Objectives: To examine smoking behavior in homeless persons, including the impact of self-reported tobacco-related health problems and drug and alcohol abuse on readiness to quit and interest in smoking cessation counseling.
Methods: Cross-sectional survey of outpatients and inpatients on the homeless service at Massachusetts General Hospital.
Results: Among 98 homeless smokers with a mean age of 44 years, tobacco-related medical diagnoses and symptoms and psychiatric illnesses were common, as were drug and alcohol abuse. One third of the smokers in this sample intended to quit smoking within the next 6 months, including 19% who planned to quit in the next 1 month. Forty-four percent of the participants were somewhat or very interested in smoking cessation counseling. In multivariate analyses, significant (P < .05) predictors of readiness to quit smoking were greater confidence in one's ability to quit (self-efficacy) and more social support for quitting. Multivariate predictors of interest in smoking cessation counseling were smoking-related symptoms and higher self-efficacy for quitting.
Conclusions: Homeless smokers recruited from the inpatient and outpatient services of a large, urban teaching hospital reported interest in both stopping tobacco use and receiving assistance to quit smoking. Having an illness that a smoker believes is tobacco-related, having greater confidence in the ability to quit, and having more social support for quitting were associated with greater readiness to quit and more interest in smoking cessation counseling. Alcohol and drug abuse were not associated with reduced interest in quitting smoking. These findings suggest that homeless smokers may benefit from smoking cessation programs that are colocated in medical or drug treatment settings.