Considering the presence of numerous barriers to medication adherence in homeless populations, problems with adherence to NRT are likely to be of a greater magnitude than in housed populations. This expectation is supported by results from a pilot study (Okuyemi et al., 2006) in which only 32% (9/28) of the participants reported using four or more patches per week sellekchem (out of recommended and study-provided seven patches/week) at their 8 weeks follow-up assessment. Those who reported using four or more patches a week had a 33.3% quit rate at Week 26 compared with 10.5% for those who used fewer than four patches per week. These data suggest that increasing NRT adherence may increase smoking cessation among homeless smokers.

To address the gap in effectiveness of evidence-based smoking cessation interventions in the homeless population, we conducted a community-based randomized study called Power To Quit (PTQ). The PTQ study assessed the effects of motivational interviewing (MI) counseling designed to improve adherence to nicotine patch (NRT) and smoking cessation outcomes among homeless smokers. The goal of the current paper is to describe the baseline smoking characteristics and comorbid conditions of homeless smokers enrolled in the PTQ study. Knowing the smoking characteristics as well as comorbid conditions of homeless adults who engage in a smoking cessation treatment study can inform the development of targeted smoking cessation interventions for homeless and other vulnerable populations. Methods All study procedures were approved and monitored by the Institutional Review Board of the University of Minnesota Medical School.

Design, Setting, and Participants Study design and recruitment procedures have been described in detail in a separate manuscript (Goldade et al., 2011). Figure 1 shows an overview of study procedures. Participant recruitment began in May 2009 and ended in September 2010. The final Week 26 follow-up assessment was completed in April 2011. This study utilized a randomized, 2-group design with 26 weeks follow-up. Once deemed eligible, participants were randomized to either the intervention arm (NRT + MI) or the Standard Care (SC) control arm (NRT + Brief Advice). Eligibility criteria included that the participants were homeless (United States, 2004), a current cigarette smoker, aged 18 years Batimastat or older, willing to use nicotine patches for 8 weeks and participate in counseling sessions, and willing to complete 15 total appointments (six during NRT treatment, eight retention contacts, and final exit interview survey) over the 26-week study period. Current smoking was defined as having smoked at least 100 cigarettes in their lifetime plus smoking at least 1 cigarette/day (CPD) in the prior 7 days.