Motivation to Quit and Interest in Cessation Treatment Among Homeless Youth Smokers

Introduction.  Approximately 70% of unaccompanied homeless youth are current smokers, which is considerably higher than the national average.  Although a few studies have described smoking behavior among homeless youth, none has focused on how to help homeless youth quit smoking.  As such, there are significant gaps in understanding their interest in quitting and what strategies might best fit their specific needs. This is the first study of homeless youth smokers to investigate their past experiences with quitting, current interest in smoking cessation services, and the psychosocial and behavioral factors associated with motivation to quit and interest in cessation treatment. 

Methods.  A stratified probability sample was used to recruit N=292 homeless youth from 12 street sites in two regions of Los Angeles County with large populations of homeless youth:  Hollywood and Venice Beach/Santa Monica.  All were current csmokers and completed a survey on their smoking-related behaviors and cognitions.

Results.  65.69% of youth had quit for at least 24 hours in the past year, and 43.37% were motivated to quit.  Previous quit attempts tended to be unassisted, but 58.59% reported that they would be interested in one or more types of formal cessation treatment (46.09% were interested in NRT, 28.46% in group counseling, 25.73% in one-on-one counseling, and 24.24% in telephone counseling).  Multivariable regression analyses indicated that motivation to quit was higher among youth who were older, African American or Hispanic (vs. White), and asked about smoking by a service provider, but lower among those who were more nicotine dependent.  Being interested in cessation treatment was more likely among youth who were asked about smoking by a service provider, anticipated more barriers to quitting, and were motivated to quit, and less likely among youth who had slept outdoors in the past 30 days.  

Conclusions. Smoking cessation is often considered a low priority for homeless youth.  However, many of these youth are motivated to quit and interested in smoking cessation products and services, but lack the assistance they need to successfully quit.  Results from this study provide important insights on the quitting-related behaviors and cognitions of homeless youth that have not been previously documented and can inform future efforts to help homeless youth quit smoking.   Implications for developing and engaging homeless youth in cessation treatment will be discussed.