Addressing tobacco use in homeless populations: An expert panel

Background: The smoking prevalence among the homeless in the U.S. is between 70 – 80% compared to only 20% in the general population. Homeless tobacco users are at a higher risk for tobacco-related death and disease than the general population. Many homeless people would like to quit but encounter unique barriers. Little research is available on tobacco use in this population, and no corresponding best practices for tobacco cessation have been established. Method: Break Free Alliance convened an expert panel of 21 homeless service providers, the formerly homeless, policy makers, tobacco control program managers, state and federal health agencies and researchers in Washington, DC on October 21, 2009. The meeting objectives were to identify successes and challenges to addressing tobacco use in homeless populations; identify current practices and models; and develop targeted recommendations that will result in a report/guide for dissemination to researchers, funding agencies, state tobacco control programs and service providers. Results: Participants shared specific knowledge of the problem as it related to their discipline; participated in a facilitated workgroup of 10-15 other panelists to set priorities; and worked collaboratively with other panelists to concur on specific recommendations. These included integrating tobacco cessation services into all points of access from street outreach to housing placement; ensuring access to all treatment modalities for cessation therapy; and establishing agency tobacco-free policies for clients/staff at facilities treating and providing services to the homeless. The results of this expert panel discussion have been compiled and are being reviewed by those who participated.