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

Eliza Skelton; Alistair Lum; Lucy E Cooper; Emma Barnett; Julie Smith; Arlene Everson; Jane Machart; Amanda L Baker; Sean Halpin; Olav Nielssen; Matthew Clapham; Billie Bonevski

doi:10.1016/j.addbeh.2021.107074

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

Addict Behav. 2022 Jan:124:107074. doi: 10.1016/j.addbeh.2021.107074. Epub 2021 Jul 30.

Authors

Eliza Skelton¹, Alistair Lum², Lucy E Cooper³, Emma Barnett⁴, Julie Smith⁵, Arlene Everson⁶, Jane Machart⁷, Amanda L Baker⁸, Sean Halpin⁹, Olav Nielssen¹⁰, Matthew Clapham¹¹, Billie Bonevski¹²

Affiliations

¹ 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.
² The University of Newcastle, College of Health, Medicine, and Wellbeing, 1 University Drive, Callaghan, NSW 2038, Australia. Electronic address: Alistair.Lum@newcastle.edu.au.
³ St Vincent's de Paul Society NSW, Support Services, Matthew Talbot Hostel Clinic, NSW 2001, Australia. Electronic address: Lucy.Cooper@vinnies.org.au.
⁴ St Vincent's de Paul Society NSW, Support Services, Matthew Talbot Hostel Clinic, NSW 2001, Australia. Electronic address: emma.barnett@svha.org.au.
⁵ St Vincent's de Paul Society NSW, Support Services, Matthew Talbot Hostel Clinic, NSW 2001, Australia. Electronic address: julie.smith@vinnies.org.au.
⁶ St Vincent's de Paul Society NSW, Support Services, Matthew Talbot Hostel Clinic, NSW 2001, Australia. Electronic address: Arlene.everson@vinnies.org.au.
⁷ St Vincent's de Paul Society NSW, Support Services, Matthew Talbot Hostel Clinic, NSW 2001, Australia. Electronic address: jane.machart@griffithuni.edu.au.
⁸ 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.
⁹ 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.
¹⁰ Macquarie University, Balaclava Road, Macquarie Park, NSW 2109, Australia. Electronic address: olav.nielssen@mq.edu.au.
¹¹ Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia. Electronic address: Matthew.clapham@hmri.org.au.
¹² 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.

PMID: 34509787
DOI: 10.1016/j.addbeh.2021.107074

Abstract

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.

Keywords: Behavioral counselling; Motivational interviewing; Nicotine dependence; Nicotine replacement therapy; Smoking cessation; Varenicline.

Publication types

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

MeSH terms

Adult
Feasibility Studies
Humans
Ill-Housed Persons*
Male
Motivational Interviewing*
Pilot Projects
Smoking
Smoking Cessation*
Tobacco Use Cessation Devices
Varenicline / therapeutic use

Substances

Varenicline