Approximately 70 percent of the homeless population of the United States smokes cigarettes. This begs the question: Why do so many of the country?s poorest citizens have such an expensive, unhealthy addiction?

A big reason was uncovered during the University of Minnesota?s Power to Quit study of smoking habits among the homeless population. Led by Minnesota professor Dr. Kola S. Okuyemi, the director of the Program in Health Disparities Research (PHDR), the research revealed their dependency was often related to alcoholism and drug addiction.

Since 2007, smoking habits among the homeless population have been studied by Okuyemi and the PHDR, part of the University of Minnesota?s Department of Family Medicine and Community Health. University researchers worked with 430 homeless people from the Minneapolis area to see if they could change the habit using motivational consultations and nicotine patches.

?They were very receptive to the treatment, the counseling and the nicotine patch, and attendance at the treatment sessions was very high,? Okuyemi said. ?We had about 75 percent of the people enrolled in the program at the beginning of the program still attending at the end of the six-month study, and many wanted to continue the program beyond that time. It was an indication of their interest in quitting smoking.?

However, Okuyemi said the result of the testing was less positive. ?Only about 10 percent quit smoking, which is very low. What we found out is that there are other issues in this population that would make the rate of success very low.?

The Power to Quit study is ready to tackle the next stage of research, which will also focus on participants? use of alcohol. The PHDR has funding in place to begin the second phase of the study, and are hiring and training staff now to do the research work.

?In our first study, we found that the ones who quit smoking were also those who stopped drinking alcohol or cut their alcohol use,? Okuyemi said. ?We need to address alcohol. That is the focus of the new project.?

The new study will require a number of changes from the first one. This phase will cover a longer period of time, and the homeless subjects will be treated with both a nicotine patch and nicotine gum (as well as more motivational consultations) in an attempt to battle that addiction. To counter alcoholism, participants will undergo counseling targeted specifically at that.

Okuyemi said the study subjects are not required to want to quit smoking. Also, those in the new study will not be required to want to quit drinking.

?The majority of our first study subjects were very enthusiastic and interested in doing something about their smoking,? he explained. ?We asked them to rate their interest in quitting, with 1 being no interest and 10 being a real desire to quit, and the average was 9.?

The reason study subjects aren?t required to want to quit smoking (or want to quit drinking in the second stage) is that the study results need to be applicable to the general population of homeless people, and not all of them want to quit smoking and drinking. Drug abuse will not be specifically targeted in the new study, but it won?t be ignored either, Okuyemi said.

In addition to better understanding a public-health issue, student involvement in these studies is a significant part of what Okuyemi is trying to accomplish.

?One of my passions is to train the next generation of students,? he said. ?It is very challenging. It is a difficult population to work with. I want to get students interested in working with me on [health disparities].?