The GSTHR report, which focused on the protential role of social workers, highlighted that these professionals who could play a crucial role in supporting smoking cessation and tobacco harm reduction in vulnerable populations, are unfortunately rarely trained for this. Tobacco harm reduction (THR) offers alternatives like vapes, snus, and nicotine pouches, which pose fewer health risks compared to traditional tobacco.
Social workers assist a wide range of individuals facing challenges such as poverty, mental health issues, and substance abuse, many of whom smoke at higher rates than the general population. Studies show that smoking is especially prevalent among people who have experienced adverse childhood experiences (ACEs), mental health issues, substance use disorders, or socioeconomic disadvantage. Other people use nicotine to cope with stress or as self-medication.
Smoking of course leads to poorer health outcomes for these groups, hence adding to any pre-existing problems while contributing to higher rates of disease and premature death. However, highlight experts, in isolation nicotine poses lower risks compared to smoking. Hence, THR provides safer ways for these individuals to continue using nicotine without the harmful effects of tobacco smoke.
Professionals can leverage the use of safer alternative nicotine products or nicotine replacement therapies (NRT) as marginalized groups are often unaware of or unable to access these products. Social workers and healthcare providers could help bridge that gap by providing low-cost or free access to these aids, or at least by informing and educating smokers about the products. In fact countless studies have indicated that integrating NRT with professional guidance significantly enhances smoking cessation outcomes.
The magic formula: a combination of effective counselling and cessation aids
Another key intervention is culturally sensitive counseling. Research indicates that when medical professionals provide personalized, culturally aware support, marginalized individuals are more likely to quit smoking. For example, a study in Tobacco Control emphasized that tailored smoking cessation programs considering cultural beliefs and community needs can increase quit rates among African Americans and Latin populations.
While research published in Addictive Behaviors, found that motivational interviewing (MI) a technique used by health professionals to engage patients and foster intrinsic motivation to quit smoking, is also very helpul. MI tends to be effective in encouraging behavior change among marginalized individuals, especially when combined with long-term support and follow-up.
By providing accessible, culturally competent care, offering smoking cessation aids, and applying evidence-based behavioral interventions, professionals can help marginalized individuals overcome barriers to quitting smoking, improving both individual and community health.
Training social workers to support smoking cessation, promote harm reduction and recommend safer nicotine alternative products, could improve public health outcomes, particularly for disadvantaged groups. Some methods, such as Very Brief Advice (VBA), MI, and cognitive behavioral therapy (CBT), can help social workers guide their clients in quitting smoking or switching to safer alternatives. However, access to smoking cessation services and safer nicotine products remains limited globally. Expanding these services and training social workers could significantly reduce the harms associated with smoking in vulnerable populations.
UK: ASH Calls For Smoking Cessation Training for Mental Health Staff
