An exploration of Michigan certified peer support specialists' perceptions on tobacco use and additional future supports.

Introduction: Certified peer support specialists, recovery coaches and community health workers uniquely connect to individuals who smoke through shared experiences. This study examines peers' perceptions of tobacco cessation supports to enhance policy and intervention opportunities in rural and non-rural communities.

Methods: Peers (n=172) responded to a needs assessment available from 30 November 2023 to 1 February 2024. Peers were asked questions about their perceptions of currently available and additional support for tobacco cessation. We report overall ratings of these services, as well as ratings stratified by rurality.

Results: Over half of peers perceived widely available tobacco cessation services (Quitline, counseling, NRT, medications, peer-to-peer support) as somewhat effective. Peers tended to favor financial accessibility, holistic health approaches, flexible approaches focused on harm reduction, and increased tobacco cessation services awareness, as well as peer support as additional services. When stratified by rurality, more rural-residing peers reported current tobacco cessation services as at least somewhat effective, but called for greater access to these services and/or the need for novel approaches specifically for individuals in rural communities. Rural peers emphasized the importance of more holistic support, cessation services awareness, virtual opportunities, peer-led services, and healthcare provider education for stigma prevention than their urban counterparts.

Conclusions: Most peers view existing supports as somewhat effective, with peer-to-peer support rated highest. Rural-residing peers favored holistic and virtual supports and urban-residing peers emphasized harm reduction and healthcare coverage, suggesting future cessation efforts within the peer workforce should address rural-specific barriers and leverage community-centered, flexible approaches.