title: Alternative tobacco product use and smoking cessation among homeless youth in los angeles county.
abstract: BACKGROUND
  Approximately 70% of homeless youth smoke cigarettes, but their use of alternative tobacco products (ATPs) is unknown. This paper reports on ATP use among past-month smokers in Los Angeles County, including whether it differs by demographic characteristics, homelessness severity, past-year quit attempts, and readiness to quit smoking. Given the growing popularity of e-cigarettes, we also report on perceptions of harm and reasons for using this product.
  
  
  METHODS
  We surveyed 292 unaccompanied homeless youth who were randomly sampled from street sites. Participants had smoked at least 100 cigarettes during their lifetime and 1 cigarette during the past month.
  
  
  RESULTS
  Seventy-two percent of youth reported past-month ATP use (e-cigarettes = 51%; little cigars/cigarillos = 46%; hookah = 31%; other smokeless tobacco product = 24%; chewing tobacco/moist snuff = 19%). Current ATP use was unrelated to most demographic characteristics or having a past-year quit attempt. However, youth who planned to quit smoking in the next 30 days were significantly less likely to report current use of hookahs, other smokeless tobacco products, or e-cigarettes. Among lifetime e-cigarette users, the most common reasons for use included not having to go outside to smoke (38%) and being able to deal with situations or places where they cannot smoke (36%); it was less common to report using e-cigarettes to quit smoking (17%-18%).
  
  
  CONCLUSIONS
  Dual use of ATPs among homeless youth smokers is common and is more likely among those who have no immediate plans to quit smoking. Effective and easily disseminable strategies for reducing all forms of tobacco use among homeless youth are urgently needed.
authors.affiliation: RAND Corporation, Santa Monica, CA; jtucker@rand.org.
authors.forename: Joan S
authors.initials: JS
authors.lastname: Tucker
authors.affiliation: RAND Corporation, Pittsburgh, PA.
authors.forename: William G
authors.initials: WG
authors.lastname: Shadel
authors.affiliation: RAND Corporation, Santa Monica, CA;
authors.forename: Daniela
authors.initials: D
authors.lastname: Golinelli
authors.affiliation: RAND Corporation, Santa Monica, CA;
authors.forename: Brett
authors.initials: B
authors.lastname: Ewing
mesh_terms: D000293:Adolescent; D000328:Adult; D003625:Data Collection / Q000379:methods; D005260:Female; D018453:Homeless Youth / Q000208:ethnology* / Q000523:psychology; D006801:Humans; D015141:Los Angeles / Q000208:ethnology; D008297:Male; D012907:Smoking / Q000208:ethnology* / Q000523:psychology / Q000628:therapy; D016540:Smoking Cessation / Q000208:ethnology* / Q000379:methods* / Q000523:psychology; D062789:Tobacco Products / Q000706:statistics & numerical data*; D014030:Tobacco, Smokeless / Q000706:statistics & numerical data; D055815:Young Adult