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Despite a smoking prevalence approaching 70% among homeless adults in the US,1,2 little is known about ways to intervene on smoking behaviour in this marginalised population. Tobacco control advocates point to marketing by the tobacco industry and the pervasiveness and social acceptance of tobacco use in homeless settings as barriers to promoting effective cessation of smoking and smoke-free environments in this vulnerable population.3 They maintain that homeless service providers continue to hold apparently common assumptions that tobacco is a resource and that their clients have higher priority needs than to quit smoking.3–5 Recent studies, however, have begun to challenge these assumptions.2–6 In a series of focus groups and interviews exploring tobacco use behaviours among the homeless,2 up to 76% of homeless persons interviewed reported an intention to quit smoking in the next 6 months. Recent investigations in tobacco, alcohol and drug addiction have also demonstrated that rehabilitation programmes for misusers are commonly more effective when risky …
Competing interests: None declared.