Department of Psychological, Health, and Learning Sciences, College of Education, The University of Houston, 491 Farish Hall, Houston, TX 77204, USA.
HEALTH Research Institute, The University of Houston, 4349 Martin Luther King Blvd., Houston, TX 77204, USA.
Int J Environ Res Public Health. 2022 Mar 18;19(6):3629. doi: 10.3390/ijerph19063629.
Adults experiencing homelessness smoke conventional cigarettes and engage in concurrent tobacco product use at very high rates; however, little is known about how use patterns, perceived disease risk, barriers to quitting smoking, and smoking cessation intervention preferences differ by sex in this group. Participants comprised a convenience sample of 626 adult conventional cigarette smokers experiencing homelessness. Participants self-reported their sex, smoking history, mental health and substance use diagnosis history, other concurrent tobacco product use (CU), disease risk perceptions, perceived barriers to quitting smoking, and preferences regarding tobacco cessation interventions via a computer-administered survey. CU rates were 58.1% amongst men and 45.3% amongst women smokers. In both sexes, CUs started smoking earlier (p-values < 0.001) and were more likely to have been diagnosed with a non-nicotine substance use disorder (p-values < 0.014) relative to cigarette-only users. Among men only, CUs were younger, smoked more cigarettes per day and were more likely to identify as non-Hispanic White (p-values < 0.003) than cigarette-only users. Additionally, male CUs reported a greater risk of developing ≥1 smoking-related disease if they did not quit for good; were more likely to endorse craving cigarettes, being around other smokers, habit, stress/mood swings, and coping with life stress as barriers for quitting smoking; and were less likely to prefer medications to quit smoking relative to male cigarette-only users (p-values < 0.04). On the other hand, female CUs reported a greater risk of developing ≥1 smoking-related disease even if they quit for good; were more likely to endorse stress/mood swings and coping with life stress as barriers for quitting smoking relative to female cigarette-only users (p-values < 0.05); and did not differentially prefer one cessation medication over another. Overall, findings confirm high rates of CU among both sexes, characterize those who may be more likely to be CUs, and reveal opportunities to educate men and women experiencing homeless on the benefits of evidence-based interventions for smoking cessation.
成年人无家可归者经常吸烟传统香烟，并同时使用多种烟草产品；然而，对于这一群体中，性别如何影响使用模式、疾病风险感知、戒烟障碍以及戒烟干预偏好，我们知之甚少。参与者由 626 名患有无家可归的成年传统香烟吸烟者组成。参与者通过计算机管理的调查自行报告其性别、吸烟史、精神健康和物质使用诊断史、其他同时使用的烟草产品（CU）、疾病风险感知、戒烟障碍感知以及对烟草戒烟干预的偏好。男性 CU 使用率为 58.1%，女性 CU 使用率为 45.3%。在男性和女性中，CU 的吸烟开始时间更早（p 值均<0.001），且更有可能被诊断为非尼古丁物质使用障碍（p 值均<0.014），而不是仅吸烟的人群。仅在男性中，CU 年龄较小，每天吸烟量较大，且更有可能是非西班牙裔白人（p 值均<0.003），而非仅吸烟的人群。此外，与仅吸烟的男性相比，男性 CU 认为如果不彻底戒烟，他们患≥1 种与吸烟相关的疾病的风险更高；更有可能认为吸烟欲望、周围有其他吸烟者、习惯、压力/情绪波动和应对生活压力是戒烟的障碍；且更不可能偏好药物戒烟，而不是仅吸烟的男性（p 值均<0.04）。另一方面，与仅吸烟的女性相比，女性 CU 认为即使彻底戒烟，她们也有更高的患≥1 种与吸烟相关的疾病的风险；更有可能认为压力/情绪波动和应对生活压力是戒烟的障碍（p 值均<0.05）；且不会特别偏好一种戒烟药物而不是另一种。总体而言，研究结果证实了男女 CU 发生率均较高，描述了那些更有可能成为 CU 的人群，并为教育无家可归的男女了解戒烟的证据为基础的干预措施的好处提供了机会。
