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. 2023 Jun:129:107202.
doi: 10.1016/j.cct.2023.107202. Epub 2023 Apr 18.

Expanding population-level interventions to help more low-income smokers quit: Study protocol for a randomized controlled trial

Jennifer M Wolff  1 , Amy McQueen  2 , Rachel Garg  3 , Tess Thompson  3 , Qiang Fu  4 , Derek S Brown  5 , Michelle Kegler  6 , Kelly M Carpenter  7 , Matthew W Kreuter  3
Affiliations

Expanding population-level interventions to help more low-income smokers quit: Study protocol for a randomized controlled trial

Jennifer M Wolff et al. Contemp Clin Trials. 2023 Jun.

Abstract

Background: Low-income Americans have higher rates of smoking and a greater burden of smoking-related disease. In the United States, smokers in every state can access evidence-based telephone counseling through free tobacco quitlines. However, quitlines target smokers who are ready to quit in the next 30 days, which can exclude many low-income smokers. A smoke-free homes intervention may help engage smokers in tobacco control services who are not yet ready to quit. Previous research in low-income populations suggests that receiving a smoke-free homes intervention is associated with higher quit rates. This study tests whether, at a population level, expanding on quitlines to include a smoke-free homes intervention for smokers not ready to quit could engage more low-income smokers and increase long-term cessation rates.

Methods: In a Hybrid Type 2 design, participants are recruited from 211 helplines in 9 states and randomly assigned to standard quitline or quitline plus smoke-free homes intervention arms. Participants in both arms are initially offered quitline services. In the quitline plus smoke-free homes condition, participants who decline the quitline are then offered a smoke-free homes intervention. Participants complete a baseline and follow-up surveys at 3 and 6 months. Those who have not yet quit at the 3-month follow-up are re-offered the interventions, which differ by study arm. The primary study outcome is self-reported 7-day point prevalence abstinence from smoking at 6-month follow-up.

Conclusion: This real-world cessation trial involving 9 state tobacco quitlines will help inform whether offering smoke-free homes as an alternative intervention could engage more low-income smokers with evidence-based interventions and increase overall cessation rates. This study has been registered at ClinicalTrials.gov (Study Identifier: NCT04311983).

Keywords: Behavior change; Behavioral intervention; Clinical protocols; Health disparities; Minority health; Smoking cessation.

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Conflict of interest statement

Declaration of Competing Interest Kelly Carpenter declares that she is employed by RVO Health and has no other competing interests. All other authors declare that they have no competing interests.

Figures

Fig. 1.
Fig. 1.
Participant flow through survey completion and randomization to intervention study arm.
See this image and copyright information in PMC

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