Tobacco cessation behaviors among older homeless adults: Results from the HOPE HOME Study
Menée aux Etats-Unis à partir d'entretiens auprès d'une cohorte de 350 fumeurs sans domicile fixe (âge : 50 ans ou plus ), cette étude évalue, par rapport à la population générale, les taux d'abstinence tabagique et de tentatives d'arrêt du tabagisme à 6 mois, puis identifie les moyens utilisés pour essayer d'arrêter de fumer ainsi que les facteurs associés au sevrage tabagique
Introduction : Tobacco-attributable deaths contribute significantly to the increased mortality observed among homeless adults aged ≥ 50 years. Little is known about the epidemiology of tobacco use among older homeless individuals. This longitudinal cohort study examines smoking behaviors and factors associated with smoking cessation among homeless individuals aged ≥ 50 years. Methods : We recruited a prospective cohort of 350 homeless individuals sampled from the community in Oakland, CA. At 6 months follow up, participants reported their cigarette quit attempts and 30-day abstinence. We used multivariable logistic regression to examine factors associated with making a quit attempt at follow-up, hypothesizing that heavier smokers would be less likely to make a quit attempt. Results : Of the 272 ever smokers, 229 (84.2%) were current smokers (quit ratio 15.8). Among current smokers at enrollment who had a follow-up interview at 6 months, 43.6% (n=71) reported making a quit attempt during the follow-up. Of those who reported making a quit attempt, 14.3% (n=10) reported 30-day abstinence at follow-up. Among those who had reported making a quit attempt at follow-up, 22.5% had used nicotine replacement therapy (NRT). Staying in shelters (Adjusted Odds Ratio (AOR) 2.5, 95% CI 1.0-5.8) was associated with higher odds of making a quit attempt at follow-up. Higher cigarette consumption was associated with lower odds of making a quit attempt (AOR 0.9, 95% CI 0.8-0.9). Conclusions : In this study of tobacco use in older homeless adults, rates of quit attempts were similar to that observed in the general population, but successful quitting was lower.