Text Messaging-Based Smoking Cessation Program for Homeless

Unaccompanied homeless youth smoke at much higher rates than non-homeless adolescents and young adults.  Approximately 70% of unaccompanied homeless youth are current cigarette smokers.  In addition, most of these smokes engage in smoking behaviors, such as sharing cigarettes with others and smoking discarded butts and filters (also known as “sniping”), that further increase the health risks associated with smoking.  Most homeless youth smokers are motivated to quit; yet, strategies specifically developed for this vulnerable population are lacking.  This study will develop and pilot test a text messaging intervention (also known as a TMI) to help homeless youth quit smoking. Text messaging can provide ongoing support for homeless youth during a quit attempt, which is important given that these youth tend to be highly mobile and lack regular access to health services. Our prior work indicates that the proposed intervention approach is acceptable to homeless youth smokers and, from the standpoint of service providers, feasible to deliver in settings where these youth typically seek services.  Participants in this study will be homeless youth who currently smoke and are motivated to quit smoking.  All participants will receive a 30-minute group-based smoking cessation counseling session and a supply of nicotine gum.  Half of these smokers will also receive the TMI, for 6 weeks following the group counseling session, which will provide: (a) continuing and more intensive education regarding nicotine dependence, quitting smoking, and relapse that addresses the specific needs of homeless youth; (b) ongoing support for quitting that does not require additional agency resources and can be available “on demand”; and (c) the ability to personalize the quitting experience. This main goal of this study is to investigate whether receiving the TMI results in greater reductions in cigarette smoking over a 3-month period compared to receiving the group counseling session alone.