Kui Kaitlyn, Hailozian Christian, Thai Mable, Chakravarty Deepalika, Apollonio Dorie E, Kroon Lisa, Vijayaraghavan Maya
Department of Clinical Pharmacy, School of Pharmacy, University of California, San Francisco, CA, USA.
Division of Prevention Science, University of California, San Francisco, CA, USA.
Drug Alcohol Depend. 2025 Feb 1;267:112527. doi: 10.1016/j.drugalcdep.2024.112527. Epub 2024 Dec 18.
The prevalence of tobacco use among people experiencing homelessness is 70 %. Mental health and substance use disorders are associated with tobacco use and pose challenges for tobacco cessation.
Between 2019 and 2024, we recruited 206 adults experiencing homelessness from three homeless shelters in San Francisco, California. Participants were enrolled in a 12-week pharmacist-linked smoking cessation program that involved pharmacist counseling and furnishing of nicotine replacement therapy (NRT) and brief cessation coaching by trained shelter staff. We examined the association of provision of tobacco cessation interventions with two outcomes-weekly cigarette consumption and quit attempts-using mixed effects Poisson and logistic regression models respectively. We ran separate models with baseline mental health conditions and substance use disorders and adjusted for age, gender, race-ethnicity, time to first cigarette after waking, and baseline cigarette consumption in all models.
Adjusting for baseline mental health conditions and other covariates, the use of pharmacist-furnished NRT was associated with lower weekly consumption (Incidence Rate Ratio [IRR]: 0.74, 95 % Confidence Interval [CI]: 0.71-0.76) and increased weekly quit attempts (Adjusted Odds Ratio (AOR): 1.78, 95 % CI: 1.23-2.58). After adjusting for baseline substances used and other covariates, use of pharmacist-furnished NRT was associated with lower weekly consumption (IRR: 0.74, 95 % CI: 0.73-0.76) and increased weekly quit attempts (AOR: 1.99, 95 % CI: 1.45-2.74).
A community pharmacist-linked cessation program in homeless shelters was associated with reduced consumption and increased weekly quit attempts, highlighting its potential for scalability among people experiencing homelessness with high rates of co-occurring behavioral health conditions.
无家可归者中烟草使用率为70%。心理健康和物质使用障碍与烟草使用相关，并给戒烟带来挑战。
2019年至2024年期间，我们从加利福尼亚州旧金山的三个无家可归者收容所招募了206名成年无家可归者。参与者参加了一个为期12周的由药剂师参与的戒烟项目，该项目包括药剂师咨询、提供尼古丁替代疗法（NRT）以及由训练有素的收容所工作人员进行简短的戒烟指导。我们分别使用混合效应泊松回归模型和逻辑回归模型，研究提供戒烟干预措施与两个结果（每周香烟消费量和戒烟尝试）之间的关联。我们针对基线心理健康状况和物质使用障碍运行了单独的模型，并在所有模型中对年龄、性别、种族、醒来后第一支烟的时间以及基线香烟消费量进行了调整。
在对基线心理健康状况和其他协变量进行调整后，使用药剂师提供的NRT与较低的每周消费量相关（发病率比值比[IRR]：0.74，95%置信区间[CI]：0.71 - 0.76），且每周戒烟尝试增加（调整后的优势比[AOR]：1.78，95% CI：1.23 - 2.58）。在对基线使用的物质和其他协变量进行调整后，使用药剂师提供的NRT与较低的每周消费量相关（IRR：0.74，95% CI：0.73 - 0.76），且每周戒烟尝试增加（AOR：1.99，95% CI：1.45 - 2.74）。
无家可归者收容所中与社区药剂师相关的戒烟项目与消费量减少和每周戒烟尝试增加相关，突出了其在同时患有高比率行为健康状况的无家可归者中扩大规模的潜力。
