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

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

Compensation: Varies

Number of Visits: 8

298 Participants Needed

Trial Summary

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 data supports the effectiveness of the Smoking Cessation Intervention treatment for homeless youth?

A study found promising preliminary effects of a text-messaging intervention for smoking cessation among young people experiencing homelessness, suggesting that tailored interventions can be effective for this group. ^{1 2 3 4 5}

Is the smoking cessation treatment safe for homeless youth?

The research does not provide specific safety data for the smoking cessation treatment, but it mentions that a text messaging intervention was pilot tested with promising effects on smoking cessation among homeless youth. ^{1 2 3 6 7}

How is the Smoking Cessation Intervention for homeless youth different from other treatments?

This treatment is unique because it is specifically designed for homeless youth, who have higher smoking rates and face unique challenges. It may include components like text messaging support, which is more accessible and less costly than traditional in-person programs, making it suitable for their transient lifestyle. ^{1 5 6 7 8}

What is the purpose of this trial?

This trial develops a contextually tailored and optimized smoking cessation intervention and studies smoking motivations and motivations to quit smoking in homeless youth. Identifying motivations for smoking and motivations to quit smoking may help researchers build a program to help homeless young people quit smoking cigarettes if desired.

Research Team

Julianna Nemeth

Principal Investigator

Ohio State University Comprehensive Cancer Center

Eligibility Criteria

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

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

Treatment Details

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.

Participant Groups

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+

Findings from Research

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 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]

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]

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]

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]

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 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]

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]

References

1. United States pubmed.ncbi.nlm.nih.gov

Providing smoking cessation programs to homeless youth: the perspective of service providers. [2015]

2. England 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. [2022]

3. England pubmed.ncbi.nlm.nih.gov

Homeless Clients Benefit From Smoking Cessation Treatment Delivered by a Homeless Persons' Program. [2022]

4. England pubmed.ncbi.nlm.nih.gov

Identifying Novel Motivation Phase-Specific Cessation Targets for Youth Experiencing Homelessness in the USA. [2023]

5. England 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. [2022]

6. Canada pubmed.ncbi.nlm.nih.gov

Text Messaging Intervention for Young Smokers Experiencing Homelessness: Lessons Learned From a Randomized Controlled Trial. [2023]

7. Netherlands pubmed.ncbi.nlm.nih.gov

Smoking cessation methods among homeless youth in a Midwestern city. [2022]

8. England pubmed.ncbi.nlm.nih.gov

Designing a smoking cessation intervention for the unique needs of homeless persons: a community-based randomized clinical trial. [2022]