By Julia Falco and Andy Lessard
This past July, CBRC launched our Smoke Break pilot program. Funded by Health Canada, the national initiative aims to reduce tobacco-related harms while building healthier, more inclusive communities that affirm and support 2S/LGBTQIA+ people. As we officially launch the Smoke Break program this month, we’re excited to invite new participants and share key findings from the pilot phase and highlight promising practices and feedback that have informed our full-scale implementation.
Smoke Break is a free, virtual, bilingual program open to 2S/LGBTQIA+ community members aged 18 and up across Canada. Services include virtual peer support, the distribution of Smoke Break kits, and referrals to and from service providers across the country. Virtual peer support services are provided by and for 2S/LGBTQIA+people, ensuring participants connect with workers who share their lived experience and understanding. Our peer support team provides trauma-informed, one-on-one sessions that use motivational interviewing and a harm reduction approach. They also offer group sessions called Smoke Break socials, as a space to generate connection, shared learnings, and community care.
Participants choose what they would like in their smoke break kits, including Nicotine Replacement Therapy (NRT), FÜM products, and care package items, which are then mailed to them. For our pilot program, we had 27 participants, 41% of which (or, 11 participants) completed four or more sessions by the end of September. Of the 27 participants, 17 were sent NRT.
To evaluate the impact of the Smoke Break program, participants were invited to complete a pre-survey at the start of the program and a post-survey after completing four sessions (a mix of one-on-one or group-based support sessions). We also plan to administer a six-month follow-up survey to see how participants are faring. Survey respondents each receive a participant code, so we’ll be able to do a matched analysis as the pre, post, and follow-up surveys are completed. Respondents receive a $25 honorarium for each survey they complete.
Of the 27 Smoke Break pilot participants, 21 completed the pre-survey. The median age of respondents was 27 years old. Ninety-five percent (95%) reported having ever smoked, and 76% reported having ever vaped. Of the 20 respondents who had ever smoked, the median length of time that they had been smoking was nine years. At program intake, 90% of respondents were smoking daily. Of these daily smokers:
- 22% smoked more than one pack per day,
- 11% smoked one pack per day,
- 28% smoked half a pack per day, and
- 39% smoked less than half a pack per day
For this analysis, a pack was defined as 20 cigarettes.
Our post-survey results have been rolling in for about the past month, and we anticipate more. As of October 27, we have collected a total of seven post-survey responses from Smoke Break pilot participants. Among the respondents:
- 57% indicated they were smoking daily (4)
- 14% indicated they were smoking monthly (defined as once or more per month, but not every week)
- 29% indicated they had not smoked at all in the preceding 4 weeks
Of the four respondents who indicated that they were smoking daily during the four weeks prior to taking the post-survey:
- 25% indicated they were smoking more than a pack a day,
- 50% indicated they were smoking half a pack a day, and
- 25% indicated they were smoking less than half a pack a day
All respondents who continued to smoke at the time of the post-survey reported a reduction in their smoking. While these are still early findings, we’re encouraged by both the promising results and the qualitative information we’ve received. Here’s some of what we heard:
“Having a dedicated space to talk authentically about my smoking with someone who understands and is non-judgmental, has been transformative. I do not have this in other areas of my life and experience a lot of shame around my smoking outside of Smoke Break. To speak honestly, Smoke Break has increased my awareness and helped me set fair goals for myself. Also hella gender-affirming program.” - Pilot participant
“I appreciate being met exactly where I am.” - Pilot participant
In terms of some of our conclusions for promising practices, one of the first things that our staff noticed is that people are coming into the program with a lot of heaviness. They often feel shame and guilt from experiences with other service providers, or with their friends and family.
We’re also seeing that participants are drawn to the program because of its harm reduction approach. In promoting the program, we share that we’re here for a variety of different goals — whether you are ready to quit, cut back, or want to take a break from smoking.
Our participants are also drawn to the 2S/LGBTQIA+ specific support we offer. We’ve seen how important it is for people to have access to affirming, non-judgmental spaces. Many participants express hope and comfort in seeing themselves reflected in the peer support they receive.
We’ve also observed that most participants are ordering NRT right away. There’s a strong interest in having the items mailed to them, along with the FÜM products or other care package items. Participants report that this combination is especially helpful when paired with peer support, allowing them to use those products in tandem with some of the mindfulness practices, motivational interviewing, journaling, and self-accountability strategies.
Lastly, motivational interviewing and journaling is helping participants to not only identify their goals, but also to really understand and develop self-awareness around why, where, and when they smoke. This helps folks not only change their smoking behaviours if they wish, but also address some of the underlying conditions or sources of stress in their lives.
Now that we have launched our full public Smoke Break program, which is open nationally to 2S/LGBTQIA+ people aged 18 and up across Canada, we invite you to help spread the word! If you happen to be a service provider who may be interested in joining our provider network, please write to us at [email protected].
