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Over 70% of people experiencing homelessness report current tobacco use, compared to 14% in the general population. One of the structural barriers that hinder cessation attempts among people experiencing homelessness is inadequate access to health care and other smoking cessation services. Researchers in this study aimed to explore tobacco use behaviors and factors influencing acceptability of engaging in a clinical trials. Researchers found that participants had attempted to quit smoking, and were interested in engaging in clinical trials as a method to quit smoking.

Formerly chronically homeless adults who live in permanent supportive housing (PSH) have a high prevalence of smoking. Smoke-free policies and smoking cessation services are among the most effective tobacco control interventions, but these policies are uncommon in PSH. Researchers outline a protocol for a cluster-randomized wait-list controlled trial to evaluate the efficacy of the same smoke-free home intervention on the primary outcome of voluntary adoption of a smoke-free home.

People with multiple, complex health and housing needs frequently receive fragmented care because the providing systems operate independently. The California Policy Lab at UC Berkeley and the UCSF Benioff Homelessness and Housing Initiative worked with partners in San Francisco’s public health and criminal legal systems to link together ten years of data from the physical health, behavioral health, housing, and criminal legal sectors.

People living with HIV/AIDS (PLWHA) have an increased risk of experiencing homelessness. The underlying drivers of homelessness are structural, however individual factors such as mental health and substance use problems are also common drivers. People living with HIV/AIDS who experience homelessness are more likely to have uncontrolled viral load. Researchers from BHHI suggest integrating HIV treatment with mental health and substance use treatment.

Managed alcohol program (MAPs) manage alcohol consumption by providing eligible individuals with regular doses of alcohol as a part of a structured program and often offer housing and other social services. UCSF BHHI researchers found that benefits of MAPs included improved quality of life, reduced alcohol consumption, less hazardous consumption, and potential stabilizations in biological markers of alcohol use during MAP participation. Researchers found MAP participants reported substantial benefits, including increased feelings of safety and security, reconnection with community, sense of belonging, improved self-efficacy, and a positive reconciliation of internalized shame and stigma.

People experiencing homelessness (PEH) have a high rate of tobacco use. Researchers examined factors associated with cigarette consumption and quit attempts. They found having an encounter with staff in the past week was associated with a 40% reduction in weekly consumption. The findings highlight the role of community-based pharmacists to expand smoking cessation services in homeless shelters.

This study from UCSF BHHI researchers examined deaths among people experiencing homelessness in San Francisco during the first year of the COVID-19 pandemic. They found 82% of 331 deaths were associated with drug overdose, not COVID-19 infection. Traumatic injury, including homicide and suicide, was the second most common cause of death. This research highlights a need for strategies that address both homelessness and drug use, including housing, evidence-based treatment of opioid addiction, and overdose prevention programs.

This UCSF study examined deaths among people experiencing homelessness in San Francisco from 2016 to 2018. Although heart disease and cancer are the first and second causes of death for California’s general population, the leading causes of homeless deaths were acute intoxication (unintended overdose) and trauma (including homicide and suicide rates over triple that of the US general population). The authors advocate that these differences in cause-specific mortality should inform death prevention efforts within the homeless population differently than the general population.

About 70-80% of adults experiencing homelessness smoke cigarettes. Researchers examined guest support for on-property smoke-free policies within an homeless shelter amongst never smokers, former smokers, and current smokers. They found that 64% of participants supported a partial smoking ban, while 32% supported a full smoking ban. These findings illustrate that implementing smoke-free living/workplace policies in homeless shelters enjoys more support from guests.

Tobacco use is common in people who experience homelessness; however, research in homeless and unstably housed (HUH) women is sparse. Researchers found that the most common reason for tobacco use was to reduce stress and anxiety. The findings suggest that tailored counseling and healthcare interactions that include smoking cessation efforts and address food insecurity during treatment.

The homeless population has a higher prevalence of mental health and substance use problems than the general population. Researchers aimed to examine the prevalence of and factors associated with unmet needs for mental health and substance use treatment in older homeless adults. They used logistic regression to examine factors associated with unmet treatment needs. Researchers found that older homeless adults have a high prevalence of unmet behavioral health treatment needs and need targeted services.

The prevalence of substance use decreases as individuals age, but older adults now have a higher prevalence of substance use than older adults did 10 years ago. People experiencing homelessness have a higher prevalence of substance use disorders compared to the general population. In this cohort study, researchers examined the prevalence of and factors associated with substance use in a population of homeless individuals aged 50 and older. They found a high prevalence of substance use and an association between psychiatric hospitalization and depression with substance use. Researchers also recommend targeted treatment programs and geriatric substance use workforce development.

Researchers examined whether childhood adversity is associated with depressive symptoms, suicide attempts, or psychiatric hospitalization among older homeless adults. Using population-based sampling methods, the study enrolled 350 homeless adults aged 50 and older in Oakland, California. They found that childhood adversities are associated with poor mental health outcomes among older homeless adults. Researchers recommend screening for childhood adversities should be undertaken by all providers who care for older homeless adults.