Smoking cessation has been less effective among low SES smokers and those with other addictions/co-morbidities. There are few studies assessing different service delivery models through rigorous scientific methods while engaging the community.

To assess the utilization and effectiveness of smoking cessation group versus individual counseling interventions among economically disadvantaged clients through a Randomized Controlled Trial (RCT).

A Community-Based Participatory Research (CBPR) approach in conjunction with RCT methodology were used to compare the effectiveness of a behavior change communication intervention and pharmacotherapy through group vs. individual counseling models. Participants were recruited from a low-income urban setting in mid Atlantic area (n = 348), and randomized to either an individual or group-based intervention. Participants received training according to the Fresh Start curriculum on their 12 weekly sessions and followed for nine months after the termination of the program.

After the intervention, the overall cessation rate was 10% with no significant difference between the two arms. The Cessation rate among participants who attended 6 to 12 sessions was significantly higher (p < 0.001) compared to those who attended 1 to 5 sessions (27.8% vs. 7.0%). Those with more positive perception of being “ready to quit” had higher odds of actual quitting (OR = 5.8).

Although individual and group counseling cessation appear to be equally effective, the group counseling is more cost-effective and feasible approach for low SES smokers and those with other co-morbidities. The effectiveness of the intervention can significantly improve with better retention and motivational enhancement strategies.

NCMHD 5-R24-MD002803.