An audit of assessment and outcome of intervention at a quit smoking clinic in a homeless hostel

Abstract

Objective: We aim to report on smoking history, mental and physical health, and the results of interventions provided by a Quit Smoking Clinic (QSC) at a Sydney homeless men's shelter.

Methods: We undertook an audit of questionnaires administered during the first QSC visit and a review of outcomes of QSC clients who attended the clinic more than once.

Results: A total of 144 men were assessed at the QSC, with mean age 45.2 years (22-71) and mean smoking duration of 29 years. About half were receiving treatment for psychotic illness, and there were high rates of other psychiatric disorders, physical illness and substance use disorder. Carbon monoxide (CO) readings were significantly higher for those smoking discarded cigarette butts. Among the subset of clients who attended the clinic more than once (n=56), only four quit for more than a month and one for a year. However, the reported number of cigarettes smoked per day was significantly lower (p=0.001), with a significant reduction in CO (p<0.008).

Conclusions: This study confirms the difficulty that homeless men experience in quitting smoking, but demonstrates the potential to reduce the physical and financial harm of smoking through cessation support interventions in this setting.

Keywords: harm reduction; homelessness; mental illness; nicotine addiction; smoking cessation.