Abstract B158: Implementation of a low-cost tobacco-free intervention in a permanent supportive housing program to address cancer disparities among people who have experienced homelessness

Abstract Introduction: Permanent supportive housing residents who have experienced homelessness use tobacco products at high rates (∼50%), contributing to an up to fourfold greater risk of cancer. Agencies that provide wraparound support services to this group are committed to rebuilding their stability by improving their health. Yet, their delivery of tobacco screening and cessation care is limited, as is information about their clients’ tobacco use behaviors and readiness to quit. Here, we evaluate a low-cost intervention for an Albert Schweitzer Fellowship project conducted in a permanent supportive housing program with ∼650 adults who have experienced homelessness in Houston, Texas, to redress these gaps. Methods: Between August 2024 and February 2025, client-facing staff members of the housing program (N=45) were offered a 90-minute live or asynchronous training on tobacco screening and intervention delivery and education on the dangers posed by tobacco use. They were also provided resources (e.g., education materials and tobacco-free signage) and guidance on how to refer clients to the Texas Tobacco Quitline, which offers free counseling and nicotine replacement therapy. As part of the intervention, housing program staff were challenged to complete a tobacco use assessment with as many clients on their caseload as possible; winners who screened their entire caseload were incentivized with a pizza party. This screening included questions about their client’s current and past tobacco use, interest in quitting, stage of behavior change (informed by the Transtheoretical Model), past quit attempts, and what evidence-based interventions the staff provided them. Results: Overall, 33 (73%) staff received education and collectively screened 586 (90%) clients. Among those screened, 74% have ever used tobacco, 50% currently used cigarettes, and 12% currently used non-cigarette tobacco products. Current tobacco users (n=310) were primarily in the precontemplation (43%), contemplation (39%), and preparation (17%) stages of the Transtheoretical Model, with 57% reporting having an interest in quitting and 70% having tried quitting. Staff reported making 86 referrals to the Quitline for clients who had a phone and consented, among other interventions (e.g., Motivational Interviewing and 5A’s). However, the Quitline reported they were only able to contact and enroll 8 of these referrals for services. Conclusion: Based on high training and screening participation, the low-cost intervention was well-received. While tobacco use remains elevated among permanent supportive housing residents, interest in quitting and past quit attempts were common. Most clients who had ever used tobacco were in the early stages of the Transtheoretical Model, and many who were referred to the Quitline were unreachable, which highlight some challenges to promoting tobacco cessation in this group. Future work should focus on building greater readiness to quit tobacco and capacity to offer on-site cessation services to reduce cancer disparities they experience from elevated tobacco use. Citation Format: Ammar D. Siddiqi, Phoebe Wong, Cathy Crouch, Asfand B. Moosa, Lorraine R. Reitzel. Implementation of a low-cost tobacco-free intervention in a permanent supportive housing program to address cancer disparities among people who have experienced homelessness [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr B158.