Smoking prevalence and tobacco control policies before and after implementing a smoking reduction program among staff and residents of transitional shelters for the homeless

Background: Smoking disproportionally affects persons who are homeless. Exposure to tobacco control policies in force at transitional shelters for the homeless may affect smoking prevalence among residents and staff of transitional homeless shelters.

Methods: An eight session smoking reduction program was implemented in 26 randomly selected shelters throughout Los Angeles County. Using a cross-sectional design, 15 staff and residents were randomly selected at each shelter to complete an individual-level survey at baseline (n=263) and 6 months following the start of the intervention (in progress). Telephone surveys with shelter management (n=26) were conducted regarding shelter-level tobacco-related policies at baseline and 6 months. Bivariate analyses and multilevel models analyzed data at the shelter level. Differences between baseline and 6 month data will be compared in further analyses.

Results: Baseline data show smoking prevalence among men (68.9%) and women (63.9%) to be considerably higher than general CA smoking prevalence (14.4% and 9.4%, respectively). At baseline, 64.9% intended to quit smoking in the next 6 months. Out of 16 tobacco control policies surveyed, shelters had 10.23 policies on average in place at baseline (CI: 3, 16). Changes in policies may influence shelter level tobacco use prevalence at 6 months.

Conclusions: This research will allow us to identify policy characteristics of shelters and characteristics of individuals that might contribute to the high rates of tobacco use. Smoking reduction programs focused on shelter tobacco use policy change may yield benefits to everyone residing and working in shelters through social norm change at the shelter level.