People Experiencing Homelessness

Smoking Prevalence

  • A national survey conducted in 2009 found that 57% of US adults with any history of homelessness smoked cigarettes.[i]
  • Data collected from 2004-2009 showed that 80% of chronically homeless adults reported currently smoking cigarettes.[ii]
  • Some individuals experiencing homelessness describe smoking initiation while residing in a homeless shelter, where there might be limited access and care, unstructured schedules, fewer stress coping outlets, and a high social value on smoking.[iii]

Smoking Cessation

  • Based on the results of a national 2009 survey, 84% of currently homeless, 89% of formerly homeless, and 82% of never homeless smokers reported wanting to quit.
  • Data from 2004-2009 shows that 48% of chronically homeless adults who smoke reported trying to limit their smoking and 75% of those who smoke had discussed smoking with a health care professional.

Health Effects

  • Much of the homeless population suffers from medical conditions as a result of exposure to cold weather, poor nutrition and hygiene, and risky behaviors. Smoking exacerbates many of these conditions.[iv]
  • Homeless individuals who smoke are more likely to smoke discarded cigarette butts or share cigarettes to save money. These behaviors put them at greater risk for infectious diseases, cancer, respiratory illness, and cardiovascular disease.
  • Among individuals living with homelessness, the primary causes of death and disability are tobacco-related chronic diseases; cancer and cardiovascular disease are the primary forms of morbidity among this population, and obstructive lung disease is more than twice as high in those experiencing homelessness as in the general population.[v]

Marketing from the Tobacco Industry

  • In 1994, Phillip Morris (under the brand name Merit) donated 7,000 blankets to homeless shelters in Brooklyn, in order to “generate media coverage.”[vi]
  • RJ Reynolds directly targeted the homeless as part of an urban marketing plan in the 1990s, focused on the advertising of “value” brands to “street people.”[vii]
  • In 1995, RJ Reynolds developed a marketing plan aimed at the homeless and LGBTQ+, titled “SCUM: Sub Culture Urban Marketing.”[viii]

Resource Links


[i] Baggett TP, Lebrun-Harris LA, Rigotti NA. Homelessness, cigarette smoking and desire to quit: results from a US national study. Addiction. 2013 Nov;108(11):2009-18. doi: 10.1111/add.12292. Epub 2013 Aug 14. PMID: 23834157; PMCID: PMC3797258.

[ii] Tsai J, Rosenheck RA. Smoking among chronically homeless adults: prevalence and correlates. Psychiatr Serv. 2012 Jun;63(6):569-76. doi: 10.1176/ PMID: 22476200.

[iii] Okuyemi KS, Goldade K, Whembolua G-L, Thomas JL, Eischen S, Sewali B, et al. Motivational interviewing to enhance nicotine patch treatment for smoking cessation among homeless smokers: a randomized controlled trial. Addiction. 2013;108(6):1136–44.

[iv] Okuyemi KS, Caldwell AR, Thomas JL, Born W, Richter KP, Nollen N, Braunstein K, Ahluwalia JS. Homelessness and smoking cessation: insights from focus groups. Nicotine Tob Res. 2006 Apr;8(2):287-96. doi: 10.1080/14622200500494971. PMID: 16766421.

[v] Kerry Cork, Tobacco Control Legal Consortium, Underserved and Overlooked: Tobacco Addiction Among the Homeless Population (2017).

[vi] Moore E. Re: Homeless/Hunger Initiative. Source: Philip Morris. Legacy Tobacco Documents Library. January 6. 1994. Access Date: October 24, 2005. Bates Number: 2041965266B/5267

[vii] Apollonio DE, Malone RE. Marketing to the marginalised: tobacco industry targeting of the homeless and mentally ill. Tob Control. 2005 Dec;14(6):409-15. doi: 10.1136/tc.2005.011890. PMID: 16319365; PMCID: PMC1748120.

[viii] Project SCUM. Legacy Tobacco Documents Library. R.J. Reynolds. December 12, 1995. Bates Number: 518021121/1129.