Integrating Financial Coaching into Smoking Cessation Treatment for Low-Income Adults Receiving Food Assistance: Secondary Analysis of a Randomized Controlled Trial

Background. Food assistance recipients face high smoking rates and limited cessation support. This study evaluated an intervention targeting smoking and financial stress among food assistance recipients recruited from two safety-net medical centers. Methods. Data were drawn from a randomized controlled trial (RCT) testing an intervention integrating money management coaching, financial empowerment services, and social needs referrals into smoking cessation treatment for low-income adults. The current analysis includes n =146 RCT participants receiving food assistance at baseline ( n =79 intervention, n =67 waitlisted control). Results. At two months, 89% of intervention participants were "very satisfied." At six months, intervention participants were more likely to report seven-day abstinence (22% vs. 9%, p =.04), less worry about meeting monthly living expenses (54% vs. 73%, p =.03), reduced living paycheck-to-paycheck (73% vs. 87%, p =.04), and lower food insecurity scores than control participants ( p =.01). Conclusions. The intervention reduced self-reported smoking, food security, and financial stress among adult food assistance recipients.