Smoking Cessation for Homeless Youth

Overseen By The Ohio State University Comprehensive Cancer Center

Age: < 65

Sex: Any

Trial Phase: Academic

Sponsor: Ohio State University Comprehensive Cancer Center

Disqualifiers: Non-smokers, Not homeless, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 8

298 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial seeks to create a smoking cessation program specifically for homeless youth. It aims to understand why these young people smoke and what might motivate them to quit. Researchers will conduct interviews, surveys, and focus groups to gather information and test components of the smoking cessation intervention. Individuals who have been homeless and smoked at least some days in the past week may be suitable for this study. As an unphased trial, this study offers a unique opportunity to contribute to developing a program that could significantly help homeless youth quit smoking.

Do I need to stop my current medications to join the trial?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that this smoking cessation intervention is safe for homeless youth?

Research has shown that programs to help people stop smoking can be safe and useful for homeless youth. One study found that more than two-thirds of homeless youth wanted to quit smoking, but proven treatments were not often used. This suggests that with the right help, many young people could successfully stop smoking.

Another study examined smoking habits among homeless youth and highlighted the difficulties they face, such as stress from unstable housing, which can lead to relapse after attempts to quit. Understanding these challenges is key to creating effective programs for smoking cessation.

While specific safety information for the stop-smoking program in this trial is not available, similar programs have been safe and well-received in other studies. This trial aims to develop a program specifically designed to help homeless youth quit smoking effectively. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it aims to develop a smoking cessation approach specifically tailored for homeless youth, a group often overlooked by existing treatments. Unlike standard options, which usually involve nicotine replacement therapies or behavioral counseling not specifically designed for homeless individuals, this trial focuses on understanding and addressing the unique challenges faced by homeless youth. By using interviews, surveys, and focus groups, the trial seeks to identify and refine intervention components that are feasible and acceptable within this community. This targeted approach has the potential to create more effective, contextually relevant support for homeless youth looking to quit smoking.

What evidence suggests that this smoking cessation intervention could be effective for homeless youth?

Research has shown that programs to help people stop smoking can benefit homeless youth. One review found that peer-support programs helped individuals from disadvantaged backgrounds, including homeless individuals, quit smoking. In one study, more than two-thirds of homeless youth expressed readiness to quit smoking. However, few smoking cessation services are available for this group, as most agencies do not offer these services despite the clear interest. Early interventions, such as text messaging, have been tested successfully to assist young smokers in this group. Overall, these findings indicate that specially designed programs can effectively help homeless youth quit smoking. This trial will explore various components of a smoking cessation intervention tailored for homeless youth, using interviews, surveys, and focus groups to establish a theoretical model and assess feasibility. ^{1 2 6 7 8}

Who Is on the Research Team?

Julianna Nemeth

Principal Investigator

Ohio State University Comprehensive Cancer Center

Are You a Good Fit for This Trial?

This trial is for homeless youth who are interested in quitting smoking. It aims to understand their reasons for smoking and wanting to quit, which will help create a tailored program to assist them in stopping cigarette use.

Inclusion Criteria

Youth who meet criteria for homelessness defined by the 2002 McKinney-Vento Act including those who lack a fixed, regular, and adequate nighttime residence; live in a welfare hotel, or place without regular sleeping accommodations; or live in a shared residence with other persons due to the loss of one's housing or economic hardship.

I have smoked daily or occasionally in the last week.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

MOST STEP Ia (interview)

Participants attend a semi-structured interview over 60 minutes to help establish a theoretical model of contextually tailored smoking cessation for homeless youth.

1 week

1 visit (in-person)

MOST STEP Ib (survey)

Participants complete a survey to help establish a theoretical model of contextually tailored smoking cessation for homeless youth.

1 week

1 visit (virtual)

MOST STEP II (focus groups)

Participants attend focus groups to help identify a set of cessation intervention components for homeless youth and determine component acceptability and feasibility.

2 weeks

2 visits (in-person)

MOST STEP II (feasibility study)

Intervention components are identified and selected from Focus Groups. Participants take part in a study to assess these components for feasibility in implementing in coordination with homeless youth services.

4 weeks

4 visits (in-person)

Follow-up

Participants are monitored for safety and effectiveness after the intervention components are implemented.

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Smoking Cessation Intervention

Trial Overview The study involves developing a specialized smoking cessation intervention through interviews, surveys, focus groups, and direct anti-smoking treatments designed specifically for the needs of homeless young people.

How Is the Trial Designed?

Group I: MOST STEP Ib (survey) Experimental Treatment 1 Intervention

Participants complete a survey to help establish theoretical model of contextually tailored smoking cessation for homeless youth.

Group II: MOST STEP Ia (interview) Experimental Treatment 1 Intervention

Participants attend a semi-structured interview over 60 minutes to help establish theoretical model of contextually tailored smoking cessation for homeless youth.

Group III: MOST STEP II (focus groups) Experimental Treatment 1 Intervention

Participants attend focus groups to help identify a set of cessation intervention components for homeless youth and determine component acceptability and feasibility.

Group IV: MOST STEP II (feasibility study) Experimental Treatment 1 Intervention

Intervention components are identified and selected from Focus Groups. Participants take part in a study to assess these components for feasibility in implementing in coordination with homeless youth services, as well as determining main effect estimates for future studies.

Who Is Running the Clinical Trial?

Ohio State University Comprehensive Cancer Center

Lead Sponsor

Trials

350

Recruited

295,000+

National Cancer Institute (NCI)

Collaborator

Trials

14,080

Recruited

41,180,000+

Published Research Related to This Trial

The study involved 49 homeless clients participating in a 12-week smoking cessation program, which included nurse support, pharmacotherapy, and Quitline support, showing that integrating these services is feasible and acceptable.

While the quit rates were low (6% at the end of the program), participants experienced significant harm reduction, including a 50% reduction in tobacco consumption and improved mental health symptoms, indicating that the program provided valuable benefits beyond just quitting smoking.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Homeless Clients Benefit From Smoking Cessation Treatment Delivered by a Homeless Persons' Program. Segan, CJ., Maddox, S., Borland, R.[2022]

A study involving 23 shelters and drop-in centers for homeless youth in Los Angeles revealed that 84% of these facilities do not currently offer smoking cessation services, despite 91% expressing interest in providing such programs.

Key barriers to implementing smoking cessation services include a lack of resources, insufficient staff training, and concerns about whether smoking cessation is a priority for homeless youth, indicating a need for tailored, less intensive programs that can be integrated into existing services.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Providing smoking cessation programs to homeless youth: the perspective of service providers. Shadel, WG., Tucker, JS., Mullins, L., et al.[2015]

A study involving 32 homeless youth aged 14-24 revealed that 69% were willing to quit smoking within the next 30 days, but most previous quit attempts (78%) were unassisted, indicating a need for structured support.

While some youth reported using nicotine replacement therapy (NRT) and found it mostly unhelpful, there is potential for developing effective smoking cessation interventions at drop-in centers, as many youth expressed interest in behavioral counseling and monitored NRT use.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Smoking cessation methods among homeless youth in a Midwestern city. Glasser, AM., Macisco, JM., Miller, LM., et al.[2022]

Over 70% of youth experiencing homelessness smoke tobacco, and while many have attempted to quit, they often use ineffective methods; this study highlights the need for targeted support in drop-in centers to help them quit smoking.

Moderate nicotine dependence was identified as a significant barrier to quitting, with factors like housing instability and social smoking impacting their willingness to make quit attempts, suggesting that addressing these broader challenges is essential for effective cessation strategies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Identifying Novel Motivation Phase-Specific Cessation Targets for Youth Experiencing Homelessness in the USA. Nemeth, JM., Glasser, AM., Macisco, J., et al.[2023]

An automated text messaging intervention (TMI) was found to be feasible and well-accepted among homeless youth smokers (aged 18-25) as an additional support tool alongside group-based cessation counseling and nicotine patches, with a high message delivery rate of about 95%.

Participants reported enjoying the group counseling sessions and suggested incorporating more group elements into the intervention, highlighting the importance of social support in smoking cessation efforts for this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Text Messaging Intervention for Young Smokers Experiencing Homelessness: Lessons Learned From a Randomized Controlled Trial. Linnemayr, S., Zutshi, R., Shadel, W., et al.[2023]

A study involving 36 youth experiencing homelessness revealed that stress and nicotine dependence are major reasons for smoking, with older youth (ages 18-24) using smoking as a way to cope with negative emotions.

The findings suggest that smoking is deeply integrated into the daily lives of these youth, highlighting the need for comprehensive interventions that address the social and environmental factors contributing to smoking, as well as strategies for stress management and nicotine dependence.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

"I Smoked That Cigarette, and It Calmed Me Down": A Qualitative Analysis of Intrapersonal, Social, and Environmental Factors Influencing Decisions to Smoke Among Youth Experiencing Homelessness. Patterson, JG., Glasser, AM., Macisco, JM., et al.[2022]

A pilot study involving 77 youth experiencing homelessness showed that a text-messaging intervention (TMI) significantly reduced not only cigarette smoking but also secondary substance use behaviors and mental health symptoms, particularly anxiety and depression.

Participants who received the TMI experienced medium effects in reducing other tobacco/nicotine use and drinking, indicating that the intervention may have broader benefits beyond just smoking cessation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Substance Use and Mental Health Outcomes from a Text Messaging-Based Intervention for Smoking Cessation Among Young People Experiencing Homelessness. Pedersen, ER., Linnemayr, S., Shadel, WG., et al.[2022]

A clinical trial involving 430 homeless participants tested the effectiveness of motivational interviewing combined with nicotine replacement therapy (NRT) to improve smoking cessation outcomes, highlighting the need for tailored interventions for high-risk populations.

The study emphasized the importance of community engagement and practical strategies, such as conducting the trial at shelters and minimizing exclusion criteria, to enhance recruitment and retention in vulnerable groups.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Designing a smoking cessation intervention for the unique needs of homeless persons: a community-based randomized clinical trial. Goldade, K., Whembolua, GL., Thomas, J., et al.[2022]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC7225613/

Smoking cessation methods among homeless youth in a ... More than two-third of homeless youth in this study were willing to quit smoking. •. Evidence-based treatments were being underutilized by ...

2. researchprotocols.org researchprotocols.org/2025/1/e69441

Addressing Tobacco-Related Disparities Among Youth ... A 2013 systematic review of 8 peer-support programs for smoking cessation in “disadvantaged groups,” including people experiencing homelessness, ...

3. jsatjournal.com jsatjournal.com/article/S0740-5472(14)00091-9/abstract

Providing smoking cessation programs to homeless youth A majority (84%) of agencies did not offer smoking cessation services. •. Almost all (91%) had an interest in offering smoking cessation services.

4. mhealth.jmir.org mhealth.jmir.org/2021/4/e23989

Text Messaging Intervention for Young Smokers Experiencing ... In this paper, we report on our experiences implementing the first TMI targeted at smoking cessation among homeless youth as a part of a pilot ...

5. journals.plos.org journals.plos.org/plosone/article?id=10.1371/journal.pone.0270665

Psychosocial factors influencing smoking relapse among ... This study describes the smoking relapse experiences of 26 youth tobacco users, aged 14–24 years, who were recruited from a homeless drop-in ...

6. sciencedirect.com sciencedirect.com/science/article/pii/S2451865423000406

Tobacco use behaviors and views on engaging in clinical ... We designed a clinical trial of an extended contingency management intervention for smoking cessation for people experiencing homelessness.

7. clinicaltrials.gov clinicaltrials.gov/study/NCT03874585

Text Messaging-Based Smoking Cessation Program for ... The main goal of this study is to investigate whether receiving the TMI results in greater reductions in cigarette smoking over a 3-month period compared to ...

8. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10803121/

Identifying Novel Motivation Phase-Specific Cessation ... While 67.1% of participants made a past-year quit attempt, 45.8% expressed 30-day quit interest. Dimensions of coping with housing were associated with quit ...