Homelessness and smoking cessation: insights from focus groups

Area of Science:

• Public Health
• Behavioral Science
• Addiction Medicine

Background:

• Smoking prevalence is high among homeless individuals (approx. 70%).
• Limited understanding of tobacco use patterns and cessation practices in this population.
• Homelessness presents unique psychosocial and environmental factors influencing smoking behavior.

Purpose of the Study:

• To assess smoking attitudes and behaviors in homeless smokers.
• To identify psychosocial and environmental influences on smoking.
• To explore barriers to quitting, interest in cessation, and preferred cessation methods among homeless smokers.

Main Methods:

• Conducted six 90-minute focus groups with 62 current homeless smokers.
• Participants recruited from homeless service facilities.
• Data collected on demographics, smoking habits, motivations, barriers, and cessation preferences.

Main Results:

• Participants smoked an average of 18.3 cigarettes/day, with high motivation to quit.
• Pervasive social acceptance of smoking in homeless settings, boredom, and stress were key barriers.
• Alternative smoking behaviors (e.g., smoking butts, self-made cigarettes) and co-use with substances were reported.
• 76% planned to quit within 6 months; interest in pharmacotherapy combined with behavioral treatment was high.

Conclusions:

• Homeless smokers encounter distinct social and environmental obstacles to quitting.
• Interventions must be flexible, innovative, and address the specific needs of this population.
• Implementing smoking restrictions at facilities and funding cessation programs can reduce prevalence.