Addressing smoking in sheltered homelessness with intensive smoking treatment (ASSIST project): A pilot feasibility study of varenicline, combination nicotine replacement therapy and motivational interviewing.


Journal

Addictive behaviors
ISSN: 1873-6327
Titre abrégé: Addict Behav
Pays: England
ID NLM: 7603486

Informations de publication

Date de publication:
01 2022
Historique:
received: 24 11 2020
revised: 14 06 2021
accepted: 28 07 2021
pubmed: 13 9 2021
medline: 5 11 2021
entrez: 12 9 2021
Statut: ppublish

Résumé

This pilot study aimed to test the feasibility of providing varenicline in combination with nicotine replacement therapy (NRT) and motivational interviewing (MI) to adult male smokers attending a clinic in a hostel for homeless people. A single group pre- and post-treatment (12 weeks following intervention commencement) design with embedded process evaluation (at weekly counselling and fortnightly safety check-ins). Participants were 20 male smokers attending a health clinic within a homelessness service in Sydney, Australia, between December 2019 and March 2020. Participants set a target quit date 7-days post intervention commencement. Adverse events, self-reported abstinence, cigarettes per day, treatment adherence and acceptability of the study interventions were assessed 12 weeks post intervention commencement. Abstinence was biochemically verified. Results are complete cases. Retention was 65% at 12-weeks post-intervention commencement (n = 13). No related adverse events were reported. Three participants (15%) reported continuous abstinence. Two participants self-reported 30-day point prevalence abstinence (10%), confirmed by CO level. Participants who did not quit smoking (n = 10), reported a significant reduction in the number of cigarettes smoked per day (19.4 vs 4.7, p < .01). Cravings, withdrawal symptoms, and psychological distress significantly decreased from baseline to 12-week follow-up (all < 0.01). Adherence to the pharmacological interventions was good, most used combination NRT and varenicline. Adherence to the counselling sessions was low, attending three of 12 sessions. Both NRT and MI were rated as highly acceptable. Some participants expressed concerns about the safety of varenicline. The intervention was feasible and acceptable and associated with short-term smoking cessation and significant reductions in the number of cigarettes smoked-per-day.

Sections du résumé

BACKGROUND
This pilot study aimed to test the feasibility of providing varenicline in combination with nicotine replacement therapy (NRT) and motivational interviewing (MI) to adult male smokers attending a clinic in a hostel for homeless people.
METHODS
A single group pre- and post-treatment (12 weeks following intervention commencement) design with embedded process evaluation (at weekly counselling and fortnightly safety check-ins). Participants were 20 male smokers attending a health clinic within a homelessness service in Sydney, Australia, between December 2019 and March 2020. Participants set a target quit date 7-days post intervention commencement. Adverse events, self-reported abstinence, cigarettes per day, treatment adherence and acceptability of the study interventions were assessed 12 weeks post intervention commencement. Abstinence was biochemically verified. Results are complete cases.
RESULTS
Retention was 65% at 12-weeks post-intervention commencement (n = 13). No related adverse events were reported. Three participants (15%) reported continuous abstinence. Two participants self-reported 30-day point prevalence abstinence (10%), confirmed by CO level. Participants who did not quit smoking (n = 10), reported a significant reduction in the number of cigarettes smoked per day (19.4 vs 4.7, p < .01). Cravings, withdrawal symptoms, and psychological distress significantly decreased from baseline to 12-week follow-up (all < 0.01). Adherence to the pharmacological interventions was good, most used combination NRT and varenicline. Adherence to the counselling sessions was low, attending three of 12 sessions. Both NRT and MI were rated as highly acceptable. Some participants expressed concerns about the safety of varenicline.
CONCLUSIONS
The intervention was feasible and acceptable and associated with short-term smoking cessation and significant reductions in the number of cigarettes smoked-per-day.

Identifiants

pubmed: 34509787
pii: S0306-4603(21)00259-8
doi: 10.1016/j.addbeh.2021.107074
pii:
doi:

Substances chimiques

Varenicline W6HS99O8ZO

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

107074

Informations de copyright

Copyright © 2021. Published by Elsevier Ltd.

Auteurs

Eliza Skelton (E)

The University of Newcastle, College of Health, Medicine, and Wellbeing, 1 University Drive, Callaghan, NSW 2038, Australia; Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia. Electronic address: Eliza.Skelton@newcastle.edu.au.

Alistair Lum (A)

The University of Newcastle, College of Health, Medicine, and Wellbeing, 1 University Drive, Callaghan, NSW 2038, Australia. Electronic address: Alistair.Lum@newcastle.edu.au.

Lucy E Cooper (LE)

St Vincent's de Paul Society NSW, Support Services, Matthew Talbot Hostel Clinic, NSW 2001, Australia. Electronic address: Lucy.Cooper@vinnies.org.au.

Emma Barnett (E)

St Vincent's de Paul Society NSW, Support Services, Matthew Talbot Hostel Clinic, NSW 2001, Australia. Electronic address: emma.barnett@svha.org.au.

Julie Smith (J)

St Vincent's de Paul Society NSW, Support Services, Matthew Talbot Hostel Clinic, NSW 2001, Australia. Electronic address: julie.smith@vinnies.org.au.

Arlene Everson (A)

St Vincent's de Paul Society NSW, Support Services, Matthew Talbot Hostel Clinic, NSW 2001, Australia. Electronic address: Arlene.everson@vinnies.org.au.

Jane Machart (J)

St Vincent's de Paul Society NSW, Support Services, Matthew Talbot Hostel Clinic, NSW 2001, Australia. Electronic address: jane.machart@griffithuni.edu.au.

Amanda L Baker (AL)

The University of Newcastle, College of Health, Medicine, and Wellbeing, 1 University Drive, Callaghan, NSW 2038, Australia; Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia. Electronic address: Amanda.Baker@newcastle.edu.au.

Sean Halpin (S)

The University of Newcastle, College of Engineering, Science and Environment, School of Psychological Sciences, 1 University Drive, Callaghan, NSW 2038, Australia. Electronic address: Sean.Halpin@newcastle.edu.au.

Olav Nielssen (O)

Macquarie University, Balaclava Road, Macquarie Park, NSW 2109, Australia. Electronic address: olav.nielssen@mq.edu.au.

Matthew Clapham (M)

Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia. Electronic address: Matthew.clapham@hmri.org.au.

Billie Bonevski (B)

The University of Newcastle, College of Health, Medicine, and Wellbeing, 1 University Drive, Callaghan, NSW 2038, Australia; Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia; Flinders University, College of Medicine and Public Health, Sturt Rd, Bedford Park, SA 5042, Australia. Electronic address: Billie.Bonevski@flinders.edu.au.

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