Smoke-free Home Study in Subsidized Housing

University of California San Francisco (UCSF)

Status: Enrolling

Conditions: Tobacco Dependence; Tobacco Smoking

Treatments: Behavioral: Smoke-free home resident intervention; Behavioral: Lay Health Worker coaching

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT06170437

24631

R01MD016898 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

Comprehensive smoke-free policies have the potential to substantially reduce tobacco-related disparities among populations in subsidized housing. This study fills this gap by identifying approaches to increase the implementation of smoke-free policies in all types of subsidized housing by increasing the voluntary adoption of smoke-free homes and promoting access to smoking cessation services.

Full description

OBJECTIVES:

The investigators will build on previous studies, where a smoke-free home intervention to increase voluntary adoption of smoke-free homes in permanent supportive housing for formerly homeless adults was developed and evaluated.

Aim 1: To estimate the effect of our adapted smoke-free home intervention on the primary outcome of residents' voluntary adoption of smoke-free homes and the secondary outcome of biochemically-verified tobacco abstinence at 6-months follow-up.

Aim 2: To determine the cost of our adapted smoke-free home intervention and determine whether it is a cost-effective use of health care resources.

Aim 3: To evaluate variation in stakeholders' perspectives on the adapted smoke-free home intervention's adaptability, scalability and sustainability.The proposed intervention can expand access to smoke-free policies and smoking cessation services in subsidized housing, thereby reducing racial/ethnic disparities in tobacco use, tobacco exposure and chronic disease in these populations.

OUTLINE:

A wait-list cluster randomized controlled trial of the adapted smoke-free home intervention compared to usual care among residents from subsidized housing sites in Northern California. Participants from twenty-four subsidized housing sites will be randomized into intervention and waitlist control arms

Enrollment: 544 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

Eligible resident participants

• Current smokers defined as:

  • Smoked at least 100 cigarettes in lifetime
  • Smoked daily in the past 7 days, and at least 5 cigarettes per day, verified by expired CO ≥ 5 parts per million [ppm] Smokerlyzer CO+ monitor),
  • Smoke in their home

• Expect to live in the subsidized housing site for at least 12 months

• Age ≥ 18 years

• Speak Chinese (Cantonese or Mandarin), English, Spanish, or Vietnamese

• Able to provide informed consent.

Exclusion criteria

• Contraindication to any study-related procedures or assessment

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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544 participants in 2 patient groups

Intervention

Experimental group

Description:

The study's investigators will train bilingual study staff to deliver the intervention to residents using a script that matches the content in the smoke-free home intervention pamphlet. The in-person delivery of the intervention and pamphlet will be the primary modes of intervention delivery to residents. The pamphlet will include: (1) the harms of tobacco, e-cigarette use, cannabis use and exposure (secondhand and thirdhand), (2) an exercise to calculate personal cost of tobacco use, (3) benefits of a smoke-free home, (4) skill-building on how to adopt a smoke-free home, and (5) motivational language on smoke-free home adoption. The study staff will qualitatively assess participants' knowledge by prompting questions on the topics covered and will refer participants to lay-health workers (LHWs) for one-on-one coaching. Participants will receive a pledge to designate their homes smoke-free.

Treatment:

Behavioral: Lay Health Worker coaching

Behavioral: Smoke-free home resident intervention

Waitlist Control Group

No Intervention group

Description:

The current standard of care does not include any interventions for smoke-free home adoption or referrals to tobacco treatment resources. At the end of the primary endpoint (6 months), control participants will be offered the intervention.