BACKGROUND: This study of homeless youth uses quantitative data to estimate the prevalence of high-risk smoking practices (obtaining or using cigarettes in a way that increase exposure to toxins and/or susceptibility to infectious diseases) and identify characteristics associated in particular with sniping (smoking discarded cigarettes), and qualitative data to describe why and how homeless youth engage in sniping. METHODS: A probability sample of 292 homeless youth smokers in Los Angeles County completed a self-administered survey, and a separate convenience sample of 27 homeless youth who were lifetime smokers participated in focus groups. Survey participants reported on background characteristics, smoking cognitions, and high-risk smoking practices. Focus group participants described how they obtained cigarettes and responses relevant to sniping were coded. RESULTS: Survey results indicated that nearly all youth engaged in at least one high-risk smoking practice, with three-quarters having sniped cigarettes in the past 30 days. Sniping was more frequent among youth with less negative smoking attitudes (b = −0.29, 95% CI = −0.55 to −0.04, p = 0.02), greater nicotine dependence (b = 0.11, 95% CI = 0.00 to 0.23, p = 0.046), lower income (b = −0.05, 95% CI = −0.09 to −0.01, p = 0.02), and more severe drug abuse (b = 0.15, 95% CI = 0.04, 0.26, p = 0.01). Focus groups data indicated that youth snipe because it provides cheap and easy access to tobacco, and use specific strategies to mitigate the perceived health risks of sniping. Conclusions: Sniping and other high-risk smoking practices deserve further attention among homeless youth, particularly those already facing greater health threats due to factors such as nicotine dependence, lower income, and drug abuse.

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