Homelessness, Cigarette Smoking, and Desire to Quit: Results From a U.S. National Study.

Homelessness, Cigarette Smoking, and Desire to Quit: Results from a U.S. National Study.

Addiction. 2013 Jul 9;
Baggett TP, Lebrun-Harris LA, Rigotti NA

We determined whether homelessness is associated with cigarette smoking independent of other socioeconomic measures and behavioral health factors, and whether homeless smokers differ from non-homeless smokers in their desire to quit.We analyzed data from 2,678 adult respondents to the 2009 Health Center Patient Survey, a nationally representative cross-sectional survey of homeless and non-homeless individuals using U.S. federally-funded community health centers.We used multivariable logistic regression to examine the association between homelessness and (1) current cigarette smoking among all adults, and (2) past-year desire to quit among current smokers, adjusting for demographic, socioeconomic, and behavioral health characteristics.Adults with any history of homelessness were more likely than never homeless respondents to be current smokers (57% vs. 27%, p<0.001). In multivariable models, a history of homelessness was independently associated with current smoking (AOR 2.09; 95% CI 1.49-2.93), even after adjusting for age, sex, race, veteran status, insurance, education, employment, income, mental illness, and alcohol and drug abuse. Housing status was not significantly associated with past-year desire to stop smoking in unadjusted (p=0.26) or adjusted (p=0.60) analyses; 84% of currently homeless, 89% of formerly homeless, and 82% of never homeless smokers reported wanting to quit.Among patients of U.S. health centers, a history of homelessness doubles the odds of being a current smoker independent of other socioeconomic factors and behavioral health conditions. However, homeless smokers do not differ from non-homeless smokers in their desire to quit and should be offered effective interventions. HubMed – addiction


Efficacy of interventions to combat tobacco addiction: Cochrane update of 2012 reviews.

Addiction. 2013 Jul 9;
Hartmann-Boyce J, Stead LF, Cahill K, Lancaster T

The Cochrane Collaboration is an international not-for profit organisation which produces and disseminates systematic reviews of healthcare interventions. This paper is the first in a series of annual updates of Cochrane reviews on tobacco addiction interventions. It also provides an up-to-date overview of review findings in this area to date and summary statistics for cessation reviews in which meta-analyses were conducted.In 2012, the Group published seven new reviews and updated 13 others. This update summarises and comments on these reviews. It also summarizes key findings from all the other reviews in this area.New reviews in 2012 found that in smokers using pharmacotherapy, behavioural support improves success rates (RR 1.16, 95% CI 1.09 to 1.24), and that combining behavioural support and pharmacotherapy aids cessation (RR 1.82, 95% CI 1.66 to 2.00). Updated reviews established mobile phones as potentially helpful in aiding cessation (RR 1.71, 95% CI 1.47 to 1.99), found that cytisine (RR 3.98, 95% CI 2.01 to 7.87) and low dose varenicline (RR 2.09, 95% CI 1.56 to 2.78) aid smoking cessation, and that training health professionals in smoking cessation improves patient cessation rates (RR 1.60, 95% CI 1.26 to 2.03). The updated reviews confirmed the benefits of NRT, standard dose varenicline, and providing cessation treatment free of charge. Lack of demonstrated efficacy remained for partner support, expired-air carbon monoxide feedback and lung function feedback.Cochrane systematic review evidence for the first time establishes the efficacy of behavioural support over and above pharmacotherapy, as well as the efficacy of cytisine, mobile phone technology, low dose varenicline and health professional training in promoting smoking cessation. HubMed – addiction