Smoking cessation in a homeless population

Connor, Sharon E.; Cook, Robert L.; Herbert, Mary; Neal, Stephen M; Williams, Joseph B

doi:10.1007/s11606-002-0042-5

Cited by 33 publications

(46 citation statements)

References 22 publications

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“…HIV-infection, unstable housing, and substance use disorders) (2, 3, 20, 47-49), we found that the majority of the participants were interested in quitting smoking. While motivation to quit smoking was associated with making a quit attempt, less than one-quarter made a quit attempt during the two-year study interval.…”

Section: Discussionmentioning

confidence: 83%

Smoking Behaviors in a Community-Based Cohort of HIV-Infected Indigent Adults

et al. 2013

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We conducted a longitudinal study of a community-based cohort of HIV-infected indigent adults to examine smoking behaviors and factors associated with quitting. We assessed “hardcore” smoking behaviors associated with a low probability of quitting. Of the 296 participants, 218 were current smokers (73.6%). The prevalence of “hardcore” smoking was high: 59.6% smoked ≥ 15 cigarettes per day, and 67.3% were daily smokers. During the study interval, 20.6% made at least one quit attempt. Of these, 53.3% were abstinent at 6 months. The successful quit rate over two years was 4.6%. Illegal substance use (adjusted odds ratio, AOR 0.2, 95% CI 0.1-0.6) and smoking within 30 minutes of waking (AOR 0.2, 95% CI 0.1-0.7) were associated with lower likelihood of making a quit attempt. Interventions that reduce nicotine dependence prior to smoking cessation and those that are integrated with substance use treatment may be effective for this population.

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Section: Discussionmentioning

confidence: 83%

Smoking Behaviors in a Community-Based Cohort of HIV-Infected Indigent Adults

et al. 2013

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“…Other reasons may involve health-care provider behaviors and attitudes toward tobacco use among homeless persons, perpetuating erroneous assumptions that homeless smokers lack interest in smoking cessation. 8–9 However, contrary to myths that homeless individuals lack interest in smoking cessation, recent studies demonstrate that when provided opportunities to do so, homeless smokers will enroll in smoking cessation programs as well as exhibit high levels of motivation to quit smoking. 10 For example, in a recent survey of 350 homeless adults aged 50 or older, smoking quit attempt rates were similar to the general population; although, successful quitting was lower.…”

Section: Introductionmentioning

confidence: 99%

“…2–3 Among homeless Veterans, the rate of smoking remains alarmingly high and nearly triple than that of the US general population (21%), with estimates ranging between 70 to 80%. 4–5 Indeed, homeless Veterans are overrepresented among tobacco-using individuals within community health settings and they are disproportionately represented within the tobacco-using homeless population, 6 rendering this population particularly vulnerable to smoking-related morbidity and mortality. 7 …”

Section: Introductionmentioning

confidence: 99%

Impact of group motivational interviewing on enhancing treatment engagement for homeless Veterans with nicotine dependence and other substance use disorders: A pilot investigation

et al. 2016

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Background: Prior studies have shown that Group Motivational Interviewing (GMI) for dually diagnosed patients holds promise for increasing treatment engagement. Objectives: The current study evaluated the impact of a novel GMI protocol that included tobacco-specific components (referred to as ‘Tobacco GMI or T-GMI’) targeting enhanced engagement in smoking cessation treatment. Methods: Thirty-seven primary alcohol and nicotine-dependent cigarette smoking homeless Veterans with co-morbid psychiatric conditions were recruited to receive four GMI sessions over four consecutive days. The first 16 participants received standard GMI, aimed at enhancing engagement in substance abuse treatment and for reducing substance use, while the remaining 21 participants received a modified ‘tobacco-specific’ GMI protocol (T-GMI) that included additional content specific to cessation of tobacco use and enhancing smoking cessation treatment, in addition to the standard substance abuse content of GMI. Results: Participants in T-GMI were more likely to attend tobacco cessation programming (p = 0.05) as well as to attend combined tobacco cessation programming with prescribed nicotine replacement therapy (p = 0.03), compared to those in standard GMI. Differences between treatment conditions with respect to alcohol and illicit drug use outcomes were not significant, although overall substance use declined over time in both groups. Conclusions and Scientific Significance Results suggest that inclusion of tobacco-specific components in the context of GMI for substance abuse may enhance treatment engagement for tobacco cessation behaviors among dually diagnosed nicotine dependent homeless patients, a highly vulnerable population for which interventional resources targeting engagement in smoking cessation treatment has historically been lacking.

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“…Consequently, smoking-attributable deaths are disproportionately high among the homeless (4, 9), even when health insurance coverage for the treatment of chronic smoking-related diseases is provided (7). However, studies suggest that anywhere between a third to three-quarters of homeless smokers are interested in quitting smoking (6, 10, 12, 13) and are receptive to getting assistance from healthcare professionals to do so (10). Unfortunately, lifetime quit rates among the homeless are very low (~9%)(1), with data from one study suggesting that the majority of homeless smokers who try to quit, even during an aided quit attempt, are unable to maintain abstinence for longer than 24 hours (14).…”

Section: Introductionmentioning

confidence: 99%

Is smoking cessation associated with worse comorbid substance use outcomes among homeless adults?

et al. 2014

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Background and Aims Smoking prevalence among homeless adults is exceedingly high, and high rates of comorbid substance use are among the barriers to abstinence experienced by this group. The extent to which smoking cessation might engender an escalation in comorbid substance use could be a concern prohibiting treatment provision and engagement. This study examined whether smoking abstinence status was associated with alcohol and substance use at 26 weeks post-randomization among homeless smokers in a smoking cessation trial. Design The current study was a secondary analysis of randomized smoking cessation intervention trial data. Setting The parent study was conducted in the Minneapolis/St. Paul area of Minnesota, USA. Participants Participants were 427 homeless adult smokers interested in quitting smoking. Measurements Covariates collected at baseline included alcohol, cocaine, marijuana/hashish, heroin, and “any” drug use, age, sex, race/ethnicity, education, tobacco dependence, length of time homeless, and treatment group. Biochemically-verified smoking abstinence and self-reported alcohol and substance use were collected at 26 weeks post-randomization. Findings Smoking abstinence was associated with fewer drinking days (p=.03), fewer drinks consumed on drinking days (p=.01), and lower odds of heavy drinking (p=.05), but not with differences in the number of days of cocaine, marijuana/hashish, heroin, or any drug use. Conclusions In homeless smokers, achieving smoking abstinence may be associated with a reduction in alcohol consumption but appears not to be associated with a substantial change in other drug use.

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Smoking cessation in a homeless population

Cited by 33 publications

References 22 publications

Smoking Behaviors in a Community-Based Cohort of HIV-Infected Indigent Adults

Smoking Behaviors in a Community-Based Cohort of HIV-Infected Indigent Adults

Impact of group motivational interviewing on enhancing treatment engagement for homeless Veterans with nicotine dependence and other substance use disorders: A pilot investigation

Is smoking cessation associated with worse comorbid substance use outcomes among homeless adults?

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