Personalised multicomponent interventions for tobacco dependence management in low socioeconomic populations: a systematic review and meta-analysis

Abstract

BackgroundThere remains a disproportionally high tobacco smoking rate in low-income populations. Multicomponent tobacco dependence interventions in theory are effective. However, which intervention components are necessary to include for low socioeconomic status (SES) populations is still unknown.ObjectiveTo assess the effectiveness of multicomponent tobacco dependence interventions for low SES and create a checklist tool examining multicomponent interventions.MethodsEMBASE and MEDLINE databases were searched to identify randomised controlled trials (RCTs) published with the primary outcome of tobacco smoking cessation measured at 6 months or post intervention. RCTs that evaluated tobacco dependence management interventions (for reduction or cessation) in low SES (experience of housing insecurity, poverty, low income, unemployment, mental health challenges, illicit substance use and/or food insecurity) were included. Two authors independently abstracted data. Random effects meta-analysis and post hoc sensitivity analysis were performed.ResultsOf the 33 included studies, the number of intervention components ranged from 1 to 6, with smoking quit rates varying between 1% and 36.6%. Meta-analysis revealed that both the 6-month and 12-month outcome timepoints, multicomponent interventions were successful in achieving higher smoking quit rates than the control (OR 1.64, 95% Cl 1.41 to 1.91; OR 1.74, 95% Cl 1.30 to 2.33). Evidence of low heterogeneity in the effect size was observed at 6-month (I2=26%) and moderate heterogeneity at 12-month (I2=56%) outcomes.ConclusionMulticomponent tobacco dependence interventions should focus on inclusion of social support, frequency and duration of components. Employing community-based participatory-action research approach is essential to addressing underlying psychosocioeconomic-structural factors, in addition to the proven combination pharmacotherapies.PROSPERO registration numberCRD42017076650.

Equity as the new normal: the economic consequences of the pandemic, from The COVID Impact Project - focusing on systemically oppressed populations

“…This likely fueled signi cant psychological stress, as re ected in high GHQ- health outcomes. [5][6][7] Existing social policies, even before the pandemic, have perpetuated health disparities. A targeted and fair recovery approach is crucial to support those hit hardest by the pandemic.…”

“…Comprehensive community-based participatory solutions centered on lived experiences, as demonstrated by the Bridge Model ™, can be used to challenge the siloed approaches to health and social services. [5][6][7] The need for a stronger, more equitable, inclusive, just, comprehensive, and most importantly compassionate social safety is evident now more than ever.…”

“…28,32 Effective strategies should focus on the broader societal factors that in uence risk and negative health outcomes, moving beyond just individual factors. [5][6][7] Conclusions…”

“…It employs the Bridge Model™, where community peer researchers represent the project's target population and are involved in every stage of the project. [5][6][7] This study aimed to examine the impact of the pandemic on employment for populations who self-identify as unhoused or insecurely housed, low income and racialized, including Indigenous peoples. The study presents pandemic impacts on income and employment status and examines how structural disadvantages and COVID-related conditions affected unevenly distributed economic vulnerabilities.…”

PROTOCOL: Effectiveness of behavioral interventions for smoking cessation among homeless persons: A systematic review and meta‐analysis

“…Soar et al (2020) endeavored to estimate smoking cessation rates among homeless populations through systematic reviews, but only simple descriptive analyses were conducted due to limited data. Huynh et al (2022) evaluated the impact of tobacco dependence management in low socioeconomic populations, revealing that the multicomponent intervention achieved a higher smoking cessation rate than the control group; however, no specific intervention was identified. While most of these reviews suggest the effectiveness of these interventions, few studies have directly compared different forms of behavioral intervention.…”