• J Am Board Fam Med · Mar 2024

    Randomized Controlled Trial

    Smoking Cessation Support in the Context of Other Social and Behavioral Needs in Community Health Centers.

    • Michael B Potter, Janice Y Tsoh, Kara Lugtu, Jose Parra, Vicky Bowyer, and Danielle Hessler.
    • From the School of Medicine, University of California San Francisco, San Francisco, CA (MBP, JYT, KL, JP, DH); King's College, London, UK (VB). michael.potter@ucsf.edu.
    • J Am Board Fam Med. 2024 Mar 11; 37 (1): 849484-94.

    BackgroundCigarette smoking rates remain disproportionately high among low income populations with unmet social and behavioral health needs. To address this problem, we sought to develop and evaluate the feasibility, acceptability, and preliminary effectiveness of a novel smoking cessation program for community health centers that serve these populations.MethodsWe implemented a randomized pilot trial of two smoking cessation programs in three county operated community health center (CHC) sites: (1) a systematic assessment of smoking habits and standard tools to assist with smoking cessation counseling ("Enhanced Standard Program" or ESP), and (2) another that added a structured assessment of social and behavioral barriers to smoking cessation, ("Connection to Health for Smokers" or CTHS). Clinical outcomes were evaluated between 10 to 16 weeks, supplemented with interviews of patient participants and health care team members.Results141 adults were randomized and 123 completed the intervention (61 in ESP, 62 in CTHS). At follow-up, over half of participants reported ≥1 quit attempts (59.7% ESP and 56.5% CTHS; adjusted p = .66) while more in ESP (24.6% vs. 12.9%) were documented as not smoking in the last 7 days (adjusted p = 0.03). In addition to being in ESP, predictors of smoking cessation included higher baseline confidence in ability to quit (p = 0.02) and more quit attempts during the study (p = 0.04). Health care teams, however, generally preferred the more comprehensive approach of CTHS.ConclusionLessons learned from this pilot study may inform the development of effective smoking cessation programs for CHCs that combine elements of both interventions.© Copyright 2023 by the American Board of Family Medicine.

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