Smoking amongst adults experiencing homelessness: A systematic review of prevalence rates, interventions and the barriers and facilitators to quitting and staying quit

Journal article

Soar, K., Dawkins, L., Robson, D. and Cox, S. (2020). Smoking amongst adults experiencing homelessness: A systematic review of prevalence rates, interventions and the barriers and facilitators to quitting and staying quit. Journal of Smoking Cessation. 15 (2), pp. 94-108. https://doi.org/10.1017/jsc.2020.11
AuthorsSoar, K., Dawkins, L., Robson, D. and Cox, S.
Abstract

Background: To date there has been no review of the research evidence examining smoking cessation among homeless adults. The current review aimed to: i. estimate smoking prevalence in homeless populations; ii. explore the efficacy of smoking cessation and smoking reduction interventions for homeless individuals; and iii. describe barriers and facilitators to smoking cessation and smoking reduction.
Method: Systematic review of peer-reviewed research. Data sources included electronic academic databases. Search terms: 'smoking' AND 'homeless' AND 'tobacco', including adult (18+ years) smokers accessing homeless support services.
Results: 53 studies met the inclusion criteria (n=46 USA). Data could not be meta-analysed due to large methodological inconsistencies and the lack of randomised controlled trials (RCTs). Smoking prevalence ranged from 57-82%. Although there was no clear evidence on which cessation methods work best, layered approaches with additions to usual care seemed to offer modest enhancements in quit rates. Key barriers to cessation exist around the priority of smoking, beliefs around negative impact on mental health and substance use, and environmental influences.
Conclusions: Homeless smokers will benefit from layered interventions which support many of their competing needs. To best understand what works, future recommendations include the need for consensus on the reporting of cessation outcomes.

Keywordshomelessness; smoking; tobacco; cessation; homeless; nicotine
Year2020
JournalJournal of Smoking Cessation
Journal citation15 (2), pp. 94-108
PublisherCambridge University Press (CUP)
ISSN1834-2612
Digital Object Identifier (DOI)https://doi.org/10.1017/jsc.2020.11
Publication dates
PrintJun 2020
Online23 Mar 2020
Publication process dates
Accepted18 Feb 2020
Deposited19 Feb 2020
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Predictors of heroin abstinence in opiate substitution therapy in heroin-only users and dual users of heroin and crack
Heidebrecht, F, MacLeod, MB and Dawkins, LE (2017). Predictors of heroin abstinence in opiate substitution therapy in heroin-only users and dual users of heroin and crack. Addictive Behaviors. https://doi.org/https://doi.org/10.1016/j.addbeh.2017.10.013
Alcohol Gel Ingestion Among Homeless Eastern and Central Europeans in London: Assessing the Effects on Cognitive Functioning and Psychological Health
Dawkins, LE, Soar, K and Papaioannou, G (2016). Alcohol Gel Ingestion Among Homeless Eastern and Central Europeans in London: Assessing the Effects on Cognitive Functioning and Psychological Health. Substance Use and Misuse. https://doi.org/10.3109/10826084.2016.1168441
Self-titration by experienced e-cigarette users: blood nicotine delivery and subjective effects
Dawkins, LE, Kimber, C., Doig, M, Feyerabend, C and Corcoran, O (2016). Self-titration by experienced e-cigarette users: blood nicotine delivery and subjective effects. Psychopharmacology. 233 (15), pp. 2933-2941. https://doi.org/10.1007/s00213-016-4338-2
The effect of alcohol dependence on automatic visuo-spatial perspective taking
Cox, S, Chandler, C, Simpson, A and Riggs, K (2016). The effect of alcohol dependence on automatic visuo-spatial perspective taking. Drug and Alcohol Dependence. 166, pp. 21-25. https://doi.org/10.1016/j.drugalcdep.2016.06.007
E-cigarette puffing patterns associated with high and low nicotine e-liquid strength: effects on toxicant and carcinogen exposure (study protocol)
Dawkins, LE, Cox, SA, Kosmider, L, McRobbie, H, Goniewicz, M, Kimber, CF and Doig, M (2016). E-cigarette puffing patterns associated with high and low nicotine e-liquid strength: effects on toxicant and carcinogen exposure (study protocol). BMC Public Health. 16. https://doi.org/10.1186/s12889-016-3653-1
Adolescent awareness and use of electronic cigarettes: A review of emerging trends and findings
Dawkins, LE, Greenhill, R, Notley, C, Finn, M and Turner, J (2016). Adolescent awareness and use of electronic cigarettes: A review of emerging trends and findings. Journal of Adolescent Health. 59 (6), pp. 612-619. https://doi.org/10.1016/j.jadohealth.2016.08.005
Recreational cocaine use is associated with attenuated latent inhibition
Soar, K., Dawkins, L., Page, F. and Woolridge, J. (2015). Recreational cocaine use is associated with attenuated latent inhibition. Addictive Behaviors. 50 (34-39). https://doi.org/10.1016/j.addbeh.2015.06.010
The effects of e-cigarette visual appearance on craving and withdrawal symptoms in abstinent smokers
Dawkins, L., Munafo, M., Christoforou, G., Olumegbon, N. and Soar, K. (2015). The effects of e-cigarette visual appearance on craving and withdrawal symptoms in abstinent smokers. Psychology of Addictive Behaviors. 30 (1), pp. 101-105. https://doi.org/10.1037/adb0000112
Acute electronic cigarette use: nicotine delivery and subjective effects in regular users
Dawkins, L. and Corcoran, O. (2014). Acute electronic cigarette use: nicotine delivery and subjective effects in regular users. Psychopharmacology. 231 (2), pp. 401-407. https://doi.org/10.1007/s00213-013-3249-8
First‐ versus second‐generation electronic cigarettes: predictors of choice and effects on urge to smoke and withdrawal symptoms
Dawkins, L., Kimber, C., Puwanesarasa, Y. and Soar, K. (2014). First‐ versus second‐generation electronic cigarettes: predictors of choice and effects on urge to smoke and withdrawal symptoms. Addiction. 110 (4), pp. 669-677. https://doi.org/10.1111/add.12807
Water consumption, not expectancies about water consumption, affects cognitive performance in adults
Edmonds, C.J., Crombie, R., Baillieux, H., Gardner, M.R. and Dawkins, L. (2013). Water consumption, not expectancies about water consumption, affects cognitive performance in adults. Appetite. 60, pp. 148-153. https://doi.org/10.1016/j.appet.2012.10.016
Vaping? profiles and preferences: an online survey of electronic cigarette users
Dawkins, L. (2013). Vaping? profiles and preferences: an online survey of electronic cigarette users. UEL Research and Knowledge Exchange Conference 2013. London 26 Jun 2013 University of East London.
Neuropsychological effects associated with recreational cocaine use
Soar, K., Mason, C., Potton, A. and Dawkins, L. (2012). Neuropsychological effects associated with recreational cocaine use. Psychopharmacology. 222, pp. 633-643. https://doi.org/10.1007/s00213-012-2666-4
The electronic-cigarette: effects on desire to smoke, withdrawal symptoms and cognition
Dawkins, L., Turner, J.J.D., Hasna, S. and Soar, K. (2012). The electronic-cigarette: effects on desire to smoke, withdrawal symptoms and cognition. Addictive Behaviors. 37, pp. 970-973. https://doi.org/10.1016/j.addbeh.2012.03.004
Investigating the impact of nicotine on executive functions using a novel virtual reality assessment
Jansari, A.S., Froggatt, D., Edginton, T. and Dawkins, L. (2012). Investigating the impact of nicotine on executive functions using a novel virtual reality assessment. Addiction. 108, pp. 977-984.
Nicotine derived from the electronic cigarette improves time-based prospective memory in abstinent smokers
Dawkins, L., Turner, J.J.D. and Crowe, E. (2012). Nicotine derived from the electronic cigarette improves time-based prospective memory in abstinent smokers. Psychopharmacology. 227, pp. 377-384.
Effects of nicotine and alcohol on affective responses to emotionally toned film clips
Dawkins, L. and Powell, J (2011). Effects of nicotine and alcohol on affective responses to emotionally toned film clips. Psychopharmacology. 216, pp. 197-205. https://doi.org/10.1007/s00213-011-2197-4
Expectation of having consumed caffeine can improve performance and mood
Dawkins, L., Shahzad, F.-Z., Ahmed, S.S and Edmonds, C.J. (2011). Expectation of having consumed caffeine can improve performance and mood. Appetite. 57, pp. 597-600. https://doi.org/10.1016/j.appet.2011.07.011
Relapse to smoking during unaided cessation: clinical, cognitive, and motivational predictors
Powell, J.H., Dawkins, L., West, R., Powell, J.F. and Pickering, A. (2010). Relapse to smoking during unaided cessation: clinical, cognitive, and motivational predictors. Psychopharmacology. 212, pp. 537-549. https://doi.org/10.1007/s00213-010-1975-8
Patterns of change in withdrawal symptoms, desire to smoke, reward motivation and response inhibition across 3 months of smoking abstinence
Dawkins, L., Powell, J.H., Pickering, A., Powell, J. and West, R. (2009). Patterns of change in withdrawal symptoms, desire to smoke, reward motivation and response inhibition across 3 months of smoking abstinence. Addiction. 104, pp. 850-858. https://doi.org/10.1111/j.1360-0443.2009.02522.x
The effects of cigarette smoking and abstinence on auditory verbal learning
Soar, K., Dawkins, L., Begum, H. and Parrott, A.C. (2008). The effects of cigarette smoking and abstinence on auditory verbal learning. Human Psychopharmacology: Clinical and Experimental. 23, pp. 621-627. https://doi.org/10.1002/hup.968
The effects of smoking and abstinence on experience of happiness and sadness in response to positively valenced, negatively valenced, and neutral film clips
Dawkins, L., Acaster, S. and Powell, J.H. (2007). The effects of smoking and abstinence on experience of happiness and sadness in response to positively valenced, negatively valenced, and neutral film clips. Addictive Behaviors. 32, pp. 425-431. https://doi.org/10.1016/j.addbeh.2006.05.010
A double-blind placebo controlled experimental study of nicotine: II - Effects on response inhibition and executive functioning
Dawkins, L., Powell, J.H., West, R., Powell, J. and Pickering, A. (2007). A double-blind placebo controlled experimental study of nicotine: II - Effects on response inhibition and executive functioning. Psychopharmacology. 190, pp. 457-467. https://doi.org/10.1007/s00213-006-0634-6
A double-blind placebo controlled experimental study of nicotine: I - Effects on incentive motivation
Dawkins, L., Powell, J.H., West, R., Powell, J. and Pickering, A. (2006). A double-blind placebo controlled experimental study of nicotine: I - Effects on incentive motivation. Psychopharmacology. 189, pp. 355-367. https://doi.org/10.1007/s00213-006-0588-8
Cognitive and psychological correlates of smoking abstinence, and predictors of successful cessation
Powell, J.H., Pickering, A.D., Dawkins, L., West, R. and Powell, J.F. (2004). Cognitive and psychological correlates of smoking abstinence, and predictors of successful cessation. Addictive Behaviors. 29, pp. 1407-1426. https://doi.org/10.1016/j.addbeh.2004.06.006
Smoking, reward responsiveness, and response inhibition: tests of an incentive motivational model
Powell, J.H., Dawkins, L. and Davis, R.E. (2002). Smoking, reward responsiveness, and response inhibition: tests of an incentive motivational model. Biological Psychiatry. 51, pp. 151-163. https://doi.org/10.1016/S0006-3223(01)01208-2