Exploring Gender-Specific Attitudes Towards Smoking among Individuals Experiencing Homelessness

Context: Among homeless individuals, smoking prevalence is strikingly higher than in the general population. UT Southwestern (UTSW) medical students address this issue with a student-run smoking cessation clinic. It is critical to understand gender-specific smoking attitudes in this population, given each gender’s unique barriers and circumstances linked to homelessness.

Objective: To investigate gender-specific attitudes and self-reported smoking habits among individuals experiencing homelessness to better tailor smoking cessation classes and interventions.

Study Design and Analysis: Cross-sectional study using weekly surveys. Descriptive statistics assessed smoking attitudes and behaviors.

Setting: This study was conducted at Union Gospel Mission’s homeless shelters: Calvert Place (male, n=68) and Center of Hope (female, n=18). Surveys were collected from April 2021 to April 2023.

Population Studied: The research involved residents of the Calvert Place and Center of Hope shelters.

Intervention/Instrument: UTSW medical students facilitated weekly smoking cessation classes, combining educational presentations, counseling, and motivational interviewing.

Outcome Measures: The study assessed participants’ understanding of smoking’s health risks, intent to quit, support systems, quitting barriers, and daily cigarette usage.

Results: Men (n=68) had an average daily cigarette consumption of 8.93, while women (n=18) averaged 4.89. Despite 66.7% of women feeling informed about smoking’s health consequences, only 31.3% acknowledged that smoking can cause chronic illness (rating >5 on a 1-10 scale). Among men, 64.6% felt informed and 53.5% agreed that smoking can cause chronic illness. A large proportion of participants (73% men and 76% women) expressed intent to quit. However, 30% of men versus 11.8% of women had never tried to quit. Stress was cited as a barrier by 66.7% of women and 36.8% of men (p=0.026). Lastly, 53% of men compared to 17.7%of women acknowledged having a strong support system to aid them in quitting smoking.

Conclusions: Our data reveals a knowledge gap concerning smoking’s long-term health impacts. Though participants intended to quit smoking, women’s lower support system levels and higher stress levels were notable barriers, suggesting these areas need addressing in future interventions. Specifically, incorporating enhanced stress management strategies into the women’s smoking cessation program may prove beneficial.