Integrating Financial Coaching into Smoking Cessation Treatment for Low-Income Adults Receiving Food Assistance: Secondary Analysis of a Randomized Controlled Trial

Abstract: Background. Food assistance recipients face high smoking rates and limited cessation support. This study evaluated an intervention targeting smoking and financial stress among food assistance recipients recruited from two safety-net medical centers. Methods. Data were drawn from a randomized controlled trial (RCT) testing an intervention integrating money management coaching, financial empowerment services, and social needs referrals into smoking cessation treatment for low-income adults. The current analysis includes n =146 RCT participants receiving food assistance at baseline ( n =79 intervention, n =67 waitlisted control). Results. At two months, 89% of intervention participants were "very satisfied." At six months, intervention participants were more likely to report seven-day abstinence (22% vs. 9%, p =.04), less worry about meeting monthly living expenses (54% vs. 73%, p =.03), reduced living paycheck-to-paycheck (73% vs. 87%, p =.04), and lower food insecurity scores than control participants ( p =.01). Conclusions. The intervention reduced self-reported smoking, food security, and financial stress among adult food assistance recipients.