Catherine Jane Segan1, Sarah Maddox2, Ron Borland2. 1. Quit Victoria, Cancer Council Victoria, Melbourne, Australia; Centre for Health Policy, School of Population and Global Health, University of Melbourne, Melbourne, Australia cathy.segan@cancervic.org.au. 2. Quit Victoria, Cancer Council Victoria, Melbourne, Australia;
Abstract
INTRODUCTION: Few homeless programs offer smoking cessation treatment. This study examined the feasibility, acceptability, and effectiveness of a smoking cessation treatment model delivered by staff of a homeless persons' program. METHODS: Fourteen nurses from Melbourne's Royal District Nursing Service Homeless Persons' Program recruited 49 clients into a 12-week program offering weekly nurse-delivered smoking cessation appointments with intermittent carbon monoxide measurements, doctor-prescribed free nicotine patch, bupropion or varenicline, and Quitline phone support. Surveys were completed at program enrolment, end of program (EoP, 3 months) and 6 months post-enrolment. RESULTS: Clients attended on average 6.7 nurse-delivered appointments. Most used pharmacotherapy (69%, n = 34) and Quitline (61%, n = 30, average 8.4 calls among users). Using all-cases analyses 29% had made a quit attempt by EoP; 24-hour point prevalence abstinence rates were 6% at EoP and 4% at 6 months (no participants achieved sustained cessation), and 29% reported 50% consumption reduction at 6 months, the latter positively associated with increased Quitline use. Tobacco consumption and money spent on tobacco halved by EoP with similar levels maintained at 6 months. Discarded butt smoking reduced. Using within-subjects analyses, all participants reported either the same or less symptoms of anxiety at EoP compared to baseline and 92% reported the same or less depressive symptoms. CONCLUSIONS: Integrating nurse support with readily accessible cessation interventions (government subsidized pharmacotherapy plus Quitline) was feasible and acceptable. While quit rates were low, treatment benefits included harm-reduction (reduced consumption and butt smoking), significant financial savings, and psychological benefits (improved or stable mood).
INTRODUCTION: Few homeless programs offer smoking cessation treatment. This study examined the feasibility, acceptability, and effectiveness of a smoking cessation treatment model delivered by staff of a homeless persons' program. METHODS: Fourteen nurses from Melbourne's Royal District Nursing Service Homeless Persons' Program recruited 49 clients into a 12-week program offering weekly nurse-delivered smoking cessation appointments with intermittent carbon monoxide measurements, doctor-prescribed free nicotine patch, bupropion or varenicline, and Quitline phone support. Surveys were completed at program enrolment, end of program (EoP, 3 months) and 6 months post-enrolment. RESULTS: Clients attended on average 6.7 nurse-delivered appointments. Most used pharmacotherapy (69%, n = 34) and Quitline (61%, n = 30, average 8.4 calls among users). Using all-cases analyses 29% had made a quit attempt by EoP; 24-hour point prevalence abstinence rates were 6% at EoP and 4% at 6 months (no participants achieved sustained cessation), and 29% reported 50% consumption reduction at 6 months, the latter positively associated with increased Quitline use. Tobacco consumption and money spent on tobacco halved by EoP with similar levels maintained at 6 months. Discarded butt smoking reduced. Using within-subjects analyses, all participants reported either the same or less symptoms of anxiety at EoP compared to baseline and 92% reported the same or less depressive symptoms. CONCLUSIONS: Integrating nurse support with readily accessible cessation interventions (government subsidized pharmacotherapy plus Quitline) was feasible and acceptable. While quit rates were low, treatment benefits included harm-reduction (reduced consumption and butt smoking), significant financial savings, and psychological benefits (improved or stable mood).
Authors: Jesse T Young; Cheneal Puljević; Alexander D Love; Emilia K Janca; Catherine J Segan; Donita Baird; Rachel Whiffen; Stan Pappos; Emma Bell; Stuart A Kinner Journal: BMJ Open Date: 2019-06-04 Impact factor: 2.692
Authors: Grace Bennett-Daly; Maria Unwin; Ha Dinh; Michele Dowlman; Leigh Harkness; Jane Laidlaw; Kathleen Tori Journal: Int J Environ Res Public Health Date: 2021-12-03 Impact factor: 3.390