Smoking increases the misery of the homeless

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News Photo: Smoking increases the misery of the homelessBy Amy Norton
HealthDay reporter

THURSDAY, Feb. 18, 2016 (HealthDay News) – Smoking is common among homeless people, and it’s costing them much of the little money they have, according to a new study.

The research, looking at more than 300 homeless adults who smoked, found that, on average, they spent $ 44 on tobacco last week. Meanwhile, their average income for the month was around $ 500, and a third or more said they had difficulty finding shelter, food, clothing or a place to bathe, according to research.

“What does $ 44 per week mean?” said lead researcher Dr Travis Baggett of Massachusetts General Hospital in Boston. “It’s a very high amount when people are really in trouble.”

Other experts said the results, published online Feb. 17 in the New England Journal of Medicine, highlight an issue that has received little attention: an estimated three-quarters of homeless American adults smoke, and there is a lack of support to get them to quit.

The health consequences are clear. Smoking-related health problems – such as heart disease and some cancers – are the leading causes of death among the homeless, said Molly Meinbresse, director of research at the National Health Care for the Homeless Council in Nashville.

The new findings highlight the daily and practical difficulties of smoking.

“Smoking places an extremely high health and financial burden on homeless people,” said Meinbresse, who was not involved in the study.

But effective help to quit smoking can be hard to find. Meinbresse said homeless health care clinics often screen patients for smoking and offer quitting advice.

“However,” she added, “programs that may involve counseling and group support are not always available.”

This is a significant shortcoming, Baggett said, because drugs that reduce the craving for nicotine are “only part” of a successful effort to quit smoking. In general, he said, research shows that smokers often need counseling – as well as support from family and friends.

When a smoker is homeless, this support system is often missing, and there are all the additional stressors of everyday life. The smoking habit, Meinbresse said, is often linked to this stress – as well as mental health issues, alcohol or drug abuse, or a history of trauma.

Plus, when most of the people around you smoke, it makes it harder to quit.

“Social norms have a lot to do with smoking and your ability to quit,” said Dr. Donna Shelley, associate professor of population health at NYU Langone Medical Center in New York City.

Shelley, who was not involved in the new research, is studying smoking cessation among the homeless and other disadvantaged groups. She said the high rates of smoking not only among the homeless, but among poor Americans in general, are “disturbing.”

“The fact that they are spending their meager resources on tobacco is tragic,” said Shelley.

In addition to financial drain, she added, a smoking habit can limit the housing options of a poor or homeless person: sources of public and low-income housing nationwide are becoming depleted. increasingly smoke-free.

The new study’s results are based on surveys of 306 homeless adults in Boston, all of whom smoked. Half said they had difficulty finding shelter or clothing in the past month, while a slightly smaller number said they had difficulty finding food, a place to wash or a bathroom. bath to use.

Despite these challenges, they spent an average of $ 44 per week on tobacco, the study found.

For some people, Baggett said, it might be easy to dismiss homeless smokers as having “bad priorities.” But, he pointed out, they are addicted to nicotine: his team found that the greater the nicotine addiction of a survey respondent, the more he spent on tobacco.

Ideally, Shelley said, smoking cessation for the homeless would be “complete,” helping them cope with the life issues that fuel their nicotine addiction.

Putting more programs in homeless shelters would help, Shelley said, since this is a time when people would receive other services, like mental health treatment and addiction assistance.

Meinbresse said his group “strongly believes” that smoking cessation should be a top priority for any organization serving the homeless.

“Tobacco addiction,” she said, “shouldn’t be an additional burden these people face when the struggle to find housing, health care, jobs and food is already on. quite difficult”.

Medical News
Copyright © 2016 HealthDay. All rights reserved.

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The references

SOURCES: Travis Baggett, MD, MPH, Massachusetts General Hospital, Boston, and staff physician, Boston Health Care for the Homeless; Donna Shelley, MD, associate professor, department of population health, NYU Langone Medical Center, New York City; Molly Meinbresse, MPH, director of research, National Health Care for the Homeless Council, Nashville, Tennessee; February 18, 2016, New England Journal of Medicine

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