Department of Population Health, New York University Grossman School of Medicine, NY, New York, USA.
VA NY Harbor Healthcare System, New York, NY, USA.
J Gen Intern Med. 2022 Sep;37(12):2973-2981. doi: 10.1007/s11606-021-07209-2. Epub 2022 Jan 11.
Financial distress is a barrier to cessation among low-income smokers.
To evaluate an intervention that integrated financial coaching and benefits referrals into a smoking cessation program for low-income smokers.
Randomized waitlist control trial conducted from 2017 to 2019.
Adult New York City residents were eligible if they reported past 30-day cigarette smoking, had income below 200% of the federal poverty level, spoke English or Spanish, and managed their own funds. Pregnant or breastfeeding people were excluded. Participants were recruited from two medical centers and from the community.
The intervention (n = 208) offered smoking cessation coaching, nicotine replacement therapy, money management coaching, and referral to financial benefits and empowerment services. The waitlist control (n=202) was usual care during a 6-month waiting period.
Treatment engagement, self-reported 7-day abstinence, and financial stress at 6 months.
At 6 months, intervention participants reported higher abstinence (17% vs. 9%, P=0.03), lower stress about finances (β, -0.8 [SE, 0.4], P=0.02), and reduced frequency of being unable to afford activities (β, -0.8 [SE, 0.4], P=0.04). Outcomes were stronger among participants recruited from the medical centers (versus from the community). Among medical center participants, the intervention was associated with higher abstinence (20% vs. 8%, P=0.01), higher satisfaction with present financial situation (β, 1.0 [SE, 0.4], P=0.01), reduced frequency of being unable to afford activities (β, -1.0 [SE, 0.5], P=0.04), reduced frequency in getting by paycheck-to-paycheck (β, -1.0 [SE, 0.4], P=0.03), and lower stress about finances in general (β, -1.0 [SE, 0.4], P = 0.02). There were no group differences in outcomes among people recruited from the community (P>0.05).
Among low-income smokers recruited from medical centers, the intervention produced higher abstinence rates and reductions in some markers of financial distress than usual care. The intervention was not efficacious with people recruited from the community.
ClinicalTrials.gov Identifier: NCT03187730.
经济拮据是低收入吸烟者戒烟的障碍。
评估一项将财务指导和福利转介纳入低收入吸烟者戒烟计划的干预措施。
2017 年至 2019 年进行的随机候补名单对照试验。
符合条件的成年纽约市居民报告过去 30 天吸烟，收入低于联邦贫困线的 200%，会说英语或西班牙语，并且能够管理自己的资金。不包括孕妇或哺乳期妇女。参与者从两家医疗中心和社区招募。
干预组（n=208）提供戒烟指导、尼古丁替代疗法、财务管理指导以及财务福利和赋权服务的转介。候补名单对照组（n=202）在 6 个月的等候期内接受常规护理。
治疗参与度、自我报告的 7 天戒烟率和 6 个月时的财务压力。
在 6 个月时，干预组参与者报告的戒烟率更高（17%比 9%，P=0.03），对财务状况的压力更小（β，-0.8[SE，0.4]，P=0.02），无力承担活动的频率更低（β，-0.8[SE，0.4]，P=0.04）。在从医疗中心招募的参与者中，结果更强（与从社区招募的参与者相比）。在医疗中心参与者中，该干预措施与更高的戒烟率（20%比 8%，P=0.01）、更高的对当前财务状况的满意度（β，1.0[SE，0.4]，P=0.01）、无力承担活动的频率降低（β，-1.0[SE，0.5]，P=0.04）、靠发薪度日的频率降低（β，-1.0[SE，0.4]，P=0.03）以及财务压力总体降低（β，-1.0[SE，0.4]，P=0.02）有关。从社区招募的参与者之间的组间差异无统计学意义（P>0.05）。
在从医疗中心招募的低收入吸烟者中，与常规护理相比，该干预措施产生了更高的戒烟率和一些财务困境指标的降低。该干预措施对从社区招募的人没有效果。
ClinicalTrials.gov 标识符：NCT03187730。
