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Randomized Controlled Trial
. 2022 Oct:133:107373.
doi: 10.1016/j.addbeh.2022.107373. Epub 2022 May 21.

Smoking reduction among homeless smokers in a randomized controlled trial targeting cessation

Manami Bhattacharya  1 , Olamide Ojo-Fati  2 , Susan A Everson-Rose  3 , Janet L Thomas  3 , Jonathan M Miller  4 , Gbenga Ogedegbe  5 , Girardin Jean-Louis  5 , Anne M Joseph  3 , Kolawole S Okuyemi  6
Affiliations
Randomized Controlled Trial

Smoking reduction among homeless smokers in a randomized controlled trial targeting cessation

Manami Bhattacharya et al. Addict Behav. 2022 Oct.

Abstract

Introduction: Homeless populations have high rates of smoking and unique barriers to quitting. General cessation strategies have been unsuccessful in this population. Smoking reduction may be a good intermediate goal. We conducted a secondary analysis to identify predictors of smoking reduction in a cohort of homeless smokers enrolled in a 26-week randomized clinical trial (RCT) targeting smoking cessation.

Methods: Data are from an RCT comparing motivational interviewing counseling plus nicotine replacement therapy (NRT) to brief advice to quit (standard care) plus NRT among homeless smokers. Using bivariate analyses and multinomial logistic regression, we compared demographics, health and psychosocial variables, tobacco use, substance use, and NRT adherence among those who reported: quitting; reducing smoking by 50-99%; and not reducing smoking by 50%.

Results: Of 324 participants who completed 26-week follow-up, 18.8% and 63.9% self-reported quitting and reducing, respectively. Compared to those who did not reduce smoking, participants reporting reducing indicated higher baseline cigarette use (OR=1.08; CI:1.04-1.12) and menthol use (OR=2.24; CI:1.05-4.77). Compared to participants who reduced, participants reporting quitting were more likely to be male (OR=1.998; CI:1.00-3.98), experience more housing instability (OR=1.97; CI:1.08-3.59), indicate higher importance of quitting (OR=1.27; CI:1.041.55), have higher NRT adherence (OR=1.75; CI:1.00-3.06), and lower odds of reported illicit drug use (OR=0.48; CI:0.24-0.95).

Conclusions: Over half of participants reduced smoking by at least 50%, indicating reduction is feasible among homeless smokers. Further research is required to understand the impact of reduction on future cessation attempts in homeless smokers. This study shows that reduction is achievable and may be a valid intermediate goal.

Keywords: Homeless populations; Nicotine replacement therapy; Patch; Smoking cessation; Smoking reduction; motivational interviewing.

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Conflict of interest statement

Declaration of Interests:

The authors declare that they have no conflicts of interests

Declarations

Ethical approval was received from University of Minnesota’s Human Research Protection Program (HRPP Approval Date: 07/30/2014). IRB Code Number: 1307M39761 and the Assurance of Compliance number, which is FWA00000312 (Fairview Health Systems

Research FWA00000325, Gillette Children’s Specialty Healthcare FWA00004003) and is registered at http://www.clinicaltrials.gov NCT0078614

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