Smoking Habits of the Homeless

The homeless population in the United States remains high, with over 600,000 homeless on any given night, and surveys in multiple homeless communities have found smoking rates to range from 68 to 80%, 3–4 times the national average (Baggett, Tobey, & Rigotti, 2013 ). This high rate is of grave concern to this vulnerable population, as cigarette smoking is the leading preventable cause of premature death in the United States, and cardiovascular disease and cancers of the lung and airway secondary to smoking are the leading causes of death within the homeless population (Porter, Houston, Anderson & Maryman, 2011 ). Over the last two decades, moves to curb smoking in New York City through taxation and bans on indoor smoking resulted in significantly lower smoking rates throughout the city (Coady et al., 2012 ). However, as primary care providers to the homeless, we have noted continued high rates of smoking among our patients despite the citywide success of cessation programs, and whether the changes over the last two decades have affected smoking rates in this vulnerable population has not been assessed in the literature. We conducted a survey of 224 homeless adults in New York City shelter walk-in clinics in the 2013 calendar year to assess the current prevalence of smoking in this population, and assess the impact of restrictions, specifically precipitous elevation in prices.