Housing evidence / case study · working draft
Call It Quits: financial-support casework
Tested whether financial-support caseworkers could deliver repeated cessation counselling.
01 / THE APPROACH
What was tried
Call It Quits tested smoking support within a non-government social-service organisation in New South Wales. Adults came for financial assistance, providing an opportunity to offer help through an existing casework relationship.
Trained caseworkers delivered five sessions using motivational interviewing and supplied free nicotine replacement. The trial compared this with usual care. After allocation and consent, 431 people participated.
The approach asked social-service staff to deliver a substantial cessation intervention themselves, rather than only introducing the subject and referring to a specialist.
02 / THE FINDINGS
What was learned
Verified continuous abstinence at six months was 1.0% with the intervention and 1.4% with usual care. There was no evidence of an improvement in the main quitting outcome.
Quit attempts and cigarette reduction improved, but these did not translate into sustained cessation. This is useful learning for partners considering staff roles: an existing relationship can create an opportunity, but adding repeated treatment sessions to casework does not guarantee better quitting outcomes.
03 / TRANSFER TO WALES
What Wales could learn
Caseworkers were trained to provide five counselling sessions and free nicotine replacement within an existing financial-support relationship.
The main quitting outcome did not improve. This is a useful caution about adding repeated treatment to a frontline role: an opportunity to raise smoking is different from sufficient capacity to deliver effective ongoing care.
Sources & review
Author accepted manuscript of pragmatic randomised trial, Preventive Medicine 2018; DOI 10.1016/j.ypmed.2018.04.005.
