Concurrent nicotine and tobacco product use among homeless smokers and associations with cigarette dependence and other factors related to quitting

Neisler, Julie; Reitzel, Lorraine R.; Garey, Lorra; Kenzdor, Darla E.; Hébert, Emily T.; Vijayaraghavan, Maya; Businelle, Michael S.

doi:10.1016/j.drugalcdep.2017.12.012

Cited by 20 publications

(17 citation statements)

References 46 publications

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“…We cannot determine how many cigarettes were smoked per week or how many drinks were consumed during each drinking event. Further, risk behaviors may be underreported as evidenced by the higher rates of tobacco use found in other recent studies of homeless adult populations (23)(24). While clearly our findings are not generalizable to individuals younger than 39, participants in this study represent 52.6% of all individuals aged 39 or older who were entered into the Los Angeles County Homeless Management Information System (HMIS) in the same zip codes and PSH types (without dependent children) during the same time period based on data provided by the Los Angeles Homeless Services Authority (LAHSA).…”

Section: Discussionmentioning

confidence: 99%

Longitudinal effects of permanent supportive housing on insomnia for homeless adults

et al. 2019

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Objectives.-To examine the longitudinal change in insomnia as adults transition from homelessness to permanent support housing (PSH), and whether additional factors may moderate this relationship. Methods.-Standardized interviews were conducted with 331 homeless participants in Los Angeles prior to moving into PSH. Outcomes were measured 3, 6, and 12 months after move-in. Insomnia was assessed using the sleep condition indicator, which is a two-item validated shortform inventory that is intended to be used in clinical settings as a brief screening instrument for insomnia. Mixed-effects models were used to examine insomnia across all four measurement points and to test for interactions between time and covariates. Results.-Participants were on average approximately 55 years old and had spent an average of 5.6 years homeless in their lifetime, with approximately 70% identifying as male. Sixty-two percent of the sample screened positive for insomnia disorder at baseline. There was a significantly reduced likelihood of insomnia at each measurement period compared to baseline but no differences were found between 3, 6, or 12 months. Mental health symptoms, physical health comorbidities, tobacco consumption, and female gender were associated with an increased likelihood of insomnia. Conclusion.-Findings indicate a significant decrease in insomnia after moving into PSH, regardless of time spent homeless.

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Section: Discussionmentioning

confidence: 99%

Longitudinal effects of permanent supportive housing on insomnia for homeless adults

et al. 2019

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“…Social support, or the availability of individuals, or resources provided by individuals, to cope with stress has been identified as a resiliency factor with the potential to improve health-related outcomes [23][24][25]. Furthermore, strong levels of social support have been associated with increased resilience and reduced stress within a sample of individuals experiencing homelessness [26].…”

Section: Introductionmentioning

confidence: 99%

Perceived Social Support Attenuates the Association between Stress and Health-Related Quality of Life among Adults Experiencing Homelessness

Jafry

Martinez

Chen

et al. 2021

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Health-related quality of life (HRQoL) is defined as a multidimensional subjective assessment of one’s physical and mental health. Homelessness is associated with numerous stressors that can reduce HRQoL. Social support is defined as the availability of individuals, or resources provided by individuals, to cope with stress. Interpersonal social support may be important in buffering HRQoL from the negative implications of stress. Here, we examine this association in a marginalized group known for high rates of physical and mental health comorbidities: adults experiencing homelessness. Participants (N = 581; 63.7% men; Mage = 43.6 ± 12.2) were recruited from homeless-serving agencies in Oklahoma City. Social support was measured with the 12-item Interpersonal Support Evaluation List (ISEL). HRQoL was measured by the Behavioral Risk Factor Surveillance System (BRFSS) survey using self-rated health, the number of poor mental and poor physical health days over the preceding 30 days, as well as the number of limited activity days as the result of poor mental and/or physical health. Perceived stress was assessed using the 4-item Perceived Stress Scale (PSS). The potential moderation effect of social support was examined by assessing the interaction term of social support and stress in a series of linear regression analyses, controlling for sex, age, months homeless, race, education, health insurance status, serious mental illness diagnosis, and recruitment agency/site. There was a significant interaction effect of social support and stress on the prediction of days of poor physical health, days of poor mental health, and days of limited activity (p in all cases ≤ 0.05). Results add to a growing literature on the potentially protective benefits of social support for HRQoL, extend them to a large sample of adults experiencing homelessness in the South, and demonstrate the significance of this moderating effect of social support over and above the influence of several prominent sociodemographic and diagnostic variables. Future work should determine if interventions designed to enhance social support can buffer HRQoL from the deleterious effects of stress among this vulnerable population.

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“…In fact, over 70% of homeless adults report current smoking-a rate that is approximately five times the national average [2,3]. Moreover, homeless smokers often use dual/multiple (≥2) tobacco products at a rate upward of 68% (compared to 7.9-10.6% among domiciled smokers) [4,5]-a practice that may have more serious implications for health than cigarette-only smoking. When compared to their domiciled counterparts, homeless smokers attempt to quit smoking at comparable rates but have much lower rates of successful quit attempts [6,7], despite a significant portion of this population being interested in quitting [6,[8][9][10] and wanting to receive help to do so [8].…”

Section: Introductionmentioning

confidence: 99%

Clinician Training in the Adaptation of a Comprehensive Tobacco-Free Workplace Program in Agencies Serving the Homeless and Vulnerably Housed

Taing

Kyburz

Leal

et al. 2020

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Tobacco use is exceedingly high among those who are homeless or at risk of homelessness but not commonly addressed by clinicians. Taking Texas Tobacco Free (TTTF) is a tobacco control program that addresses known clinician barriers to intervention (e.g., low training receipt, limited resources). Here, we examine the process and outcomes of TTTF’s adaptation within four agencies that provide housing or other services to individuals who are homeless or vulnerably housed. Pre- and post-implementation data were collected from clinicians (N = 68) to assess changes in training receipt, knowledge, and intervention behaviors, relative to program goals. Results indicated significant gains in clinicians’ receipt of training in 9 (of 9) target areas (p’s ≤ 0.0042) and a 53% knowledge gain (p < 0.0001). From pre- to post-implementation, there were mean increases in the use of the 5As (ask, advise, assess, assist, and arrange) and other evidence-based interventions for tobacco cessation, with significant gains seen in assisting residents/clients to quit, arranging follow-ups, and providing or referring for non-nicotine medications (p’s ≤ 0.0491). All program goals, except gains related to advising smokers to quit and the use of specific interventions (behavioral counseling), were met. Overall, TTTF improved clinicians’ capacity to address tobacco use among homeless and vulnerably housed individuals and can serve as a model for tobacco control efforts in similar agencies.

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Concurrent nicotine and tobacco product use among homeless smokers and associations with cigarette dependence and other factors related to quitting

Abstract: The need for cessation efforts that account for concurrent use for homeless adult smokers is great. Study findings indicate that concurrent users are commonly pursuing the reduction or elimination of cigarette usage and should be specifically targeted for cessation intervention.

Cited by 20 publications

References 46 publications

Longitudinal effects of permanent supportive housing on insomnia for homeless adults

Longitudinal effects of permanent supportive housing on insomnia for homeless adults

Perceived Social Support Attenuates the Association between Stress and Health-Related Quality of Life among Adults Experiencing Homelessness

Clinician Training in the Adaptation of a Comprehensive Tobacco-Free Workplace Program in Agencies Serving the Homeless and Vulnerably Housed

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