Tabaquismo y sinhogarismo: un ejemplo de jerarquías de necesidades discriminatorias

Drug use is a public health problem with growing mortality attributable to a range of substances, both legal and illegal. The opioid crisis in North America and the United Kingdom has revealed an alarming increase in overdose deaths, with the United States recording 107,941 deaths in 2022, of which 81,806 were opioid-related. In Europe, Scotland has the highest overdose mortality rates. However, these figures do not include other causes of death related to drug use, such as cardiovascular disease, respiratory disease and cancer.

Tobacco is the substance with the greatest impact on global mortality, with an estimated rate of 83.75 deaths per 100,000 inhabitants. Its use is strongly associated with poverty, with 80% of smokers living in low- and middle-income countries. Despite the effectiveness of smoking cessation treatments, access to them remains limited, especially among vulnerable populations such as people with substance use disorders and people experiencing homelessness, among whom smoking prevalence is 75-82%.

Drug dependence treatment services rarely address smoking, despite its impact on morbidity and mortality. In addition, the normalisation of tobacco use among health professionals makes it more difficult to address. Implementing integrated strategies that include smoking cessation in addiction treatment programmes could significantly reduce associated mortality and improve quality of life among these vulnerable populations.