Sifat Munjireen S, Alexander Adam C, Businelle Michael S, Frank-Pearce Summer G, Boozary Laili Kharazi, Wagener Theodore L, Ahluwalia Jasjit S, Kendzor Darla E
Department of Medical Oncology, Division of Population Sciences, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA.
Department of Family and Preventive Medicine, College of Medicine, The University of Oklahoma Health Sciences, Oklahoma City, OK, USA.
Drug Alcohol Depend Rep. 2024 Nov 6;13:100295. doi: 10.1016/j.dadr.2024.100295. eCollection 2024 Dec.
Smoking prevalence among U.S. adults experiencing homelessness is ≥70 %. Interventions are needed to address persisting tobacco disparities.
Adults who smoked combustible cigarettes (CC) daily (=60) were recruited from an urban day shelter and randomly assigned to an e-cigarette switching intervention with or without financial incentives for carbon monoxide (CO)-verified CC abstinence (EC vs. EC+FI). All participants received an e-cigarette device and nicotine pods during the first 4 weeks post-switch; and those in the EC+FI group also received escalating weekly incentives for CC abstinence during the same period. Key follow-ups were conducted at 4- and 8-weeks post-switch.
Participants were predominantly male (75 %), 50 % were racially/ethnically minoritized, with an average age of 48.8 years. Descriptive analyses indicated that CC smoking abstinence rates among EC and EC+FI were 3.3 % vs. 13.3 % at 4 weeks (8.3 % overall) and 10.0 % vs. 13.3 % at 8 weeks (11.7 % overall) in the intent-to-treat analyses (missing considered smoking). Among those who completed follow-ups (51.7 % and 45.0 % at 4- and 8-weeks), CC abstinence rates in EC and EC+FI were 6.3 % vs. 26.7 % at 4 weeks (16.1 % overall) and 21.4 % vs. 30.8 % at 8 weeks (25.9 % overall). EC+FI participants reported fewer days of smoking, more days of e-cigarette use, and greater reductions in CO at 4-week follow-up. Most participants reported a high likelihood of switching to e-cigarettes (67.7 %).
E-cigarette switching with financial incentives for CC cessation is a promising approach to tobacco harm reduction among adults accessing shelter services. Refinements are needed to improve engagement.
美国无家可归的成年人中吸烟率≥70%。需要采取干预措施来解决持续存在的烟草差异问题。
从城市日间收容所招募每天吸可燃香烟（CC）的成年人（=60名），并将他们随机分配到电子烟转换干预组，一组有或没有针对经一氧化碳（CO）验证的CC戒烟的经济激励措施（电子烟组与电子烟+经济激励组）。所有参与者在转换后的前4周内都会收到一个电子烟设备和尼古丁烟弹；电子烟+经济激励组的参与者在同一时期还会每周收到递增的CC戒烟激励。在转换后的4周和8周进行关键随访。
参与者以男性为主（75%），50%为少数族裔，平均年龄为48.8岁。描述性分析表明，在意向性分析（将缺失值视为仍在吸烟）中，电子烟组和电子烟+经济激励组在4周时的CC戒烟率分别为3.3%和13.3%（总体为8.3%），在8周时分别为10.0%和13.3%（总体为11.7%）。在完成随访的人群中（4周和8周时分别为51.7%和45.0%），电子烟组和电子烟+经济激励组在4周时的CC戒烟率分别为6.3%和26.7%（总体为16.1%），在8周时分别为21.4%和30.8%（总体为25.9%）。电子烟+经济激励组的参与者报告吸烟天数减少、使用电子烟天数增加，并且在4周随访时一氧化碳水平降低幅度更大。大多数参与者报告转向使用电子烟的可能性很高（67.7%）。
通过提供经济激励来促使CC戒烟的电子烟转换方法，对于使用收容服务的成年人减少烟草危害而言是一种有前景的方法。需要进一步改进以提高参与度。
