O2116: Introduction of a Tobacco Cessation Pilot Program in Community Residences

Background: In the U.S., smoking prevalence among people experiencing homelessness is approximately four times higher than that of the general population. Smoking cessation rates are lower among the unhoused, but those living in shelters may be more likely to attempt to quit.

In a prior study, our group conducted focus groups and anonymous surveys in two Suffolk County community residences (CR) to identify opportunities for improved tobacco cessation efforts for this vulnerable population. The current work builds upon those initial findings with the implementation of a tobacco cessation education program in three CR.

Methods: Staff members and residents of three CR were invited to participate. At the start of the six-month pilot, all participants completed an IRB-approved, anonymous paper survey regarding attitudes and behaviors related to tobacco cessation. Consent was implied by survey completion. Staff and residents attended a one-hour educational session led by health educators, which focused on the harms of tobacco use and exposure, prevention, and resources/tips for cessation. The session for staff included additional detail regarding quit resources. Staff attended a second one-hour session on motivational interviewing (MI). Surveys were completed at the initiation of the program, prior to and immediately following each of the educational sessions; a six-month follow up survey is currently underway.

Results: Of 80 initial resident surveys, 10 (12.5%) reported only cigarette use, 7 (8.8%) only used e-cigarettes, and 13 (16.3%) reported dual use (both cigarettes and e-cigarettes). After the resident educational session, 19/22 (86.4%) indicated they would use what they learned to cut back or quit using tobacco. Of 28 staff members surveyed prior to the MI session, 18 (64.3%) felt it was their responsibility to address residents’ smoking. 10 (35.5%) indicated they assist residents with quitting all the time, 7 (25%) indicated they assist residents in quitting some of the time; 11 (39.3%) never assisted residents in quitting. In the immediate post-session survey, there was no change in the percent of staff members who felt responsible to assist residents in tobacco cessation (64.3%). Ongoing final survey collection will assess whether staff report increased frequency of cessation assistance for residents.

Conclusion: Based on this preliminary analysis, educational sessions for residents of CR may promote residents’ tobacco cessation efforts. While staff attitudes regarding their responsibility in assisting resident tobacco cessation showed no change after the MI session, the final survey will assess if staff cessation assistance efforts changed. Future studies should focus on improving staff commitment to cessation efforts and identifying more streamlined processes for referrals to cessation services such as NYS Quitline. While the small sample size is a limitation, our results may inform the implementation of improved tobacco cessation programs within CR.