Three quarters of homeless adults smoke cigarettes. The substantial health consequences of tobacco use among homeless people have been documented, but less is known about the financial effects of tobacco use in this population.
From April through July 2014, we used time–location sampling to survey homeless adult cigarette smokers at five high-volume clinics operated by the Boston Health Care for the Homeless Program in an emergency shelter, a daytime drop-in center, and an academic medical center. Among 357 eligible persons, 306 (86%) participated. We asked participants how much money they had spent on tobacco in the previous week, examined overall expenditures for that week, and stratified the sample into thirds according to the level of nicotine dependence, as assessed with the use of the Fagerström Test for Nicotine Dependence….
Three quarters of participants were men, and the mean age was 48 years; 36% were white, 41% were black, and 18% were Hispanic. Participants reported spending a mean of $44 (95% confidence interval [CI], $40 to $47) on tobacco in the previous week and having a mean income of $513 (95% CI, $462 to $564) in the previous month . A considerable proportion reported difficulty finding shelter (49%), food (41%), clothing (50%), somewhere to wash (35%), and somewhere to use the bathroom (43%) in the previous month…
I very much doubt that there are any health consequences due to smoking among the homeless. I would instead imagine that there are very considerable health consequences due to homelessness among the homeless. After all, half of them were having difficulty in finding food, clothing, and shelter.
But, since this was a survey carried out by antismokers, naturally it wasn’t cold or rain or snow or hunger that were identified as the most pressing problem: it was the fact that the homeless were mostly smokers.
The… findings suggest that helping homeless smokers to quit smoking may be of considerable personal financial benefit.
It might indeed be of financial benefit, but absolutely nothing else. I have no doubt that being homeless is highly stressful, and that the one thing that the homeless are very glad of is the warmth and comfort and companionship of the occasional blessed cigarette.
But no such thing would ever have occurred the blind, heartless, antismoking bastards ticking boxes as they conducted their vacuous survey. And quite clearly it didn’t.
But it most certainly used to occur to me when, in my student days, I’d get talking to a homeless man who used to regularly sit all day outside the university. And the first thing I always did was to offer him one of my roll-ups, which offer he would invariably accept.
And then we’d sit talking, sometimes for quite a long time. And he would tell me of life in Old Japan, and how in Old Japan everyone lived above their own personal coal mine, and wore clogs with corrugated soles to allow them to walk on the coal. And how the Japanese were related to the English Somersets. And many other wondrous things.
In addition, he once explained how he had become homeless, and how many administrative trap doors he’d fallen through on his way to the street. And it wasn’t the cold that was the worst of it: it was the wind.
And when we parted, I always made sure to give him a large pinch of tobacco, so that he could at least enjoy a smoke or two in whatever chilly doorway he found himself that night. It was the very least I could do.