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ABSTRACT
Background: Tobacco use is higher among homeless individuals than the general population. Homeless individuals are also more likely to have symptoms of depression. Depression symptoms may add to the burden of homelessness by increasing psychological distress and serve as a barrier to quitting smoking. Objectives: The primary goal of this study is to assess the impact of depression symptoms on psychological distress in homeless smokers. The effect of depression symptoms on abstinence and the effect of Motivational Interviewing (MI) on cessation among smokers is also explored. Methods: Homeless smokers (N = 430) enrolled in a smoking cessation study were randomized to Motivational Interviewing (MI) or standard care (SC). Participants received nicotine replacement therapy and were followed for 26 weeks. Participants were categorized into a depression symptoms (DS) group or control group using the Patient Health Questionnaire-9. Between group differences of perceived stress, hopelessness, confidence, craving and abstinence were assessed at weeks 8 and 26. The interaction between depression symptoms (levels: DS and control) and the intervention (levels: MI and SC) was also assessed. Results: Homeless smokers in the DS group reported higher levels of hopelessness, perceived stress, and craving. There was no effect of DS status on abstinence at week 8 or week 26. There was no significant interaction between depression symptoms (DS vs. Control) and the intervention (MI vs. SC). Conclusion: Despite reporting greater psychological distress, homeless smokers with depression symptoms in this sample had abstinence levels similar to the control group. Future research should explore protective factors among depressed smokers.
Declaration of interest
The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.
Funding
Ths work was supported by the National Cancer Institute [Grant number R25CA16318] and the National Heart, Lung, and Blood Institute [Grant numbers R01HL0815 and R25CA16318].
Additional information
Notes on contributors
Cendrine D. Robinson
Cendrine D. Robinson received her PhD in Medical & Clinical Psychology at the Uniformed Services University of the Health Sciences in 2015. She is currently a Postdoctoral Fellow at the National Cancer Institute and a Master of Public Health candidate at Harvard T.H. Chan School of Public Health. Cendrine's research focuses on tobacco health disparities with an emphasis on smoking cessation interventions for African Americans. Cendrine has co-authored a book chapter and several manuscripts on smoking cessation. Cendrine has received dissertation research funding from the National Cancer Institute and the American Lung Association.
Charles R. Rogers
Charles R. Rogers, a behavioral scientist and certified health education specialist (CHES), currently serves as a National Cancer Institute-funded Post-Doctoral Associate with the Program in Health Disparities Research in the University of Minnesota Medical School. Since racial inequalities in health are extensive in the U.S., he is committed to serving poor, medically underserved, and minority populations. Over the past 12 years, Dr. Rogers has supplemented his education with 15+ extensive research projects across the U.S. and West Africa. Dr. Rogers' research foci include colorectal cancer prevention & control, men's health disparities, behavioral & community-based interventions, health policy, and survey methodology.
Kolawole S. Okuyemi
Kolawole S. Okuyemi, M.D., M.P.H., is a tenured Professor of Family Medicine and Community Health and Director for the Program in Health Disparities Research at the University of Minnesota Medical School. He is also Director of Cancer Health Disparities for the Masonic Cancer Center, an NCI-designated Comprehensive Cancer Center at the University of Minnesota. Dr. Okuyemi's career in the last 20 years has focused on research and programs to improve the health of underserved populations and eliminate health disparities using pharmacological and culturally tailored behavioral interventions. Dr. Okuyemi has published over 120 peer-reviewed scientific articles and book chapters.