Homeless Clients Benefit From Smoking Cessation Treatment Delivered by a Homeless Persons' Program

Nicotine Tob Res. 2015 Aug;17(8):996-1001. doi: 10.1093/ntr/ntv062.

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).

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bupropion / administration & dosage
  • Community Health Nursing
  • Delivery of Health Care, Integrated
  • Female
  • Health Promotion
  • Homeless Persons*
  • Humans
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care*
  • Smoking Cessation / methods*
  • Surveys and Questionnaires
  • Telemedicine
  • Tobacco Use Cessation Devices
  • Treatment Outcome
  • Varenicline / administration & dosage
  • Victoria

Substances

  • Bupropion
  • Varenicline