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Treating tobacco use among high risk, low income smokers

Institution: University of California, San Francisco
Investigator(s): Joseph Guydish, Ph.D.
Award Cycle: 2019 (Cycle 28) Grant #: 28CP-0038 Award: $1,835,949
Subject Area: Tobacco-Use Prevention and Cessation
Award Type: Community Practice-Based Research

Initial Award Abstract

Tobacco control efforts have driven smoking prevalence among adults to 11.7% in California and 10.8% in San Francisco.  However, smoking prevalence remains high among San Francisco subgroups: 63% among persons in low-income primary care, and 70% among persons in addiction treatment. Further reduction in smoking in California requires that we address smoking in these vulnerable populations. This application builds on an existing Community Practice- Based Research (CPBR) network, including providers who serve low-income and high-risk smokers in San Francisco.

Our community partners include HealthRight360 (HR360), a large community-based behavioral health provider, and the San Francisco Health Network (SFHN), a network of 14 clinics providing primary care to low-income populations in San Francisco.

In this implementation study, we will conduct two Signature Research Projects tailored to the different settings (HR360, SFHN). These projects have a common foundation in that they build on the work of a prior panning phase.  The first project, conducted with HR360, involves including tobacco assessment and intervention for every new client as part of the initial physical exam, and introducing both motivational readiness groups and smoking cessation groups into the treatment programs. The second project, conducted with the SFHN, implements an electronic registry with point-of-care tobacco use data, to improve team-based care for the treatment of tobacco dependence. The use of a registry is enhanced by workforce development and counseling training for primary care providers, Medical Assistants and Behavioral Assistants.

Integration of this work with the San Francisco Department of Public Health and the California Department of Healthcare Services supports local, statewide and national policy development. The long-term goal of our CPBR project is to reduce smoking, by tailoring tobacco control efforts to the needs of these low income and high risk populations.