What is being done to help homeless people beat smoking?
Not enough, says Katie Weiss, a-23-year-old freelance writer studying Postgraduate Journalism at Monash University in Melbourne.
Weiss says that initially, she wanted to explore how homeless smokers were feeling the pinch after tobacco prices soared under the Rudd Government earlier this year. However, in researching the story, she discovered few options are available to tackle this addiction among the destitute.
Meanwhile, Croakey has a query for readers: given that homeless people are likely to miss out on a range of public health initiatives, does anyone know of successful public health interventions for this group, whether in Australia or elsewhere? Please let us know, if so.
Katie Weiss writes:
Quit Victoria admits it has neglected homeless people – who have among the highest rates of smoking in the state – from its anti-tobacco campaigns.
Quit Victoria Manager Ian Ferretter said that Quit Victoria struggled to end tobacco abuse in the homeless community as it lacked awareness of the complexities of a homeless person’s agenda.
“I’m not sure what a homeless person’s agenda looks like,” Mr Ferretter said.
A Cancer Council Victoria report showed 77 per cent of homeless people in Australia smoked cigarettes.
The report, known as Tobacco in Australia, also revealed that 93 per cent of homeless people who lived on the street were smokers.
Mr Ferretter said that competing stresses in a person’s life were the main obstacles that prevented a person from quitting.
He said that smokers needed to place the decision to quit smoking at the top of their day to day lists in order to succeed.
“It might be about finding somewhere to stay rather than trying to quit smoking, he said of homeless people.
“Quitting smoking is competing with a range of priorities among homeless people. I think that getting on to that agenda is a difficult task.”
But Victorian Department of Health spokesman Bram Alexander believed that Quit Victoria was effectively addressing the issue of smoking among socio-economically disadvantaged groups.
When asked how the government was addressing tobacco addiction among the homeless, Mr Alexander said:
“Quit are at the forefront of social marketing and smoking cessation programs. As well as the free telephone advice line, Quit has specific programs to target socially and economically disadvantaged groups in the community.”
Yet, contrary to Mr Alexander’s suggestion, Mr Ferretter said that smoking cessation among Victoria’s homeless “hasn’t been a huge focus of our work.”
Quit Victoria lacked any ‘special programs’ addressing the specific needs of homeless people.
Quit Victoria said that, although a high proportion of homeless people smoked, this group was too small a minority in Australia to be considered as a “special target” for such programs.
According to Melbourne General Practice Network’s (MGPN) statistics, the mortality rate of homeless people was up to four times higher than that of the general population.
Because the homeless were commonly affected by mental disorders and physical ailments such as malnutrition, blood borne infections, heart and lung disorders and asthma, smoking was considered to be exceptionally dangerous.
“Many of us working in the health industry are well aware of the complex physical and mental health needs of those experiencing homelessness,” said MGPN Clinical Services Manager Julie Borninkhof.
The Victorian Department of Health gave $8.5 million to Quit Victoria’s anti-smoking advertisements as part of its 2008 Victoria Tobacco Control Strategy.
However, MGPN stressed that Quit Victoria’s anti-smoking advertisements and call services failed to reach people who were unable to access televisions or telephones.
According to Ms Borninkhof, many people living on the streets missed out on important lessons about the dangers of smoking and how to quit because public health promotions – along with social marketing – were unavailable to them.
“The homeless community especially pose significant challenges when we consider the current mechanisms used to raise awareness of the risks of smoking, such as TV and web based awareness campaigns,” Ms Borninkhof said.
Because homeless people were left out of these facilities, Ms Borninkhof believed that street dwellers were in “greater risk” of picking up tobacco smoking habits than the general public.
MGPN believed that anti-smoking campaigns could only be successful through research about health among homeless people.
The network, whose membership stretches to 500 members in Melbourne, received a research grant from the Federal Government in November last year to explore the health issues surrounding homeless people.
MGPN said it would use the money provided by Department of Families, Housing, Community Services and Indigenous Affairs to analyse the dynamics between homeless people and existing health facilities.
Such research would contribute to a greater understanding on how GPs and clinics should facilitate homeless people.
“As with any community we need to look at creative and sustainable ways of delivering key health messages,” Ms Borninkhof said.
“Whilst there are a number of programs and supports in place to assist this community, it is hoped that we can do more to better support all of the health needs of those experiencing homelessness in the future.”