| Sumario: | This study examines cigarette smoking trajectories from homelessness to housing and assesses demographic and clinical characteristics associated with multiple longitudinal smoking behavior patterns. Data were drawn from a longitudinal prospective cohort study of 421 adults experiencing homelessness who entered permanent supportive housing (PSH). Four quantitative surveys (baseline [while homeless], 3-, 6-, and 12 months post-housing) gathered participants' smoking frequency used for Repeated Measure Latent Class Analysis (RMLCA), which identified subgroups that share longitudinal smoking behavior patterns. Baseline and time-varying demographic, mental health (e.g., schizophrenia), and substance use (e.g., cannabis use) measures were examined as correlates of class membership. RMLCA estimates supported a three-class model: (1) mixed-frequency decreasers (n = 71): who smoked at differing frequencies while demonstrating a significant decrease over time; (2) high-frequency maintainers (n = 194): participants who smoked daily/almost-daily and maintained this smoking rate across waves; and (3) low-frequency increasers (n = 56): participants who generally were non-smokers at baseline and significantly increased to monthly or weekly consumption longitudinally. Compared to Black and African American participants, Hispanic and Latino participants had greater odds of low-frequency increaser and mixed-frequency decreaser membership. Schizophrenia and bipolar disorder diagnoses increased odds of high-frequency maintainer membership compared to the two less-frequent-using subgroups. Cannabis use increased longitudinally and was associated with greater odds of high-frequency maintainer membership. This is the first study to find smoking changes from homelessness to housing. While encouraging that some residents reduce their smoking post-housing, many maintained high smoking rates. Cessation services that address mental health and co-occurring substance use within PSH are warranted.
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