TY - JOUR
T1 - Feasibility of precision smoking treatment in a low-income community setting
T2 - results of a pilot randomized controlled trial in The Southern Community Cohort Study
AU - Lee, Scott S.
AU - Senft Everson, Nicole
AU - Sanderson, Maureen
AU - Selove, Rebecca
AU - Blot, William J.
AU - King, Stephen
AU - Gilliam, Karen
AU - Kundu, Suman
AU - Steinwandel, Mark
AU - Sternlieb, Sarah J.
AU - Cai, Qiuyin
AU - Warren Andersen, Shaneda
AU - Friedman, Debra L.
AU - Connors Kelly, Erin
AU - Fadden, Mary Kay
AU - Freiberg, Matthew S.
AU - Wells, Quinn S.
AU - Canedo, Juan
AU - Tyndale, Rachel F.
AU - Young, Robert P.
AU - Hopkins, Raewyn J.
AU - Tindle, Hilary A.
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2024/12
Y1 - 2024/12
N2 - Background: The feasibility of precision smoking treatment in socioeconomically disadvantaged communities has not been studied. Methods: Participants in the Southern Community Cohort Study who smoked daily were invited to join a pilot randomized controlled trial of three smoking cessation interventions: guideline-based care (GBC), GBC plus nicotine metabolism-informed care (MIC), and GBC plus counseling guided by a polygenic risk score (PRS) for lung cancer. Feasibility was assessed by rates of study enrollment, engagement, and retention, targeting > 70% for each. Using logistic regression, we also assessed whether feasibility varied by age, sex, race, income, education, and attitudes toward precision smoking treatment. Results: Of 92 eligible individuals (79.3% Black; 68.2% with household income < $15,000), 67 (72.8%; 95% CI 63.0–80.9%) enrolled and were randomized. Of these, 58 (86.6%; 95% CI 76.4–92.8%) engaged with the intervention, and of these engaged participants, 43 (74.1%; 95% CI 61.6–83.7%) were retained at 6-month follow-up. Conditional on enrollment, older age was associated with lower engagement (OR 0.83, 95% CI 0.73–0.95, p = 0.008). Conditional on engagement, retention was significantly lower in the PRS arm than in the GBC arm (OR 0.18, 95% CI 0.03–1.00, p = 0.050). No other selection effects were observed. Conclusions: Genetically informed precision smoking cessation interventions are feasible in socioeconomically disadvantaged communities, exhibiting high enrollment, engagement, and retention irrespective of race, sex, income, education, or attitudes toward precision smoking treatment. Future smoking cessation interventions in this population should take steps to engage older people and to sustain participation in interventions that include genetic risk counseling. Trial registration: ClinicalTrials.gov No. NCT03521141, Registered 27 April 2018, https://www.clinicaltrials.gov/study/NCT03521141.
AB - Background: The feasibility of precision smoking treatment in socioeconomically disadvantaged communities has not been studied. Methods: Participants in the Southern Community Cohort Study who smoked daily were invited to join a pilot randomized controlled trial of three smoking cessation interventions: guideline-based care (GBC), GBC plus nicotine metabolism-informed care (MIC), and GBC plus counseling guided by a polygenic risk score (PRS) for lung cancer. Feasibility was assessed by rates of study enrollment, engagement, and retention, targeting > 70% for each. Using logistic regression, we also assessed whether feasibility varied by age, sex, race, income, education, and attitudes toward precision smoking treatment. Results: Of 92 eligible individuals (79.3% Black; 68.2% with household income < $15,000), 67 (72.8%; 95% CI 63.0–80.9%) enrolled and were randomized. Of these, 58 (86.6%; 95% CI 76.4–92.8%) engaged with the intervention, and of these engaged participants, 43 (74.1%; 95% CI 61.6–83.7%) were retained at 6-month follow-up. Conditional on enrollment, older age was associated with lower engagement (OR 0.83, 95% CI 0.73–0.95, p = 0.008). Conditional on engagement, retention was significantly lower in the PRS arm than in the GBC arm (OR 0.18, 95% CI 0.03–1.00, p = 0.050). No other selection effects were observed. Conclusions: Genetically informed precision smoking cessation interventions are feasible in socioeconomically disadvantaged communities, exhibiting high enrollment, engagement, and retention irrespective of race, sex, income, education, or attitudes toward precision smoking treatment. Future smoking cessation interventions in this population should take steps to engage older people and to sustain participation in interventions that include genetic risk counseling. Trial registration: ClinicalTrials.gov No. NCT03521141, Registered 27 April 2018, https://www.clinicaltrials.gov/study/NCT03521141.
KW - Health disparities
KW - Precision medicine
KW - Smoking cessation treatment
UR - http://www.scopus.com/inward/record.url?scp=85187913659&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85187913659&partnerID=8YFLogxK
U2 - 10.1186/s13722-024-00441-1
DO - 10.1186/s13722-024-00441-1
M3 - Article
C2 - 38491559
AN - SCOPUS:85187913659
SN - 1940-0632
VL - 19
JO - Addiction Science and Clinical Practice
JF - Addiction Science and Clinical Practice
IS - 1
M1 - 16
ER -