Reducing stress and smoking behaviour among disadvantaged citizens using a targeted intervention

Abstract Background Smoking is more prevalent among citizens with lower socioeconomic position. Stress and financial strain can limit mental bandwidth, inhibiting health behaviour change. In collaboration with a mental health organization and the municipality of Rotterdam, a six-session intervention took place to concurrently reduce stress, smoking, and financial strain among socioeconomically disadvantaged citizens. This study evaluated its effects on stress and smoking-related behaviours. Methods Participants (N = 70 at baseline) completed questionnaires and carbon monoxide in parts per million (COppm) measurements at baseline (T0), after session 4 (T1, N = 50), and follow-up (T2, N = 57). Outcomes included motivation to quit (three-point scale), perceived stress (scale 0-42) and nicotine dependency. Results Motivation to quit smoking increased significantly from T0 (M = 1.76) to T2 (M = 2.12, p = .017) This increase appeared stronger for male participants than female participants. Mean nicotine dependency scores did not significantly decrease. COppm values decreased non-significantly from 20.1 at T0 to 17.5 at T2. Perceived stress significantly decreased from T0 (M = 14.04) to T2 (M = 11.86, p = .046). This reduction was stronger for female participants than male participants, but female participants started with higher average stress scores at T0 (M = 16.6) compared to male participants (M = 10.9). Recommendations An integrated approach addressing both stress and smoking behaviour appears beneficial to increase motivation to quit smoking. Future efforts should focus on how increased motivation can be translated into sustained behaviour change. Study results were shared with a Dutch insurance company and our recommendation to offer this intervention to citizens receiving income benefits from local government was adopted.