Skip to main content

Advertisement

Log in

Interest in Smoking Cessation Related to a Smoke-Free Policy Among Homeless Adults

  • Original Paper
  • Published:
Journal of Community Health Aims and scope Submit manuscript

Abstract

Homeless adults have among the highest rates of cigarette smoking. Few studies have explored the potential of smoke-free policies as facilitators of smoking cessation or harm reduction among sheltered homeless adults. We focused on clients of a homeless shelter in San Diego, California. The facility prohibited smoking indoors and outdoors within five blocks of the building, and permitted smoking during four smoking breaks during the day in designated smoking zones away from the building. Current and former smokers who were residents of the facility were interviewed on smoking behaviors and attitudes toward these policies. Of the 170 ever smokers, 75.3 % were current smokers. The average daily cigarette consumption was 6.6 cigarettes per day (SD 4.3). More than half of the participants (57.8 %) attempted to quit smoking in the past year. Of the current smokers, three-fourths agreed that the facility policies were associated with their reduced consumption, and about half agreed that the policies were associated with either making a quit attempt or getting ready to quit completely. Sixty percent agreed that further restrictions on smoking, beyond the current policies, would be associated with increased interest in quitting smoking completely. Less than 10 % agreed that they were unhappy to stay in the facility because of the policies. Findings suggest that smoke-free policies may not influence occupancy rates in shelters serving clientele with high rates of cigarette smoking. Smoke-free policies in homeless service settings present an important and un-tapped opportunity to reduce smoking behaviors among homeless adults.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Baggett, T. P., & Rigotti, N. A. (2010). Cigarette smoking and advice to quit in a national sample of homeless adults. American Journal of Preventive Medicine, 39, 164–172.

    Article  PubMed  Google Scholar 

  2. Centers for Disease Control and Prevention. (2011). Vital signs: Current cigarette smoking among adults age ≥18 years—United States, 2005–2010. MMWR Morbidity Mortality Weekly Report, 60, 1207–1212.

    Google Scholar 

  3. Okuyemi, K. S., Goldade, K., Whembolua, G. L., Thomas, J. L., Eischen, S., Guo, H., et al. (2012). Smoking characteristics and comorbidities in the power to quit randomized clinical trial for homeless smokers. Nicotine & Tobacco Research, 15, 22–28.

    Article  Google Scholar 

  4. Gilpin, E. A., Messer, K., & Pierce, J. P. (2006). Population effectiveness of pharmaceutical aids for smoking cessation: What is associated with increased success? Nicotine & Tobacco Research, 8, 661–669.

    Article  Google Scholar 

  5. Biener, L., Hamilton, W. L., Siegel, M., & Sullivan, E. M. (2010). Individual, social-normative, and policy predictors of smoking cessation: A multilevel longitudinal analysis. American Journal of Public Health, 100, 547–554.

    Article  PubMed Central  PubMed  Google Scholar 

  6. Mills, A. L., Messer, K., Gilpin, E. A., & Pierce, J. P. (2009). The effect of smoke-free homes on adult smoking behavior: A review. Nicotine & Tobacco Research, 11, 1131–1141.

    Article  Google Scholar 

  7. Gilpin, E. A., Farkas, A. J., Emery, S. L., Ake, C. F., & Pierce, J. P. (2002). Clean indoor air: Advances in California, 1990–1999. American Journal of Public Health, 92, 785–791.

    Article  PubMed Central  PubMed  Google Scholar 

  8. Messer, K., Mills, A. L., White, M. M., & Pierce, J. P. (2008). The effect of smoke-free homes on smoking behavior in the US. American Journal of Preventive Medicine, 35(3), 210–216.

    Article  PubMed  Google Scholar 

  9. California Department of Public Health. (1998). A model for change: The California experience in tobacco control. http://www.cdph.ca.gov/programs/tobacco/Documents/CTCPmodelforchange1998.pdf

  10. Arangua, L., McCarthy, W. J., Moskowitz, R., Gelberg, L., & Kuo, T. (2007). Are homeless transitional shelters receptive to environmental tobacco control interventions? Tobacco Control, 16, 143–144.

    Article  PubMed Central  PubMed  Google Scholar 

  11. Businelle, M. S., Poonawalla, I. B., Kendzor, D. E., Rios, D. M., Cuate, E. L., Savoy, E. J., et al. (2014). Smoking policy change at a homeless shelter: Attitudes and effects. Addictive Behaviors, 40C, 51–56.

    Google Scholar 

  12. The McKinney–Vento Homeless Assistance Act. (2009). General definition of homeless individuals. https://www.onecpd.info/resources/documents/homelessassistanceactamendedbyhearth.pdf

  13. Okuyemi, K. S., Caldwell, A. R., Thomas, J. L., Born, W., Richter, K. P., Nollen, N., et al. (2006). Homelessness and smoking cessation: Insights from focus groups. Nicotine & Tobacco Research, 8, 287–296.

    Article  Google Scholar 

  14. Connor, S. E., Cook, R. L., Herbert, M. I., Neal, S. M., & Williams, J. T. (2002). Smoking cessation in a homeless population: There is a will, but is there a way? Journal of General Internal Medicine, 17, 369–372.

    PubMed Central  PubMed  Google Scholar 

  15. Apollonio, D. E., & Malone, R. E. (2005). Marketing to the marginalised: Tobacco industry targeting of the homeless and mentally ill. Tobacco Control, 14, 409–415.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  16. Porter, J., Houston, L., Anderson, R. H., & Maryman, K. (2011). Addressing tobacco use in homeless populations: Recommendations of an expert panel. Health Promotion & Practice, 12, 144S–151S.

    Article  Google Scholar 

  17. Goldade, K., Guo, H., Jarlais, D. D., Connet, J. E., Whembolua, G. L., Owen, G., et al. (2012). Homeless former smokers’ interest in helping homeless current smokers quit. American Journal of Health Promotion, 27, 90–93.

    Article  PubMed  Google Scholar 

  18. Clinical Practice Guideline Treating Tobacco Use and Dependence 2008 Update Panel, Liaisons, and Staff. (2008). A clinical practice guideline for treating tobacco use and dependence: 2008 Update. American Journal of Preventive Medicine, 35, 158–176.

    Article  Google Scholar 

  19. Haas, J. S., Linder, J. A., Park, E. R., Gonzalez, I., Rigotti, N. A., Klinger, E. V., et al. (2014). Proactive tobacco cessation outreach to smokers of low socioeconomic status: A randomized clinical trial. JAMA Intern Med [Epub ahead of print].

  20. Connor, S. E., Scharf, D. M., Jonkman, L. J., & Herbert, M. I. (2014). Focusing on the five A’s: A comparison of homeless and housed patients’ access to and use of pharmacist-provided smoking cessation treatment. Research in Social and Adminstrative Pharmacy, 10, 369–377.

    Article  Google Scholar 

  21. McQueen, A., Shacham, E., Sumner, W., & Overton, E. T. (2014). Beliefs, experience, and interest in pharmacotherapy among smokers with HIV. American Journal of Health Behavior, 38, 284–296.

    Article  PubMed Central  PubMed  Google Scholar 

  22. The Regional Taskforce on the Homeless. (2011). 2011 San Diego Point-in-time homeless census & survey. http://www.rtfhsd.org/docs/RTFH-PITC-2011.pdf

  23. Hwang, S. W., Wilkins, R., Tjepkema, M., O’Campo, P. J., & Dunn, J. R. (2009). Mortality among residents of shelters, rooming houses, and hotels in Canada: 11 year follow-up study. British Medical Journal, 339, b4036.

    Article  PubMed Central  PubMed  Google Scholar 

  24. Baggett, T. P., Hwang, S. W., O’Connell, J. J., Porneala, B. C., Stringfellow, E. J., Orav, E. J., et al. (2013). Mortality among homeless adults in Boston: Shifts in causes of death over a 15-year period. JAMA Internal Medicine, 173, 189–195.

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Acknowledgments

We thank the leadership and staff at the shelter for their support and work during the study conception and data collection phases of the study. We would also like to thank research staff (Kristin Parrinella B.A., Theresa Wong B.A., Arvin Wali B.A., and Devesh Vashishtha B.A.) for conducting some of the participant interviews. This work was supported by the California Tobacco Related Disease Research Program Grant 22XT-0020.

Conflict of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Maya Vijayaraghavan.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Vijayaraghavan, M., Pierce, J.P. Interest in Smoking Cessation Related to a Smoke-Free Policy Among Homeless Adults. J Community Health 40, 686–691 (2015). https://doi.org/10.1007/s10900-014-9985-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10900-014-9985-9

Keywords

Navigation