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Subsistence difficulties are associated with more barriers to quitting and worse abstinence outcomes among homeless smokers: evidence from two studies in Boston, Massachusetts

Overview of attention for article published in BMC Public Health, April 2018
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2 tweeters

Citations

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11 Dimensions

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73 Mendeley
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Title
Subsistence difficulties are associated with more barriers to quitting and worse abstinence outcomes among homeless smokers: evidence from two studies in Boston, Massachusetts
Published in
BMC Public Health, April 2018
DOI 10.1186/s12889-018-5375-z
Pubmed ID
Authors

Travis P. Baggett, Awesta Yaqubi, Seth A. Berkowitz, Sara M. Kalkhoran, Claire McGlave, Yuchiao Chang, Eric G. Campbell, Nancy A. Rigotti

Abstract

Three-quarters of homeless people smoke cigarettes. Competing priorities for shelter, food, and other subsistence needs may be one explanation for low smoking cessation rates in this population. We analyzed data from two samples of homeless smokers to examine the associations between subsistence difficulties and 1) smoking cessation readiness, confidence, and barriers in a cross-sectional study, and 2) smoking abstinence during follow-up in a longitudinal study. We conducted a survey of homeless smokers (N = 306) in 4/2014-7/2014 and a pilot randomized controlled trial (RCT) for homeless smokers (N = 75) in 10/2015-6/2016 at Boston Health Care for the Homeless Program. In both studies, subsistence difficulties were characterized as none, low, or high based on responses to a 5-item scale assessing the frequency of past-month difficulty finding shelter, food, clothing, a place to wash, and a place to go to the bathroom. Among survey participants, we used linear regression to assess the associations between subsistence difficulty level and readiness to quit, confidence to quit, and a composite measure of perceived barriers to quitting. Among RCT participants, we used repeated-measures logistic regression to examine the association between baseline subsistence difficulty level and carbon monoxide-defined brief smoking abstinence assessed 14 times over 8 weeks of follow-up. Analyses adjusted for demographic characteristics, substance use, mental illness, and nicotine dependence. Subsistence difficulties were common in both study samples. Among survey participants, greater subsistence difficulties were associated with more perceived barriers to quitting (p < 0.001) but not with cessation readiness or confidence. A dose-response relationship was observed for most barriers, particularly psychosocial barriers. Among RCT participants, greater baseline subsistence difficulties predicted less smoking abstinence during follow-up in a dose-response fashion. In adjusted analyses, individuals with the highest level of subsistence difficulty had one-third the odds of being abstinent during follow-up compared to those without subsistence difficulties (OR 0.33, 95% CI 0.11-0.93) despite making a similar number of quit attempts. Homeless smokers with greater subsistence difficulties perceive more barriers to quitting and are less likely to do so despite similar readiness, confidence, and attempts. Future studies should assess whether addressing subsistence difficulties improves cessation outcomes in this population. ClinicalTrials.gov: NCT02565381 .

Twitter Demographics

The data shown below were collected from the profiles of 2 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 73 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 73 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 12 16%
Student > Bachelor 7 10%
Researcher 7 10%
Student > Ph. D. Student 5 7%
Lecturer 2 3%
Other 6 8%
Unknown 34 47%
Readers by discipline Count As %
Medicine and Dentistry 13 18%
Nursing and Health Professions 12 16%
Psychology 6 8%
Engineering 3 4%
Social Sciences 3 4%
Other 5 7%
Unknown 31 42%

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 11 April 2018.
All research outputs
#13,127,698
of 21,778,818 outputs
Outputs from BMC Public Health
#9,414
of 14,121 outputs
Outputs of similar age
#156,512
of 299,239 outputs
Outputs of similar age from BMC Public Health
#1
of 1 outputs
Altmetric has tracked 21,778,818 research outputs across all sources so far. This one is in the 38th percentile – i.e., 38% of other outputs scored the same or lower than it.
So far Altmetric has tracked 14,121 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 13.8. This one is in the 32nd percentile – i.e., 32% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 299,239 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 46th percentile – i.e., 46% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them