Smoking is extremely common in adults experiencing homelessness, with prevalence rates being reported upwards of 70%; this is extremely high even when compared to other disadvantaged groups. Smoking maintains and exacerbates many of the poor health and social factors for adults experiencing homelessness. Despite obvious negative consequences, smoking can be considered an overlooked, neglected addiction within the context of homelessness. Research shows smoking cessation is desired amongst this group and there is good engagement in interventions, success is however extremely low. This talk will present the current issues facing homeless smokers, including data from a recent systematic review of the evidence. Furthermore, new opportunities for harm reduction are introduced through a feasibility study exploring the uptake and use of e-cigarettes to adult smokers already engaged in homeless support services. Results from this study will be presented, including uptake and follow up rates, cessation rates and markers of potential harm reduction effects.

This work is funded by the National Institute of Health Research Public Health.