Feasibility and acceptability of strategies aiming to increase smoking cessation rates among people experiencing homelessness: A scoping review.

Introduction: People experiencing homelessness (PEH) have high smoking rates, limited access to smoking cessation support, and face specific challenges in quitting tobacco. To date, optimal strategies to reduce smoking rates in this marginalized population are not clearly identified. This study aims to identify the feasibility and acceptability of smoking cessation interventions evaluated among PEH. Methods: We assessed evidence regarding the feasibility and acceptability of interventions promoting smoking cessation among persons aged >18 years, experiencing homelessness, and who smoke tobacco. We included primary quantitative, qualitative, and mixed-methods studies informing on PEH's and professionals' attending to their needs, experiences, and perspectives. We searched the scientific literature (PubMed, Web of Science) published up to 1 July 2026. Results: A total of 55 articles and six intervention categories were identified: 1) counseling/motivational interviewing (MI); 2) contingency management (CM); 3) text messaging-based interventions (TMI); 4) e-cigarettes; 5) collaborative professional models; and 6) smoking cessation policies. Most interventions aimed at increasing participants' motivation to quit smoking. Counseling/MI and CM were the most frequently tested programs, showing limited to moderate results. TMI had limited results with regard to smoking relapse. All tested interventions were deemed acceptable by participants. Patient-centered and harm reduction approaches were particularly appreciated. Conclusions: This scoping review shows that counseling/MI and CM, which appear to have limited to moderate effectiveness in terms of smoking cessation support among PEH, are well accepted; however, their feasibility is questionable - especially CM. Other forms of smoking cessation support show lower levels of effectiveness. There is a need for further research on effective and acceptable ways of promoting smoking cessation among marginalized groups such as PEH.