from health care providers.
Kreuter MW, Garg R, Thompson T, McQueen A, Javed I, Golla B, Caburnay C, Greer R. Assessing the capacity of local social service agencies to respond to referrals from health care providers. Health Affairs 2020;39(4):679-688. doi: 10.1377/hlthaff.2019.01256
Comparing two approaches to remote biochemical verification of self-reported cessation in very low-income smokers
Garg R, McQueen A, Wolff J, Butler T, Thompson T, Caburnay C, Kreuter MW. Comparing two approaches to remote biochemical verification of self-reported cessation in very low-income smokers. Addictive Behaviors Reports. 2021;12:100343. doi: 10.1016/j.abrep.2021.100343
Correlates of smoking discarded cigarettes in a sample of low-income smokers
Garg R, Croston MA, Thompson T, McQueen A, Kreuter MW. Correlates of smoking discarded cigarettes in a sample of low-income smokers. Addictive Behaviors. 2022;128:107237. doi: 10.1016/j.addbeh.2022.107237
Correlates of smoking discarded cigarettes in a sample of low-income smokers
Garg R, Croston MA, Thompson T, McQueen A, Kreuter MW. Correlates of smoking discarded cigarettes in a sample of low-income smokers. Addictive Behaviors. 2022;128:107237. doi: 10.1016/j.addbeh.2022.107237
Expressed and unexpressed social needs in low-income adults in the US
Verdecias N, Garg R, Steensma J, McQueen A, Greer R, Kreuter MW. Expressed and unexpressed social needs in low-income adults in the US. Health & Social Care in the Community. 2021;29(5):e184-e189. doi: 10.1111/hsc.13265
How do social needs cluster among low-income individuals?
Kreuter MW, Garg R, Li L, McNulty L, Thompson T, McQueen A, Luke AA. How do social needs cluster among low-income individuals? Population Health Management. 2021;24(3):322-332. doi: 10.1089/pop.2020.0107
Re-examining phone counseling for smoking cessation: Does the evidence apply to low-SES smokers?
Garg R, McQueen A, Evbuoma-Fike EI, Kreuter MW. Re-examining phone counseling for smoking cessation: Does the evidence apply to low-SES smokers? Patient Education and Counseling. 2021. doi: 10.1016/j.pec.2021.11.008
Specialized tobacco quitline and basic needs navigation interventions to increase cessation among low income smokers: Study protocol for a randomized controlled trial
McQueen A, Roberts C, Garg R, Caburnay C, Fu Q, Gordon J, Bush T, Pokojski R, Thompson T, Kreuter M. Specialized tobacco quitline and basic needs navigation interventions to increase cessation among low income smokers: Study protocol for a randomized controlled trial. Contemporary Clinical Trials 2019;80:40-47. doi: 10.1016/j.cct.2019.03.009
Stress, depression, sleep problems and unmet social needs: Baseline characteristics of low-income smokers in a randomized cessation trial
Garg R, McQueen A, Roberts C, Butler T, Grimes LM, Thompson T, Caburnay C, Wolff J, Javed I, Carpenter KM, Wartts JG, Charles C, Howard V, Kreuter MW. Stress, depression, sleep problems and unmet social needs: Baseline characteristics of low-income smokers in a randomized cessation trial. Contemporary Clinical Trials Communications. 2021;24:100857. doi: 10.1016/j.conctc.2021.100857