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Multicenter Study
. 2013 Nov;108(11):2009-18.
doi: 10.1111/add.12292. Epub 2013 Aug 14.

Homelessness, cigarette smoking and desire to quit: results from a US national study

Travis P Baggett  1 , Lydie A Lebrun-Harris, Nancy A Rigotti
Affiliations
Multicenter Study

Homelessness, cigarette smoking and desire to quit: results from a US national study

Travis P Baggett et al. Addiction. 2013 Nov.

Abstract

Aims: We determined whether or not homelessness is associated with cigarette smoking independent of other socio-economic measures and behavioral health factors, and whether homeless smokers differ from non-homeless smokers in their desire to quit.

Design, setting and participants: We analyzed data from 2678 adult respondents to the 2009 Health Center Patient Survey, a nationally representative cross-sectional survey of homeless and non-homeless individuals using US federally funded community health centers.

Measurements: We used multivariable logistic regression to examine the association between homelessness and (i) current cigarette smoking among all adults, and (ii) past-year desire to quit among current smokers, adjusting for demographic, socio-economic and behavioral health characteristics.

Findings: Adults with any history of homelessness were more likely than never homeless respondents to be current smokers (57 versus 27%, P < 0.001). In multivariable models, a history of homelessness was associated independently with current smoking [adjusted odds ratio (AOR) 2.09; 95% confidence interval (CI) = 1.49-2.93], even after adjusting for age, sex, race, veteran status, insurance, education, employment, income, mental illness and alcohol and drug abuse. Housing status was not associated significantly with past-year desire to stop smoking in unadjusted (P = 0.26) or adjusted (P = 0.60) analyses; 84% of currently homeless, 89% of formerly homeless and 82% of never homeless smokers reported wanting to quit.

Conclusions: Among patients of US health centers, a history of homelessness doubles the odds of being a current smoker independent of other socio-economic factors and behavioral health conditions. However, homeless smokers do not differ from non-homeless smokers in their desire to quit and should be offered effective interventions.

Keywords: Homeless persons; smoking cessation; tobacco use.

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References

    1. United Nations Commission on Human Rights . Report of the Special Rapporteur on adequate housing as a component of the right to an adequate standard of living, Miloon Kothari. 2005. UN document E/CN.4/2005/48.
    1. Burt MR, Aron LY, Lee E, Valente J. Helping America’s Homeless: Emergency Shelter or Affordable Housing? Urban Institute; Washington, D.C.: 2001. How Many Homeless People Are There? pp. 23–54.
    1. Human Resources and Skills Development Canada: Homelessness Partnering Strategy The National Shelter Study, 2005-2009. 2012 Available at http://www12.hrsdc.gc.ca.
    1. Fédération Européenne des Associations Nationales Travaillant avec les Sans-Abri (FEANTSA) On the Way Home?: FEANTSA Monitoring Report on Homelessness and Homeless Policies in Europe. Brussels, Belgium: 2012.
    1. Australian Bureau of Statistics . Census of population and housing: Estimating homelessness, 2011. 2012. Cat. no. 2049.0.

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