ASPO Abstracts
Unmet basic needs and cessation history among very low income smokers
Category: Behavioral Science & Health Communication, Cancer Health Disparities
Conference Year: 2018
Abstract Body:
Purpose: A preliminary examination of prior cessation attempts among very low income smokers enrolled in a novel cessation intervention. Methods: Adults who call MO 2-1-1 for assistance meeting their basic needs (e.g., food, housing, utilities) are screened for smoking status, interest in quitting in the next 30 days and willingness to share their contact information. Research staff contacted smokers to invite their participation, obtain consent, and administer a baseline survey. Participants are randomized to a 2x2 intervention: basic needs navigation (yes/no) x quitline program (standard/specialized). Interventions last 3 months and follow up surveys are administered at 3 & 6 mo follow up. Results: Of the 200 initial baseline respondents, 80% are female, 63% African American, 26% White, mean age = 45 years (SD=12.6). About a third had less than a high school education and a third completed HS or a GED, 71% were unemployed, and 78% had a total annual income <$20,000 (49% <$10,000). Most had medical insurance (38% Medicaid, 12% Medicare, 14% dual) but 30% were uninsured; 38% don’t have a regular doctor. Many rated their health as poor/fair (58%; 83% had a chronic disease (M=2.4). Unmet needs recorded (M=2.0, SD=1.3) include: not having enough money for unexpected expenses (82%), bills (54%), necessities (36%), trouble finding childcare, if needed (44%), transportation (19%), food (14%), housing (11%), and unsafe neighborhood (24%). Participants had been smoking M=29 years (SD=13.3), 16.3 cigs/day. Nearly all (91%) tried to quit before using various resources: 65% print materials, 34% websites, 16% quitline, 7% group class, 66% NRT (58% patch, 31% gum, 15% lozenge) and 27% prescription quit aids. Number of cigarettes smoked daily (OR=1.05, p=.008) and chronic conditions (OR=1.30, p=.004) were positively associated with prior use of quit aids. The number of chronic conditions (OR=1.24, p=.043) was also positively associated with prior use of a quitline. CONCLUSION: Smokers who call 2-1-1 and enroll in our cessation intervention are willing to quit in the next 30 days and nearly all have tried before. We found higher than expected rates of ever use of NRT. Greater unmet needs may make quitting harder for very low income smokers.
Keywords: smoking cessation, health disparity, poverty