Courage to Quit® rolling group: Implementation in an urban medical center in primarily low-income Black smokers

Abstract

Background

Continuous “rolling” tobacco group treatments may help reduce cessation disparities by increasing access among underserved people who smoke cigarettes. We evaluated the implementation of a rolling enrollment adaptation of an evidence-based tobacco treatment group intervention, Courage to Quit®-Rolling (CTQ®-R).

Methods

The 4-session CTQ®-R incorporating psychoeducation, motivational enhancement, and cognitive behavioral skills was evaluated by examining feasibility and preliminary program outcomes with a pre-post design using the SQUIRE method in a sample of 289 primarily low-income, Black people who smoke. Feasibility was measured by examining program retention. Paired t-tests evaluated changes in behavioral intentions and knowledge about smoking cessation and differences in average daily cigarettes smoked from first to last session attended.

Results

CTQ-R was feasible to implement in an urban medical center program enrolling primarily low-income Black people who smoke, with 52% attending at least 2 sessions and 24% completing the full program. Participants demonstrated improvements in knowledge of smoking cessation strategies and confidence in quitting (ps < .004). Preliminary effectiveness analyses showed a 30% reduction in average daily cigarette use, with group completers reporting greater reduction than non-completers.

Conclusions

CTQ®-R is feasible and showed preliminary effectiveness for increasing knowledge about stop smoking skills and reducing cigarette smoking.

Implications

A rolling enrollment smoking group treatment is feasible and may be effective among people who smoke who face historical and systemic barriers to tobacco treatment engagement. Evaluation in other settings and over longer periods of time is needed.