Smoking among people who use drugs

Background: Tobacco smoking is one of the leading causes of morbidity and premature death in high-income countries. Smoking is more prevalent among people with low socioeconomic status (SES). This study aimed to improve our understanding of smoking behaviour in a socially disadvantaged yet understudied group of people who use drugs (PUD). 
Methods: In a cross-sectional study conducted in September and October 2023, 975 hard-to-reach PUD were recruited from the streets and low-threshold services across Norway. Descriptive statistics were examined. Logistic and linear regression analyses investigated the correlates of smoking prevalence, daily smoking and number of cigarettes per month. These correlates included sociodemographic and situational factors and substance use behaviours.
Results: The study cohort exhibited a mean age of 46 years (ranging from 16 to 76 years), with 74% being male. Nine percent of the participants were non-smokers, while 77% reported daily smoking. Females were more likely to be smokers and had a higher likelihood of being daily smokers. Individuals aged 45 and above exhibited a lower likelihood of smoking compared to those under 35 years (AOR=0.37, p=0.036), but they were more likely to be daily smokers. Increased age (β=10.0, p=0.042), daily alcohol consumption (β=14.7, p=0.003), daily amphetamine injecting (β=9.6, p=0.037), and multiple income sources (β=5.2, p=0.037) were correlated with a higher number of cigarettes consumed per month. Further findings will be presented.
Preliminary conclusion: This study gives a novel insight into the smoking behaviour of a hard-to-reach population of PUD. The elevated prevalence of smoking underscores the imperative for targeted smoking prevention initiatives within this specific subpopulation.