Background Tobacco use remains a major public health problem in the U.S. disproportionately affecting underserved communities. The Communities Engaged and Advocating for a Smoke-free Environment (CEASE) initiative is an intervention to address the problem using a community-based participatory research (CBPR) approach. Objective This study compares quit rates in a peer-led community-based intervention with those achieved in a clinical setting. Methods The intervention consisted of three Phases. Phase I (n= 404) was a clinic-based trial comparing two types of counseling. Phase II (n= 398) and Phase III (n=163) interventions were conducted in community venues by trained Peer Motivators. Results Quit rates at 12-week follow-up increased from 9.4% in Phase I (clinic-based) to an average of 23.7% in Phases II and III combined (community-based). The main predictor of smoking cessation was delivery of services in community settings (OR=2.6, 95% CI=, 1.7–4.2) while controlling for possible confounders. Conclusion A community-based approach can significantly guide and improve effectiveness and acceptability of smoking cessation services designed for low-income urban populations. In addition, CBPR can result in better recruitment and retention of the participants.

Smoking disproportionally affects minority and underserved populations but only a handful of interventions tailored to these populations have demonstrated effectiveness in real-life situations. We use community-based participatory research (CBPR) to test two interventions delivered by a community-based health care center. Methods Participants randomly assigned to individual or group-based intervention for smoking cessation (N= 400). Both included cessation counseling and health education, a contingency behavioral program, Nicotine Replacement Therapy, and health care for other comorbidities. Smoking cessation was verified by expired carbon monoxide at the end of the program. Results No differences were observed between the two treatment modalities (8.9% and 8.6%, respectively). Those with greater attendance had 1.4 times better odds of cessation per additional session. Retention and follow up proved to be challenging with this population.

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