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Published Online: 1 June 2012

Smoking Among Chronically Homeless Adults: Prevalence and Correlates

Abstract

Objective:

Cigarette smoking is one of the leading preventable causes of death, and adults who are chronically homeless have among the highest death rates. This study examined the prevalence and correlates of smoking in this population.

Methods:

Data were analyzed for 754 chronically homeless adults who were receiving mental health, primary care, and supported housing services at 11 U.S. sites in a federal initiative, the Collaborative Initiative to Help End Chronic Homelessness. The prevalence of current smoking (past three months), sociodemographic and clinical correlates of smoking, and change in smoking status (nonsmoker, self-limiting smoker, or regular smoker) over a one-year period were examined by use of stepwise multinomial regression analysis.

Results:

Overall, 80% of the 754 chronically homeless adults reported current cigarette smoking; 48% of the smokers reported trying to limit their smoking, and 75% of the smokers had discussed smoking with a health care professional. No significant overall change in smoking status was found during the study year; however, change in alcohol and drug use was associated with change in smoking status in the same direction. Having a diagnosis of posttraumatic stress disorder and reducing alcohol use predicted quitting or limiting smoking.

Conclusions:

A large majority of chronically homeless adults reported being current smokers. Smoking cessation interventions, integrated with alcohol and drug treatment, that target this population are needed. (Psychiatric Services 63:569–576, 2012; doi: 10.1176/appi.ps.201100398)

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Figures and Tables

Figure 1 Percentage of homeless adults who had quit or limited their smoking at the 12-month follow-up, by diagnosis of posttraumatic stress disorder (PTSD) and change in alcohol use
Table 1 Baseline sociodemographic characteristics of 754 chronically homeless adults, by smoking group status in the past three months
Table 2 Baseline clinical characteristics of 754 chronically homeless adults, by smoking group status in the past three months
Table 3 Stepwise multinomial logistic regression analysis of variables as predictors of smoking group at baseline among 754 chronically homeless adults
Table 4 Comparison of smoking group status at baseline and 12 months of 754 chronically homeless adults

Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services
Psychiatric Services
Pages: 569 - 576
PubMed: 22476200

History

Published online: 1 June 2012
Published in print: June 2012

Authors

Details

Jack Tsai, Ph.D. [email protected]
Dr. Tsai and Dr. Rosenheck are affiliated with the U.S. Department of Veterans Affairs Connecticut Healthcare System, 950 Campbell Ave., 151D, West Haven, CT 06516 (e-mail: [email protected]). They are also with the Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut.
Robert A. Rosenheck, M.D. [email protected]
Dr. Tsai and Dr. Rosenheck are affiliated with the U.S. Department of Veterans Affairs Connecticut Healthcare System, 950 Campbell Ave., 151D, West Haven, CT 06516 (e-mail: [email protected]). They are also with the Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut.

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