75% of Homeless Smoke; Doctors Say it’s Time to Intervene

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About three-quarters of homeless people smoke cigarettes, and the complacent approach to that situation needs to change to support efforts to get them to quit, doctors wrote in the New England Journal of Medicine.

….There exists “a fatalistic attitude among healthcare professionals toward addressing tobacco use in this population,” they wrote in the Thursday issue of the journal.

The authors acknowledged particular difficulties in getting homeless people to stop or reduce their smoking, including psychiatric and substance abuse issues. A lack of health insurance also means a lack of access to smoking cessation programs.

“Whereas most homeless shelters no longer permit smoking indoors, smoking around shelters is commonplace and contributes to a culture of tobacco use that makes quitting more difficult and relapse more likely,” the doctors wrote.

The lead author, Dr. Travis Baggett, an instructor in medicine at Harvard Medical School and Massachusetts General Hospital, said that during much of his 13 years of work with homeless people, he would have agreed that tobacco was not a top priority. But he said his attitude has changed in the last five years.

Smoking “causes too many problems for us to ignore it,” he said in an accompanying interview on the journal’s website. It is “making our patients poorer or sicker, and they want to quit.”

by Mary MacVean, Los Angeles Times

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