Grant: CIHR Fellowship

Tobacco is the most preventable cause of disease and death in Canada. Although tobacco use has gone down in the general population, significant differences exist between sub-populations in Canada, where for example marginalized populations in Ottawa report a 96% tobacco smoking rate relative to 9-18% in Ottawa's mainstream populations. This stark inequity in tobacco use translates into devastating healthcare outcomes such as a disproportionate amount of cancer, stroke, heart disease and death. To tackle tobacco related health disparities, a novel approach to smoking cessation in vulnerable populations is required. Pragmatic peer-led community-based approaches to treat and manage tobacco dependence can be implemented with great success in marginalized populations. The Healthy People Initiative (HPI), an example of a pragmatic peer-led community-based approach, will be utilized to compare two tobacco dependence management strategies in the homeless (or at-risk for homelessness) substance using populations of two large Canadian cities (Ottawa and Toronto).