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A behavioral economic intervention for low-income smokers

Award Number: R37CA252483
ORGANIZATION: NATIONAL CANCER INSTITUTE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 12/14/2021
PERIOD OF PERFORMANCE END DATE: 11/30/2026

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A behavioral economic intervention for low-income smokers - PROJECT SUMMARY People with low income are three times more likely to smoke than people with high income. The income disparity in tobacco use has persisted over the past 50 years—in part because there have been limited efforts to design cessation interventions that address the sociocontextual determinants of smoking among low-income adults. Tobacco use not only causes extreme health consequences for low-income people, but it can also exacerbate their financial strain by using funds on tobacco that could go towards essentials. Low-income smokers also face unique barriers to cessation, including high levels of financial distress and other social needs, which results in the use of smoking as a coping mechanism. Behavioral economics further finds that people experiencing financial strain have an increased focus on immediate needs at the expense of delayed goals (such as the long- term health benefits of cessation)—resulting in limited cognitive “bandwidth” to attend to smoking cessation. Interventions that alleviate financial stress and help low-income smokers attend to the benefits of quitting may improve quit rates in this vulnerable population. We previously conducted a randomized study testing a novel intervention that integrates financial coaching into a smoking cessation program for low-income smokers. At follow-up, intervention participants were more likely to have quit smoking, report lower levels of financial stress, and report higher levels of financial satisfaction than a minimal usual care control group. Our goal with the proposed R01 is to leverage the successes of the prior study and conduct a large randomized controlled trial (RCT) comparing the effectiveness, mechanisms, and costs of the integrated intervention against standard intensive cessation treatment. We have the following Specific Aims: (1) Compare the effectiveness of the integrated intervention to standard cessation counseling on long-term abstinence; (2) Identify the significant mechanisms of action of the integrated intervention; and (3) Estimate the cost and cost-effectiveness of the integrated intervention compared to standard counseling. To accomplish these aims, we will conduct a two-arm, parallel-group, RCT. We will recruit and randomize 900 smokers (n=450 per arm) to either: (1) Control: Standard Smoking Cessation Counseling or (2) Intervention: Integrated Financial-Smoking Cessation Counseling. Both groups will receive 8 weeks of nicotine replacement therapy. We will survey participants at baseline, 6 months, and 12 months to assess outcomes and mechanisms, and biochemically verify self-reported abstinence at 12 months (our primary outcome). We will assess and compare the cost-per-quit in the two treatment arms.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $626,343 )
2026	2026	NEW YORK UNIVERSITY	550 1ST AVE	NEW YORK	NY	10016	NEW YORK	USA	Cancer Cause and Prevention Research	000	5	12/11/2025	NON-COMPETING CONTINUATION	$626,343
														Subtotal = $626,343

Issue Date FY: 2025 ( Subtotal = $700,077 )
2025	2025	NEW YORK UNIVERSITY	550 1ST AVE	NEW YORK	NY	10016	NEW YORK	USA	Cancer Cause and Prevention Research	000	4	11/14/2024	NON-COMPETING CONTINUATION	$630,069
2025	2025	NEW YORK UNIVERSITY	550 1ST AVE	NEW YORK	NY	10016	NEW YORK	USA	Cancer Cause and Prevention Research	001	4	6/2/2025	NON-COMPETING CONTINUATION	$70,008
														Subtotal = $700,077

Issue Date FY: 2024 ( Subtotal = $666,714 )
2024	2024	NEW YORK UNIVERSITY	550 1ST AVE	NEW YORK	NY	10016	NEW YORK	USA	Cancer Cause and Prevention Research	000	3	12/6/2023	NON-COMPETING CONTINUATION	$631,621
2024	2024	NEW YORK UNIVERSITY	550 1ST AVE	NEW YORK	NY	10016	NEW YORK	USA	Cancer Cause and Prevention Research	001	3	4/17/2024	NON-COMPETING CONTINUATION	$35,093
														Subtotal = $666,714

Issue Date FY: 2023 ( Subtotal = $920,133 )
2023	2023	NEW YORK UNIVERSITY	550 1ST AVE	NEW YORK	NY	10016	NEW YORK	USA	Trans-NIH Research Support	002	2	9/18/2023	SUPPLEMENT FOR EXPANSION	$226,794
2023	2023	NEW YORK UNIVERSITY	550 1ST AVE	NEW YORK	NY	10016	NEW YORK	USA	Cancer Cause and Prevention Research	001	2	3/15/2023	NON-COMPETING CONTINUATION	$56,600
2023	2023	NEW YORK UNIVERSITY	550 1ST AVE	NEW YORK	NY	10016	NEW YORK	USA	Cancer Cause and Prevention Research	000	2	11/28/2022	NON-COMPETING CONTINUATION	$636,739
														Subtotal = $920,133

Issue Date FY: 2022 ( Subtotal = $688,443 )
2022	2022	NEW YORK UNIVERSITY	550 1ST AVE	NEW YORK	NY	10016	NEW YORK	USA	Cancer Cause and Prevention Research	000	1	12/14/2021	NEW	$688,443
														Subtotal = $688,443

Grand Total All Awards = $3,601,710

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A behavioral economic intervention for low-income smokers

Award Number: R37CA252483

ORGANIZATION: NATIONAL CANCER INSTITUTE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 12/14/2021

PERIOD OF PERFORMANCE END DATE: 11/30/2026

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