O Ojo-Fati1,2, J L Thomas2,3,4, R I Vogel4,5, O Ogedegbe6, G Jean-Louis6, K S Okuyemi1,2,4. 1. Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA. 2. Program in Health Disparities Research, University Of Minnesota, Minneapolis, MN, USA. 3. Department of Medicine, University of Minnesota, Minneapolis, MN, USA. 4. Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA. 5. Department of Obstetrics, Gynecology and Women's Health, University of Minnesota, Minneapolis, MN, USA. 6. Department of Population Health, New York University School of Medicine, New York, NY, USA.
Abstract
INTRODUCTION: Adherence to smoking cessation treatment is generally low, especially among socio-economically disadvantaged groups including individuals experiencing homelessness and those with mental illnesses. Despite the high smoking rates in homeless populations (~70%) no study to date has systematically examined predictors of adherence to nicotine replacement therapy (NRT) in this population. OBJECTIVE: The aim of this secondary analysis was to identify predictors of adherence to NRT in a smoking cessation trial conducted among homeless smokers. METHODS: Secondary analysis of data from a randomized controlled trial enrolling 430 persons who were homeless and current cigarette smokers. Participants were assigned to one of the two study conditions to enhance smoking cessation: Motivational Interviewing (MI; 6 sessions of MI + 8 weeks of NRT) or Standard Care (Brief advice to quit+ 8 weeks of NRT). The primary outcome for the current analysis was adherence to NRT at end of treatment (8 weeks following randomization). Adherence was defined as a total score of zero on a modified Morisky adherence scale). Demographic and baseline psychosocial, tobacco-related, and substance abuse measures were compared between those who did and did not adhere to NRT. RESULTS: After adjusting for confounders, smokers who were depressed at baseline (OR=0.58, 95% CI, 0.38-0.87, p=0.01), had lower confidence to quit (OR=1.10, 95% CI, 1.01-1.19, p=0.04), were less motivated to adhere (OR=1.04, 95% CI, 1.00-1.07, p=0.04), and were less likely to be adherent to NRT. Further, age of initial smoking was positively associated with adherence status (OR= 0.83, 95% CI, 0.69-0.99, p=0.04). CONCLUSION: These results suggest that smoking cessation programs conducted in this population may target increased adherence to NRT by addressing both depression and motivation to quit. TRIAL REGISTRATION: clinicaltrials.gov: NCT00786149.
RCT Entities:
INTRODUCTION: Adherence to smoking cessation treatment is generally low, especially among socio-economically disadvantaged groups including individuals experiencing homelessness and those with mental illnesses. Despite the high smoking rates in homeless populations (~70%) no study to date has systematically examined predictors of adherence to nicotine replacement therapy (NRT) in this population. OBJECTIVE: The aim of this secondary analysis was to identify predictors of adherence to NRT in a smoking cessation trial conducted among homeless smokers. METHODS: Secondary analysis of data from a randomized controlled trial enrolling 430 persons who were homeless and current cigarette smokers. Participants were assigned to one of the two study conditions to enhance smoking cessation: Motivational Interviewing (MI; 6 sessions of MI + 8 weeks of NRT) or Standard Care (Brief advice to quit+ 8 weeks of NRT). The primary outcome for the current analysis was adherence to NRT at end of treatment (8 weeks following randomization). Adherence was defined as a total score of zero on a modified Morisky adherence scale). Demographic and baseline psychosocial, tobacco-related, and substance abuse measures were compared between those who did and did not adhere to NRT. RESULTS: After adjusting for confounders, smokers who were depressed at baseline (OR=0.58, 95% CI, 0.38-0.87, p=0.01), had lower confidence to quit (OR=1.10, 95% CI, 1.01-1.19, p=0.04), were less motivated to adhere (OR=1.04, 95% CI, 1.00-1.07, p=0.04), and were less likely to be adherent to NRT. Further, age of initial smoking was positively associated with adherence status (OR= 0.83, 95% CI, 0.69-0.99, p=0.04). CONCLUSION: These results suggest that smoking cessation programs conducted in this population may target increased adherence to NRT by addressing both depression and motivation to quit. TRIAL REGISTRATION: clinicaltrials.gov: NCT00786149.
Authors: Mallory O Johnson; Torsten B Neilands; Samantha E Dilworth; Stephen F Morin; Robert H Remien; Margaret A Chesney Journal: J Behav Med Date: 2007-06-23
Authors: Tony C Lee; John G Hanlon; Jessica Ben-David; Gillian L Booth; Warren J Cantor; Philip W Connelly; Stephen W Hwang Journal: Circulation Date: 2005-05-16 Impact factor: 29.690
Authors: D V Sheehan; Y Lecrubier; K H Sheehan; P Amorim; J Janavs; E Weiller; T Hergueta; R Baker; G C Dunbar Journal: J Clin Psychiatry Date: 1998 Impact factor: 4.384
Authors: Kolawole S Okuyemi; Kate Goldade; Guy-Lucien Whembolua; Janet L Thomas; Sara Eischen; Barrett Sewali; Hongfei Guo; John E Connett; Jon Grant; Jasjit S Ahluwalia; Ken Resnicow; Greg Owen; Lillian Gelberg; Don Des Jarlais Journal: Addiction Date: 2013-03-19 Impact factor: 6.526
Authors: Amanual Getnet Mersha; Gillian Sandra Gould; Michelle Bovill; Parivash Eftekhari Journal: Int J Environ Res Public Health Date: 2020-11-30 Impact factor: 3.390
Authors: Amanual Getnet Mersha; Michelle Kennedy; Parivash Eftekhari; Gillian Sandra Gould Journal: Int J Environ Res Public Health Date: 2021-11-21 Impact factor: 3.390