RAND Corporation, Santa Monica, CA, USA.
Department of Psychiatry and Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Nicotine Tob Res. 2021 Aug 29;23(10):1691-1698. doi: 10.1093/ntr/ntab055.
Smoking rates are alarmingly high among young people experiencing homelessness (YEH), yet there are no evidence-based cessation programs for this population. This paper presents results from a pilot evaluation of a text messaging-based smoking cessation treatment, as an adjunct to brief group cessation counseling, to improve abstinence rates among 18-25-year-old smokers experiencing homelessness. The goal of this study was to estimate effect sizes for a larger trial and it was not powered to detect group differences.
YEH smokers who had a working cell phone with them at recruitment were randomized to receive a group counseling session, nicotine patches, and written material on quitting (n = 37) or a similar program that also included a 6-week automated text messaging intervention (TMI) to provide ongoing support for quitting (n = 40). Smoking outcomes were evaluated through a 90-day follow-up.
Seven-day point prevalence abstinence at 90-day follow-up was higher in the TMI condition than standard condition (17.50% vs. 8.11%, respectively; Cohen's h = .37); however, the 90-day continuous abstinence rate was not statistically different from zero in either condition. Reductions in the number of days smoked in the past 30 days from baseline to follow-up were greater in the TMI condition than the standard condition (-14.24 vs. -8.62, respectively; Cohen's d = .49).
Adding a 6-week TMI support to a brief group counseling and pharmacotherapy protocol holds promise for smoking reduction and abstinence among YEH smokers. Results indicate that further development and evaluation of the TMI in this population is warranted.
ClinicalTrials.gov Identifier NCT03874585. Registered March 14, 2019, https://clinicaltrials.gov/ct2/show/record/NCT03874585.
This is the first study to evaluate the feasibility of using a text messaging-based intervention (TMI) for behavior change with 18-25 year olds experiencing homelessness, and more specifically, the first to test a TMI to provide ongoing support for smoking cessation. Small to medium effect sizes for the TMI are promising in terms of implementing a TMI using participants' own cell phones, as well as the efficacy of this approach as an adjunct to standard care (brief group counseling and pharmacotherapy) for smoking cessation among YEH.
无家可归的年轻人（YEH）中吸烟率高得惊人，但针对这一人群，还没有基于循证的戒烟方案。本文介绍了一项短信戒烟治疗的试点评估结果，作为简短的团体戒烟咨询的辅助手段，以提高 18-25 岁无家可归吸烟者的戒烟成功率。本研究的目的是估计更大规模试验的效应大小，因此没有足够的能力来检测组间差异。
在招募时携带可正常使用手机的 YEH 吸烟者，随机分配接受团体咨询、尼古丁贴片和戒烟书面材料（n=37），或接受类似方案，同时包括为期 6 周的自动化短信干预（TMI），以提供戒烟的持续支持（n=40）。通过 90 天随访评估吸烟结局。
90 天随访时，TMI 条件下的 7 天点现患戒烟率高于标准条件（分别为 17.50%和 8.11%，Cohen's h=0.37）；然而，两种条件下的 90 天持续戒烟率均未达到统计学意义。与基线相比，TMI 条件下过去 30 天内吸烟天数的减少幅度大于标准条件（分别为-14.24 和-8.62，Cohen's d=0.49）。
在简短的团体咨询和药物治疗方案基础上，增加 6 周 TMI 支持有望减少 YEH 吸烟者的吸烟量并实现戒烟。结果表明，有必要进一步开发和评估该 TMI 在这一人群中的应用。
ClinicalTrials.gov 标识符 NCT03874585。2019 年 3 月 14 日注册，https://clinicaltrials.gov/ct2/show/record/NCT03874585。
这是第一项评估使用基于短信的干预（TMI）改变 18-25 岁无家可归者行为的可行性的研究，特别是第一项测试 TMI 以提供戒烟持续支持的研究。TMI 的小到中等效应大小很有希望，因为可以使用参与者自己的手机实施 TMI，并且这种方法作为 YEH 戒烟标准护理（简短的团体咨询和药物治疗）的辅助手段也很有效。
