Smoking amongst adults experiencing homelessness: a systematic review of prevalence rates, interventions and the barriers and facilitators to quitting and staying quit

Article


Soar, K., Dawkins, L., Robson, D. and Cox, S. 2020. Smoking amongst adults experiencing homelessness: a systematic review of prevalence rates, interventions and the barriers and facilitators to quitting and staying quit. Journal of Smoking Cessation. 15 (2), pp. 94-108.
AuthorsSoar, K., Dawkins, L., Robson, D. and Cox, S.
Abstract

Background

To date, there has been no review of the research evidence examining smoking cessation among homeless adults. The current review aimed to: (i) estimate smoking prevalence in homeless populations; (ii) explore the efficacy of smoking cessation and smoking reduction interventions for homeless individuals; and (iii) describe the barriers and facilitators to smoking cessation and smoking reduction.

Method

Systematic review of peer-reviewed research. Data sources included electronic academic databases. Search terms: ‘smoking’ AND ‘homeless’ AND ‘tobacco’, including adult (18+ years) smokers accessing homeless support services.

Results

Fifty-three studies met the inclusion criteria (n = 46 USA). Data could not be meta-analysed due to large methodological inconsistencies and the lack of randomised controlled trials. Smoking prevalence ranged from 57% to 82%. Although there was no clear evidence on which cessation methods work best, layered approaches with additions to usual care seemed to offer modest enhancements in quit rates. Key barriers to cessation exist around the priority of smoking, beliefs around negative impact on mental health and substance use, and environmental influences.

Conclusions

Homeless smokers will benefit from layered interventions which support many of their competing needs. To best understand what works, future recommendations include the need for consensus on the reporting of cessation outcomes.

Keywordssmoking; homeless; cessation; systematic review
JournalJournal of Smoking Cessation
Journal citation15 (2), pp. 94-108
ISSN1834-2612
Year2020
PublisherCambridge University Press for Australian Association of Smoking Cessation Professionals
Accepted author manuscript
License
File Access Level
Anyone
Digital Object Identifier (DOI)doi:10.1017/jsc.2020.11
Web address (URL)https://doi.org/10.1017/jsc.2020.11
Publication dates
Online23 Mar 2020
Publication process dates
Accepted18 Feb 2020
Deposited20 Apr 2020
Copyright holder© 2020 The Authors
Copyright informationThis article has been published in a revised form in Journal of Smoking Cessation https://doi.org/10.1017/jsc.2020.11. This version is published under a Creative Commons CC-BY-NC-ND. No commercial re-distribution or re-use allowed. Derivative works cannot be distributed.
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