Attitudes Towards Smoking Cessation Among Sheltered Homeless Parents in Northern California

Background: The prevalence of smoking among homeless adults is approximately 70%. Cessation programs designed for family shelters are a high priority given the dangers cigarette smoke poses to children. However, the unique nature of smoking in the family shelter setting remains unstudied.

Objectives: To assess cessation attitudes, barriers and motivators among homeless parents living in family shelters.

Methods: Focus groups were conducted at four family shelters in Northern California. The focus groups were audiorecorded, transcribed, and a representative team performed qualitative theme analysis.

Results: Seven 45-minute focus groups were performed (N = 33, ages 23-54). 8 males and 25 females participated. The following major themes emerged:

1. Most participants intended to quit eventually, citing concern for their children, concern for their personal health, and stigmatization of cigarette smoking as major motivating factors.

2. Significant barriers to quitting include the ubiquity of cigarette smoking, its central role in social interactions  in the family shelter setting, and its importance as a coping mechanism.

3. Participants expressed their interest in quitting “cold turkey” and in e-cigarettes, but were skeptical of the patch and pharmacotherapy.

4. There was no consensus among participants as to whether individual, group or family counseling would be most effective.   

Conclusion: Homeless parents may be motivated to quit because of their children, but still face unique social and environmental barriers to quitting. Successful cessation programs in family shelters must be designed with the distinct motivations of this vulnerable population in mind.