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Randomised controlled trial of a financial counselling intervention and smoking cessation assistance to reduce smoking in socioeconomically disadvantaged groups

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Tags:
Date Commenced:
01/2012
Expected Date of Completion:
12/2015
Project Supporters:

National Health & Medical Research Council

Drug Type:
Project Members: 
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Honorary Professor
Ph 02 9385 0333
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Director
Ph EA Tori Barnes: 02 9385 0292 / t.barnes@unsw.edu.au
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Heart Foundation Future Leader Fellow
Ph +61-2-90657655
Ms Emma Black
Adjunct Associate Lecturer
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Postdoctoral Research Fellow
Ph 02 9385 0333
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Ms Danya Braunstein
Research Assistant
image - Phillip Clare
Adjunct Lecturer
Ph 02 9385 0333
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Miss Jaimi Iredale
Research Assistant
Mr Sundresan Naicker
Research Assistant
Dr Lauren Winkler
Research Assistant
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Consultancies and Vendor Staff
Ph 02 9385 0333
Project Main Description: 

Socioeconomically disadvantaged groups are more likely to smoke than other sectors of the community. This difference has been attributed, in part, to increased rates of relapse. Relapse is strongly and consistently predicted by financial stress. This project attempts to reduce relapse by reducing financial stress among disadvantaged smokers through the provision of financial counselling as an adjunct to Nicotine Replacement Therapy (NRT).

Project Collaborators: External: 

Dr Kristy Matire
School of Psychology, UNSW

Dr Billie Bonevski
University of Newcastle

Professor Ron Borland
The Cancer Council Victoria

Professor Christopher Doran
University of Newcastle

Professor Wayne Hall
University of Queensland

Rationale: 

 Increasingly, Australian smokers represent the socially marginalised and economically disadvantaged sector of our community. They also are a group of people with an increased likelihood of experiencing financial stress. Our knowledge-base regarding the efficacy of various interventions for low socio-economic (SES) smokers is scant. Reducing smoking rates among this population groups requires the development and implementation of rigorous intervention studies. The current research aims to investigate a novel intervention for smoking cessation - financial counselling as an adjunct to nicotine replacement therapy (NRT) with Quitline call-back – assessing its effectiveness as a public health intervention when compared with NRT and Quitline call-back alone. This investigation will provide insight into whether or not financial counselling is effective, is perceived by participants as a viable intervention approach, and whether its effectiveness is determined by the financial stressors experienced by participants. 

Aims: 

Socioeconomically disadvantaged groups are more likely to smoke than other sectors of the community. This difference has been attributed, in part, to increased rates of relapse. Relapse is strongly and consistently predicted by financial stress. This project attempts to reduce relapse by reducing financial stress among disadvantaged smokers through the provision of financial counselling as an adjunct to Nicotine Replacement Therapy (NRT).

Design and Method: 

We will conduct a randomised controlled trial comparing cessation rates between low SES smokers who receive the standard intervention comprising NRT with a Quitline call-back with those who receive NRT and Quitline call-back plus financial counselling. Smoking outcomes will be assessed at 2 and 8 months post-intervention.

Progress/Update: 

November 2015: To date, the following project milestones in accordance with projected timelines have been met:

Recruitment

N = 1047 smokers successfully recruited from three recruitment streams:
(i) poster presentations in Centrelink Customer Service Centres Nationally;
(ii) referrals from Quitline services nationally; and
(iii) newspaper advertisements (completed September, 2014);

Follow-up interviews

2-month follow-up interviews have been completed (December, 2014) with > 90% retention rate achieved. Final follow-up interviews have finished with an 84% retention rate achieved. 

Data analysis and write-up in peer reviewed journals 

Completion expected by late 2015.  Several manuscripts are currently published, in-preparation or under editorial review.

Output: 
Papers
 
Clare, P.,  Bradford, D.,  Courtney, R., Martire, K., Mattick, R. (2014) The relationship between socioeconomic status and ‘hardcore’ smoking over time – greater accumulation of hardened smokers in low-SES than high-SES smokers, Tobacco Control, Advance online publication, doi:10.1136/tobaccocontrol-2013-051436
 
Posters
 
R. Courtney, D. Bradford, K. Martire, B. Bonevski, R. Borland, C. Doran, W. Hall, M. Farrell, R. Sanson-Fisher, M. Siahpush, R. West, V. Boland, D. Braunstein, P. Clare, J. Iredale, L. Touyz, E. Upton & R. Mattick. (2013) A randomised clinical trial of a financial education intervention with nicotine replacement therapy for low socioeconomic status smokers – a protocol description. Presented at the 2013 NDARC Annual Symposium, Sydney, 4 September. 
 
Presentations
 
R. Courtney. (2013) NDARC Seminar. A randomized controlled trial of a financial education intervention with nicotine replacement therapy (NRT) for low socio-economic status smokers. 10 October, 2013 NDARC, UNSW, New South Wales, Australia.
 
Benefits: 

The results from this project will provide valuable information on the efficacy of targeted interventions for socioeconomically disadvantaged smokers.

Project Research Area: 
Drug Type: 
Project Status: 
Completed