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. 2025 Jul 22:16:100363.
doi: 10.1016/j.dadr.2025.100363. eCollection 2025 Sep.

Cigarette smoke-free home adoption attempts among formerly homeless adults living in permanent supportive housing

Mark Hawes  1   2 , Jessica Alway  3 , Deepalika Chakravarty  4 , Margot Kushel  2   5 , Wendy Max  6   7 , Fan Xia  8 , Narges Neyazi  1 , Maya Vijayaraghavan  1   3   9
Affiliations

Cigarette smoke-free home adoption attempts among formerly homeless adults living in permanent supportive housing

Mark Hawes et al. Drug Alcohol Depend Rep. .

Abstract

Introduction: Globally, tobacco use causes 8.7 million deaths annually. Approximately 50 % of formerly homeless adults in permanent supportive housing (PSH) in the United States smoke cigarettes. Secondhand smoke exposure is high in the absence of smoke-free policies. There is a need to understand attitudes toward smoke-free policies and factors associated with smoke-free home adoption attempts among PSH residents.

Methods: Between 2022 and 2024, we recruited 400 PSH residents who smoked into a smoke-free home intervention trial in 40 multi-unit PSH sites. Using baseline data, we applied generalized linear mixed models to examine factors associated with past 3-month smoke-free home adoption attempts, adjusting for age, gender, and race-ethnicity.

Results: Median age was 56 years (IQR 46, 62), and 41.8 % were Black/African American. Of the sample, 34.8 % previously attempted to adopt a smoke-free home, daily cigarette consumption averaged 11.1 (SD 7.5), and 19.3 % used e-cigarettes in the past 30 days. E-cigarette use (AOR 2.92, 95 % CI 1.48, 5.77) and positive attitudes toward smoke-free policies (AOR 2.13, 95 % CI 1.43, 3.18) were associated with increased odds of smoke-free home adoption attempts. Longer tenure at current residence (AOR 0.94, 95 % CI 0.89, 0.99), smoking within 5 min of waking (AOR 0.55, 95 % CI 0.31, 0.97), and having a serious mental illness (AOR 0.51, 95 % CI 0.30, 0.88) were associated with lower odds.

Conclusions: Support for smoke-free policies among PSH residents can be strengthened by promoting access to tobacco treatment, addressing the role of e-cigarette use, and providing tailored support for residents with serious mental illness.

Keywords: Cessation; Homelessness; Permanent Supportive Housing; Secondhand Smoke Exposure; Smoke-Free Policies; Smoke-free Home Adoption.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Locations where participants said they were most exposed to secondhand smoke (N = 400).
See this image and copyright information in PMC

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