Evaluation of a Student-Run Smoking Cessation Program in a Dallas Homeless Population

BACKGROUND: Tobacco use has been shown to be modifiable risk factor for myriad chronic conditions and diseases. Amongst all smokers, homeless men continue to have high relative rates of smoking; it is estimated that 75% of homeless men use tobacco, compared to the general population. Given such high rates, targeted interventions for helping homeless men cease tobacco usage need to be developed. While most adult smokers will try to quit at least once, homeless individuals face very specific barriers to quitting. UT Southwestern medical students are addressing the disparity of tobacco use among the homeless men through a smoking cessation program in Dallas, Texas. Medical student volunteers, under the supervision of faculty, provide coaching and education for homeless men concerning smoking cessation and their general health. This study aims to demonstrate that this program improves tobacco cessation outcomes for homeless men in Dallas. A secondary objective of this project is to evaluate the efficacy of the smoking cessation efforts over time. METHODS: The smoking cessation program is conducted at a men’s homeless shelter in Dallas, Texas. The structure of the program involves weekly smoking-related health topic discussions led by a medical student. In addition, medical student volunteers lead individual and group coaching session via motivational interviewing. Data collected include addiction levels, willingness to quit, and CO levels, measured weekly. Paired t-tests in these categories, along with class attendance, retention, and use of nicotine replacement therapy are measured. RESULTS: Retention rates among participants improved from 11% in 2017 to 28% in 2018. 2019 saw a slight decrease in total number of visits; however, the difference in the average number of participants between 2018 and 2019 was not statistically significant. Returning clients reported higher willingness to quit scores and quit rates, verified by average CO values. CONCLUSIONS: The results of this study demonstrate that under the supervision of faculty, medical students are able to create a sustainable and effective smoking cessation program among underserved populations. Future directions include improved data collection to address longitudinal quality improvement.