Participatory evaluation of a community based peer-led smoking cessation intervention

Background. Low-income urban residents still smoke at higher rates and they are less likely to utilize treatment services compared to the U.S. general population. The Communities Engaged and Advocating for a Smoke-free Environment (CEASE) initiative is a peer-led community-based smoking cessation intervention in response to the problem of high rates smoking among inner-city low-income communities. Methods.  The effectiveness of the CEASE intervention was evaluated using both qualitative and quantitative methodologies. Data for this study were triangulated from the following sources: street intercept surveys (n=3901); focus group discussions (n=38); Individual in-depth interviews (n=4). Individuals were surveyed in different locations of an urban community of the Mid-Atlantic region (corresponding to 2,554 residents and 1,377 community visitors).  Tobacco use and other variables were measured using a self-report questionnaire at community settings. Peer-motivators and CEASE intervention participants were interviewed in 6 groups (n=38). They were asked to explain their experience with the CEASE intervention. In addition, four Site coordinators for smoking cessation intervention were individually interviewed. Results. Smoking among residents was twice as high compared to visitors (56% vs. 27%, p <0.001). Peer-motivators facilitated interventions in community sites yielded better outcomes such as more abstinence (40% vs. 10%), higher retention (60% vs. 27%), and more services (p<0.001). Different stakeholder identified important opportunities and challenges for improving the quality and effectiveness of the intervention. Conclusion.  Community-based peer-led approach to nicotine dependence treatment groups is a challenging and at the same time effective strategy to help current smokers among underserved populations quit smoking.