title: Smoking characteristics and comorbidities in the power to quit randomized clinical trial for homeless smokers.
abstract: BACKGROUND
  Smoking prevalence in homeless populations is strikingly high (∼70%); yet, little is known about effective smoking cessation interventions for this population. We conducted a community-based clinical trial, Power To Quit (PTQ), to assess the effects of motivational interviewing (MI) and nicotine patch (nicotine replacement therapy [NRT]) on smoking cessation among homeless smokers. This paper describes the smoking characteristics and comorbidities of smokers in the study.
  
  
  METHODS
  Four hundred and thirty homeless adult smokers were randomized to either the intervention arm (NRT + MI) or the control arm (NRT + Brief Advice). Baseline assessment included demographic information, shelter status, smoking history, motivation to quit smoking, alcohol/other substance abuse, and psychiatric comorbidities.
  
  
  RESULTS
  Of the 849 individuals who completed the eligibility survey, 578 (68.1%) were eligible and 430 (74.4% of eligibles) were enrolled. Participants were predominantly Black, male, and had mean age of 44.4 years (S  D = 9.9), and the majority were unemployed (90.5%). Most participants reported sleeping in emergency shelters; nearly half had been homeless for more than a year. Nearly all the participants were daily smokers who smoked an average of 20 cigarettes/day. Nearly 40% had patient health questionnaire-9 depression scores in the moderate or worse range, and more than 80% screened positive for lifetime history of drug abuse or dependence.
  
  
  CONCLUSIONS
  This study demonstrates the feasibility of enrolling a diverse sample of homeless smokers into a smoking cessation clinical trial. The uniqueness of the study sample enables investigators to examine the influence of nicotine dependence as well as psychiatric and substance abuse comorbidities on smoking cessation outcomes.
authors.affiliation: Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN 55414, USA. kokuyemi@umn.edu
authors.forename: Kolawole S
authors.initials: KS
authors.lastname: Okuyemi
authors.forename: Kate
authors.initials: K
authors.lastname: Goldade
authors.forename: Guy-Lucien
authors.initials: GL
authors.lastname: Whembolua
authors.forename: Janet L
authors.initials: JL
authors.lastname: Thomas
authors.forename: Sara
authors.initials: S
authors.lastname: Eischen
authors.forename: Hongfei
authors.initials: H
authors.lastname: Guo
authors.forename: John E
authors.initials: JE
authors.lastname: Connett
authors.forename: Jon
authors.initials: J
authors.lastname: Grant
authors.forename: Jasjit S
authors.initials: JS
authors.lastname: Ahluwalia
authors.forename: Ken
authors.initials: K
authors.lastname: Resnicow
authors.forename: Greg
authors.initials: G
authors.lastname: Owen
authors.forename: Lillian
authors.initials: L
authors.lastname: Gelberg
authors.forename: Don Des
authors.initials: DD
authors.lastname: Jarlais
mesh_terms: D000328:Adult; D001741:Black or African American; D000368:Aged; D015897:Comorbidity; D005260:Female; D006703:Ill-Housed Persons / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D050177:Overweight / Q000453:epidemiology; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology; D016540:Smoking Cessation / Q000379:methods* / Q000523:psychology*; D019966:Substance-Related Disorders / Q000453:epidemiology; D062789:Tobacco Products; D061485:Tobacco Use Cessation Devices; D014029:Tobacco Use Disorder / Q000453:epidemiology / Q000523:psychology / Q000628:therapy