Abstract
BackgroundCigarette smoking is much more prevalent among young people experiencing homelessness than in the general population of adolescents and young adults. Although many young homeless smokers are motivated to quit, there are no empirically-evaluated smoking cessation programs for this population. It is important that any such program address the factors known to be associated with quitting-related outcomes among homeless young people, to provide ongoing support in a way that accommodates the mobility of this population, and does not rely on scarce service provider resources for its delivery. The objective of this project is to develop and pilot test a text messaging-based intervention (TMI), as an adjunct to brief cessation counseling and provision of nicotine patches, to help homeless young people who want to quit smoking.Methods/designThis pilot study will utilize a cluster cross-over randomized controlled design with up to 80 current smokers who desire to quit and are recruited from three drop-in centers serving young people experiencing homelessness in the Los Angeles area. All participants will be provided with a minimum standard of care: a 30-min group-based smoking cessation counseling session and free nicotine replacement. Half of these smokers will then also receive the TMI, as an adjunct to this standard care, which will provide 6 weeks of ongoing support for quitting. This support includes continued and more intensive education regarding nicotine dependence, quitting smoking, and relapse; does not require additional agency resources; can be available “on demand” to users; and includes features to personalize the quitting experience. This study will investigate whether receiving the TMI adjunct to standard smoking cessation care results in greater reductions in cigarette smoking compared to standard care alone over a 3-month period.DiscussionThis study has the potential to address an important gap in the clinical research literature on cigarette smoking cessation and provide empirical support for using a TMI to provide ongoing assistance and support for quitting among young smokers experiencing homelessness.Trial registration ClinicalTrials.gov Identifier NCT03874585. Registered March 14, 2019, https://clinicaltrials.gov/ct2/show/record/NCT03874585.
Highlights
Cigarette smoking is much more prevalent among young people experiencing homelessness than in the general population of adolescents and young adults
In a sample of nearly 300 homeless adolescents and young adults recruited from street venues, we found that almost half (43%) were motivated to quit in the 30 days, and 76% of those who were motivated to quit were interested in using a nicotine replacement product and/or smoking cessation counseling to help them quit [9, 22]
Our work has found that homeless young people who are interested in quitting enjoy the camaraderie and peer support that groupbased programs offer [23]
Summary
Cigarette smoking is much more prevalent among young people experiencing homelessness than in the general population of adolescents and young adults. It is important that any such program address the factors known to be associated with quitting-related outcomes among homeless young people, to provide ongoing support in a way that accommodates the mobility of this population, and does not rely on scarce service provider resources for its delivery. The objective of this project is to develop and pilot test a text messagingbased intervention (TMI), as an adjunct to brief cessation counseling and provision of nicotine patches, to help homeless young people who want to quit smoking. The health of homeless young people is adversely affected by unsafe living environments, nutritional deficiencies, mental health problems, problematic substance use, and insufficient access to health services [8, 15,16,17,18]
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