Smoking and mental health - NCSCT

Smoking and mental disorders: special circumstances 7
pathways 98 indicate that further research exploring the effectiveness of bespoke
interventions in this population is warranted in this group. 72,96
7.3.6 Summary points
> Smoking is highly prevalent among people who misuse alcohol and other
drugs.
> Smokers who misuse alcohol and/or other drugs are often concerned about
their smoking, and willing to address it.
> Interventions to address smoking concurrently with alcohol and/or drug
misuse are effective and can also support alcohol and drug abstinence.
However, only a minority of those with alcohol and/or drug misuse receive
smoking cessation interventions.
> Efforts to address this shortcoming through the development and
assessment of more effective tailored treatment programmes, and through
systematic integration into care pathways, are urgently required
7.4 Homeless people
7.4.1 The size of the UK homeless population
The number of homeless people, comprising those of no fixed abode who sleep
rough or in hostels or night shelters, is difficult to measure. The Department of
Health estimated that there were about 100,000 homeless people in England in
2007–8, 99 but this figure excluded the ‘hidden homeless’ such as those who do
not use hostel services. The resulting underestimate is likely to be substantial,
because a recent survey of 437 single homeless people found that 62% were
‘hidden homeless’ on the night that they were interviewed, and that the majority
had never stayed in hostels. 100 The true figure may therefore be closer to the
380,000 estimated by the charity Crisis for 2003. 101
7.4.2 Homelessness and mental disorders
Mental disorders, including substance abuse, are significantly more prevalent in
homeless people than in the general population. 99 Homeless people in England
in 2000 were more than ten times more likely to have psychosis, four times more
likely to have a current common mental disorder and over five times more likely
to be dependent on alcohol or other drugs. 102 A more recent review suggests that
mental illness and alcohol or drug misuse occur together in around 10–20% of
the homeless population, 103 whereas research from a London-based charity for
homeless people found that around a third (32%) of service users were alcohol
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