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Grant Details

Grant Number: 5R01CA201429-05 Interpret this number
Primary Investigator: Kreuter, Matthew
Organization: Washington University
Project Title: Helping the Poor Quit Smoking: Specialized Quitlines and Meeting Basic Needs
Fiscal Year: 2020


Smoking in the U.S. follows a clear socio-economic gradient: low-income Americans smoke more and quit less than those with more education and income. Evidence-based interventions like tobacco quitlines are designed to make effective smoking cessation services available on a population basis to all smokers, regardless of financial means. Yet these interventions were not designed specifically for economically vulnerable populations, and therefore don't address many of the unique challenges faced by low- income smokers. As the demographics of smoking in the U.S. continue to shift, so too must the strategies employed to control smoking, including helping smokers quit. The proposed study will test the effects of two innovations to help low-income smokers quit: a Specialized Quitline and Basic Needs navigation. In low-income populations, basic needs like food, housing, personal safety and money for necessities supersede health needs. We have demonstrated that among low-income smokers, those with multiple unmet basic needs are significantly less likely to contact a quitline referral they received, and less likely to remember even getting the referral. But when basic needs problems are resolved, the odds of calling a quitline increase. Addressing basic needs should therefore increase low-income smokers' participation in quit smoking programs. However, those programs will have limited effectiveness if they are not made relevant to economically vulnerable populations. Thus proven approaches like quitlines should be more beneficial when they are adapted to the context and life circumstances of the poor. Using a 2x2 randomized factorial design, we will compare the effects of Standard and Specialized Quitlines with and without a Basic Needs navigator on smoking cessation among 2000 low-income smokers. The primary study outcome is self-reported 7-day point prevalence abstinence at 6-month follow up, with biochemical validation. This statewide field trial will draw smokers from United Way 2-1-1 Missouri and refer them to the Missouri Tobacco Quitline, provided by Alere Wellbeing, Inc. Both are key members of the study team. Embedding the study in these practice agencies will accelerate the path to application should our findings support it.  


Expressed and unexpressed social needs in low-income adults in the U.S.
Authors: Verdecias N. , Garg R. , Steensma J. , McQueen A. , Greer R. , Kreuter M.W. .
Source: Health & social care in the community, 2021 Sep; 29(5), p. e184-e191.
EPub date: 2020-12-30.
PMID: 33378603
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How Do Social Needs Cluster Among Low-Income Individuals?
Authors: Kreuter M.W. , Garg R. , Li L. , McNulty L. , Thompson T. , McQueen A. , Luke A.A. .
Source: Population health management, 2021 06; 24(3), p. 322-332.
EPub date: 2020-09-01.
PMID: 32877298
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Medication Adherence and Characteristics of Patients Who Spend Less on Basic Needs to Afford Medications.
Authors: Rohatgi K.W. , Humble S. , McQueen A. , Hunleth J.M. , Chang S.H. , Herrick C.J. , James A.S. .
Source: Journal of the American Board of Family Medicine : JABFM, 2021 May-Jun; 34(3), p. 561-570.
PMID: 34088816
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Addressing Social Needs in Health Care Settings: Evidence, Challenges, and Opportunities for Public Health.
Authors: Kreuter M.W. , Thompson T. , McQueen A. , Garg R. .
Source: Annual review of public health, 2021-04-01; 42, p. 329-344.
EPub date: 2021-12-16.
PMID: 33326298
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Assessing The Capacity Of Local Social Services Agencies To Respond To Referrals From Health Care Providers.
Authors: Kreuter M. , Garg R. , Thompson T. , McQueen A. , Javed I. , Golla B. , Caburnay C. , Greer R. .
Source: Health affairs (Project Hope), 2020 04; 39(4), p. 679-688.
PMID: 32250682
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Specialized tobacco quitline and basic needs navigation interventions to increase cessation among low income smokers: Study protocol for a randomized controlled trial.
Authors: McQueen A. , Roberts C. , Garg R. , Caburnay C. , Fu Q. , Gordon J. , Bush T. , Pokojski R. , Thompson T. , Kreuter M. .
Source: Contemporary clinical trials, 2019 05; 80, p. 40-47.
EPub date: 2019-03-20.
PMID: 30904596
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