A prospective longitudinal study of tobacco use and tobacco use disorder in a homeless population.

BACKGROUND: Little is known about smoking habits and disorders among homeless populations. Previous research has not generally differentiated tobacco use from tobacco use disorders in this population. Known associations of tobacco use and morbidity and mortality in general populations may also apply to homeless populations. METHODS: A 2-year longitudinal prospective study of 255 homeless individuals examined tobacco use and tobacco use disorders in association with other psychiatric disorders and service use and homeless outcomes. RESULTS: The majority of the sample used tobacco daily and had a tobacco use disorder, characteristics that changed little over the 2-year follow-up period. Tobacco use disorder was associated with greater substance, medical, and psychiatric service use during the 2 follow-up years. However, tobacco use was not associated with change in housing status over the 2-year follow-up period. Cessation of tobacco use was associated with cessation of alcohol use. CONCLUSIONS: Smoking is a major health issue for homeless populations. This study found that smoking status was unassociated with the achievement of stable housing. In addition, homeless people who smoke were found to be more likely to use health care services, indicating a potential source of intervention for smoking cessation.

A Needs Assessment Among Transgender Patients at an LGBTQ Service Organization in Texas.

Purpose: Transgender adults have difficulty accessing health care due to multiple barriers. This study examined the health care-related needs of transgender patients in Dallas, Texas. Methods: This study examined cross-sectional data from a survey completed by 62 patients who identified as transgender. Results: Many participants reported depression (50%) and anxiety (51%). Over half did not receive preventive screenings (60%) or health care (61%) elsewhere. One-third of patients felt their primary care physician outside the clinic was not transgender-friendly. Conclusion: These findings provide evidence that transgender patients demonstrate increased reported mental health disorders and decreased access to medical care.