A qualitative study of smoking cessation experiences and perceptions among homeless young adults

ABSTRACT

Up to 70% of homeless youth smoke, but there is little information available on their smoking cessation experiences and perceptions to guide cessation intervention efforts. This study examined reasons for quitting smoking, previous experiences quitting smoking, and preferences for smoking cessation programs among homeless young adults. Four focus groups (N = 27) were conducted in centers serving homeless 18–25 year olds in Los Angeles. Sessions were audio recorded, transcribed, and analyzed by a systematic procedure for qualitative analysis to identify key themes on the topics of interest. The short-term health-related consequences of smoking and high cost of cigarettes were the main reasons participants indicated for quitting or wanting to quit. In terms of barriers to quitting, exposure to peers who smoke and smoking to cope with the daily stressors of homelessness were the two most salient themes. Suggested features of a smoking cessation program for homeless youth included having a group-based component to provide support, offering incentives to attend, and using “scare tactics” as a tool to increase motivation to quit. To increase acceptability and uptake, smoking cessation programs for homeless youth need to focus on the short-term consequences of smoking and harness of the power of peer influences.

KEYWORDS:

• Tobacco use
• homelessness
• health
• risk behavior
• peers
• focus groups
• qualitative methods

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes on contributors

Leslie Mullins was a doctoral candidate at the Pardee RAND Graduate School and an assistant policy analyst at the RAND Corporation at the time this study was conducted. Mullins is now a research associate at the Urban Institute. Mullins received her Ph.D. in policy analysis from the Pardee RAND Graduate School. She holds a Master’s in city and regional planning from the Massachusetts Institute of Technology and a B.S. in civil engineering from Carnegie Mellon University.

Claire E. O’Hanlon is a doctoral candidate in policy analysis at the Pardee RAND Graduate School and an assistant policy analyst at the RAND Corporation. O’Hanlon holds a Master of Public Policy from the University of Chicago Harris School, a certificate in Health Administration and Policy from the University of Chicago, and a B.S. in engineering from Harvey Mudd College.

William G. Shadel is a senior behavioral scientist and associate director of the Population Health Program at the RAND Corporation. He also holds an adjunct faculty appointment in the Department of Psychology at the University of Pittsburgh and is a member of the Biobehavioral Medicine Program at the University of Pittsburgh Cancer Center. Shadel received his Ph.D. in clinical health psychology and social/personality psychology from the University of Illinois at Chicago.

Joan S. Tucker is a senior behavioral scientist at the RAND Corporation and a member of the Pardee RAND Graduate School faculty. Tucker is an elected Fellow of the Association for Psychological Science, Society of Behavioral Medicine, and Western Psychological Association. She received her Ph.D. in social psychology from University of California, Riverside.

Geolocation

Los Angeles, CA.

ORCID

Claire E. O’Hanlon http://orcid.org/0000-0001-6398-5845

Additional information

Funding

This research was supported by the California Tobacco-Related Disease Research Grants Program Office of the University of California under [grant number 21RT-0118] (PI: Tucker).