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. 2019 May 24;19(1):635.
doi: 10.1186/s12889-019-6987-7.

"It's a hard thing to manage when you're homeless": the impact of the social environment on smoking cessation for smokers experiencing homelessness

Rebekah Pratt  1 , Claire Pernat  2 , Linda Kerandi  2 , Azul Kmiecik  2 , Cathy Strobel-Ayres  2 , Anne Joseph  3 , Susan A Everson Rose  4 , Xianghua Luo  5 , Ned Cooney  6 , Janet Thomas  2 , Kola Okuyemi  7
Affiliations

"It's a hard thing to manage when you're homeless": the impact of the social environment on smoking cessation for smokers experiencing homelessness

Rebekah Pratt et al. BMC Public Health. .

Abstract

Background: Up to 80% of the adult homeless population use tobacco, and smoking cessation programs could offer an important opportunity to address preventable mortality and morbidity for this population. This population faces serious challenges to smoking cessation, including the impact of the social environment.

Methods: Forty participants (11 female; 29 male) from an ongoing smoking cessation randomized clinical trial conducted at 2 urban homeless shelters in the Upper Midwest were invited to take part in semi-structured interviews in 2016-2017. An interviewer used a semi-structured interview guide asking participants to describe their experience of how the social environment impacted their attempt to quit smoking.

Results: Participants described feeling pressure to smoke and drink in and around shelters, and that this pressure had led some to start smoking or resume smoking, along with making it very challenging to quit. Participants described being motivated to quit, and seeing smoking cessation as positively impacting the time and focus they felt they had for finding housing. However many felt more interested in reducing their smoking, rather than quitting.

Conclusions: Addressing smoking cessation for people experiencing homelessness is both an important public health opportunity, and a challenge. There is a need to consider cessation in the context of the social and environmental factors impacting smokers who are experiencing homelessness. In particular, there is a need to address the collective value placed on smoking in social interactions. Despite these challenges, there are high levels of motivation and interest in addressing smoking.

Trial registration: NCT01932996 . Date of registration 30th August 2013. Prospectively registered.

Keywords: Homelessness; Participant experience; Qualitative; Randomized control trial; Smoking cessation; Social environment.

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Conflict of interest statement

The authors declare that they have no competing interests.

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References

    1. Tsai J. Lifetime and 1-year prevalence of homelessness in the US population: results from the National Epidemiologic Survey on alcohol and related conditions-III. J Public Health (Bangkok) 2017;40(1):1–10. doi: 10.1093/pubmed/fdx034. - DOI - PubMed
    1. Baggett TP, Lebrun-Harris LA, Rigotti NA. Homelessness, cigarette smoking and desire to quit: results from a US national study. Addiction. 2013;108(11):2009–2018. doi: 10.1111/add.12292. - DOI - PMC - PubMed
    1. Reitsma M, Fullman N, Ng M, Salama J, Abajobir A, Abate K, et al. Smoking prevalence and attributable disease burden in 195 countries and territories, 1990–2015: a systematic analysis from the global burden of disease study 2015. Lancet. 2017;389(10082):1885–1906. doi: 10.1016/S0140-6736(17)30819-X. - DOI - PMC - PubMed
    1. Baggett TP, Chang Y, Singer DE, Porneala BC, Gaeta JM, O’Connell JJ, et al. Tobacco-, alcohol-, and drug-attributable deaths and their contribution to mortality disparities in a cohort of homeless adults in Boston. Am J Public Health. 2015;105(6):1189–1197. doi: 10.2105/AJPH.2014.302248. - DOI - PMC - PubMed
    1. Levano Whitney, Miller Jacqueline W., Leonard Banning, Bellick Linda, Crane Barbara E., Kennedy Stephenie K., Haslage Natalie M., Hammond Whitney, Tharpe Felicia S. Public education and targeted outreach to underserved women through the National Breast and Cervical Cancer Early Detection Program. Cancer. 2014;120(S16):2591–2596. doi: 10.1002/cncr.28819. - DOI - PMC - PubMed

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