Tobacco smoking, associated risk behaviours, and experience with quitting: a qualitative study with homeless smokers addicted to drugs and alcohol

Garner, Laura; Ratschen, Elena

Abstract

Background
The prevalence of tobacco smoking among homeless people can reach more than 90%, with related morbidity and mortality being high. However, research in this area is scarce. This study aims to explore smoking and quitting related behaviours, experiences and knowledge in homeless smokers in the context of other substance abuse.

Methods
Face-to-face interviews were conducted with homeless smokers accessing a harm reduction service in Nottingham, UK. Data on smoking history, nicotine dependence, motivation and confidence to quit were collected using structured instruments; a semi-structured interview guide was used to elicit responses to predefined subject areas, and to encourage the emergence of unprecedented themes. Data were analysed using framework analysis and descriptive statistics.

Results
Participants were generally highly dependent smokers who did not display good knowledge/awareness of smoking related harms and reported to engage in high risk smoking behaviours. The majority reported notable motivation and confidence to quit in the future, despite or indeed for the benefit of addressing other dependencies. Of the many who had tried to quit in the past, all had done so on their own initiative, and several described a lack of support or active discouragement by practitioners to address smoking.

Conclusion
High levels of tobacco dependence and engagement in unique smoking related risk behaviours and social interplays appear to add to the vulnerability of homeless smokers. Given reported motivation, confidence, previous attempts and lack of support to quit, opportunities to address smoking in one of the most disadvantaged groups are currently missed.

Citation

Garner, L., & Ratschen, E. (2013). Tobacco smoking, associated risk behaviours, and experience with quitting: a qualitative study with homeless smokers addicted to drugs and alcohol. BMC Public Health, 13, Article 951. https://doi.org/10.1186/1471-2458-13-951

• Journal Article Type: Article
• Publication Date: Oct 10, 2013
• Deposit Date: Apr 7, 2014
• Publicly Available Date: Apr 7, 2014
• Journal: BMC Public Health
• Electronic ISSN: 1471-2458
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 13
• Article Number: 951
• DOI: https://doi.org/10.1186/1471-2458-13-951
• Keywords: Tobacco; Smoking; Smoking cessation; Homeless; Vulnerable groups
• Public URL: https://nottingham-repository.worktribe.com/output/718863
• Publisher URL: http://www.biomedcentral.com/1471-2458/13/951