scholarly journals Smoking cessation treatment outcomes among people with and without mental and substance use disorders: An observational real-world study

2018 ◽  
Vol 52 ◽  
pp. 22-28 ◽  
Author(s):  
João Mauricio Castaldelli-Maia ◽  
Aline Rodrigues Loreto ◽  
Bruna Beatriz Sales Guimarães-Pereira ◽  
Carlos Felipe Cavalcanti Carvalho ◽  
Felipe Gil ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Substance Use ◽  
Substance Use Disorders ◽  
Tobacco Use ◽  
Psychiatric Treatment ◽  
Nicotine Patch ◽  
Treatment Success ◽  
Smoking Cessation Treatment ◽  
Tobacco Treatment ◽  
Cessation Treatment

AbstractBackground:There is a lack of studies evaluating smoking cessation treatment protocols which include people with and without mental and substance use disorders (MSUD), and which allows for individuals with MSUD undergoing their psychiatric treatment.Methods:We compared treatment success between participants with (n = 277) and without (n = 419) MSUD among patients in a 6-week treatment provided by a Brazilian Psychosocial Care Center (CAPS) from 2007 to 2013. Sociodemographic, medical and tobacco use characteristics were assessed at baseline. Tobacco treatment consisted of 1) group cognitive behavior therapy, which included people with and without MSUD in the same groups, and 2) pharmacotherapy, which could include either nicotine patches, nicotine gum, bupropion or nortriptyline. For participants with MSUD, tobacco treatment was integrated into their ongoing mental health treatment. The main outcome was 30-day point prevalence abstinence, measured at last day of treatment.Results:Abstinence rates did not differ significantly between participants with and without MSUD (31.1% and 34.4%, respectively). Variables that were significantly associated with treatment success included years smoking, the Heaviness of Smoking Index, and use of nicotine patch or bupropion.Conclusions:The inclusion of individuals with and without MSUD in the same protocol, allowing for individuals with MSUD undergoing their psychiatric treatment, generates at least comparable success rates between the groups. Predictors of treatment success were similar to those found in the general population. Facilities that treat patients with MSUD should treat tobacco use in order to reduce the disparities in morbidity and mortality experienced by this population.

scholarly journals Pilot Randomized Controlled Trial of a Novel Smoking Cessation App Designed for Individuals With Co-Occurring Tobacco Use Disorder and Serious Mental Illness

2019 ◽  
Vol 22 (9) ◽  
pp. 1533-1542 ◽  
Author(s):  
Roger Vilardaga ◽  
Javier Rizo ◽  
Paige E Palenski ◽  
Paolo Mannelli ◽  
Jason A Oliver ◽  
...  
Keyword(s):  
Mental Illness ◽  
Randomized Controlled Trial ◽  
Smoking Cessation ◽  
Tobacco Use ◽  
Controlled Trial ◽  
Smoking Cessation Treatment ◽  
Tobacco Use Disorder ◽  
Randomized Controlled ◽  
Cessation Treatment ◽  
Pilot Randomized Controlled Trial

Abstract Introduction High rates of tobacco use among people with serious mental illness (SMI), along with their unique needs, suggest the importance of developing tailored smoking cessation interventions for this group. Previous early-phase work empirically validated the design and content of Learn to Quit, a theory-based app designed for this population. Methods In a pilot randomized controlled trial, we compared the feasibility, acceptability, and preliminary efficacy of Learn to Quit versus QuitGuide, an app designed for the general population. All participants received nicotine replacement therapy and technical assistance. Daily smokers with SMI (N = 62) participated in the trial with outcomes assessed at weeks 4, 8, 12, and 16. Results Compared to QuitGuide, Learn to Quit participants had similar number of days of app use (34 vs. 32, p = .754), but larger number of app interactions (335 vs. 205; p = .001), longer durations of app use (4.24 hrs. vs. 2.14 hrs; p = .044), and higher usability scores (85 vs. 79, p = .046). At week 16, Learn to Quit led to greater reductions in cigarettes per day (12.3 vs. 5.9 for QuitGuide; p = 0.10). Thirty-day point prevalence abstinence was verified in 12% of Learn to Quit participants versus 3% of QuitGuide participants (odds ratio = 3.86, confidence interval = 0.41 to 36, p = .239). Changes in psychiatric symptoms and adverse events were not clinically significant between conditions. Conclusions This pilot trial provides strong evidence of Learn to Quit’s usability, feasibility, and safety. Preliminary evidence suggests the app may be efficacious. A randomized controlled efficacy trial is needed to test the app in a larger sample of smokers with SMI. Implications This study suggests that the Learn to Quit app is a feasible approach to deliver smoking cessation treatment in patients with co-occurring tobacco use disorder and SMI. This means that, if found efficacious, this technology could be used to deploy smoking cessation treatment to larger segments of this population, hence improving public health. Therefore, a randomized controlled trial should be conducted to examine the efficacy of this digital intervention.

scholarly journals Depression, anxiety, stress, and motivation over the course of smoking cessation treatment

2015 ◽  
Vol 41 (5) ◽  
pp. 433-439 ◽  
Author(s):  
Maritza Muzzi Cardozo Pawlina ◽  
Regina de Cássia Rondina ◽  
Mariano Martinez Espinosa ◽  
Clóvis Botelho
Keyword(s):  
Smoking Cessation ◽  
Rhode Island ◽  
Smoking Status ◽  
Behavioral Therapy ◽  
Treatment Success ◽  
Wilcoxon Test ◽  
Patient Anxiety ◽  
Smoking Cessation Treatment ◽  
Cessation Treatment ◽  
Anxiety Depression

Objective: To evaluate changes in the levels of patient anxiety, depression, motivation, and stress over the course of smoking cessation treatment. Methods: This cohort study involved patients enrolled in a smoking cessation program in Cuiabá, Brazil. We selected patients who completed the program in six months or less (n = 142). Patient evaluations were conducted at enrollment (evaluation 1 [E1]); after 45 days of treatment with medication and cognitive-behavioral therapy (E2); and at the end of the six-month study period (E3). Patients were evaluated with a standardized questionnaire (to collect sociodemographic data and determine smoking status), as well as with the University of Rhode Island Change Assessment scale, Beck Anxiety Inventory, Beck Depression Inventory, and Lipp Inventory of Stress Symptoms for Adults. The data were analyzed with the nonparametric Wilcoxon test for paired comparisons. To compare treatment success (smoking cessation) with treatment failure, the test for two proportions was used. Results: Among the 142 patients evaluated, there were improvements, in terms of the levels of anxiety, depression, motivation, and stress, between E1 and E2, as well as between E1 and E3. In addition, treatment success correlated significantly with the levels of motivation and anxiety throughout the study period, whereas it correlated significantly with the level of depression only at E2 and E3. Conclusions: We conclude that there are in fact changes in the levels of patient anxiety, depression, motivation, and stress over the course of smoking cessation treatment. Those changes appear to be more pronounced in patients in whom the treatment succeeded.

A Pilot Study of Nicotine Replacement Therapy Sampling and Selection to Increase Medication Adherence in Low-Income Smokers

2021 ◽  
Author(s):  
Karen L Cropsey ◽  
Caitlin Wolford-Clevenger ◽  
Michelle L Sisson ◽  
Keith R Chichester ◽  
Mickeah Hugley ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Medication Adherence ◽  
Low Income ◽  
Gold Standard ◽  
Short Form ◽  
Nicotine Patch ◽  
Smoking Behavior ◽  
Smoking Cessation Treatment ◽  
Cessation Treatment

Abstract Introduction Adherence to smoking cessation medications remains suboptimal, particularly among low-income smokers. Guided, experiential sampling of nicotine replacement therapies (NRTs) may increase NRT adherence and smoking cessation over gold standard counseling plus NRT. The present pilot study aimed to examine feasibility, acceptability, and preliminary efficacy of a novel experiential intervention. Aims and Methods This pilot randomized controlled trial (N = 83) compared gold standard smoking cessation treatment (four weekly sessions of behavioral counseling followed by self-selected combination NRT in week 5) to a novel experiential approach (ie, In Vivo; four weekly sessions of sampling each short form of NRT-gum, lozenge, inhaler, nasal spray-in-session while wearing the nicotine patch followed by NRT selection in week 5). Both groups received 8 weeks of nicotine patch plus their selected additional short form NRT for smoking cessation followed by a 1-month assessment. Results Screening and enrollment rates supported feasibility. In Vivo was comparable in acceptability with the gold standard of care intervention; however, there was greater attrition in the In Vivo group compared with the gold standard of care group. Results suggested higher medication adherence and improvements in smoking behavior in the In Vivo intervention; with generally small-to-medium effect sizes. Conclusions This experiential approach to sampling NRT is feasible and acceptable to low-income people who smoke. This intervention may increase adherence and reduce harmful smoking behavior but needs to be tested on a larger scale. Implications Medication adherence remains a significant impediment to the successful smoking cessation. The results of this study suggest that guided sampling of NRT products improves adherence among low-income smokers. Additionally, this approach yielded greater improvements in smoking behavior compared with gold standard smoking cessation treatment. This intervention shows promise as a feasible smoking cessation treatment for low-income smokers.

scholarly journals Integrating a Behavioural Sleep Intervention into Smoking Cessation Treatment for Smokers with Insomnia: A Randomised Pilot Study

2013 ◽  
Vol 9 (1) ◽  
pp. 31-38 ◽  
Author(s):  
Lisa M. Fucito ◽  
Nancy S. Redeker ◽  
Samuel A. Ball ◽  
Benjamin A. Toll ◽  
Jolomi T. Ikomi ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Pilot Study ◽  
Nicotine Patch ◽  
Behavioural Therapy ◽  
Smoking Abstinence ◽  
Smoking Cessation Treatment ◽  
Smoking Cessation Counselling ◽  
Cognitive Behavioural ◽  
Cessation Treatment ◽  
End Of Treatment

Introduction: Sleep disturbance is common among cigarette smokers and predicts smoking cessation failure. Aims: The purpose of this study was to conduct a pilot test of whether provision of a sleep intervention might bolster smoking cessation outcomes among this vulnerable group. Methods: Smokers with insomnia (N = 19) seeking smoking cessation treatment were randomly assigned to receive 8 sessions over 10 weeks of either: (1) cognitive-behavioural therapy for insomnia + smoking cessation counselling (CBT-I+SC; n = 9) or (2) smoking cessation counselling alone (SC; n = 10). Counselling commenced 4 weeks prior to a scheduled quit date, and nicotine patch therapy was also provided for 6 weeks starting on the quit date. Results: There was no significant effect of counselling condition on smoking cessation outcomes. Most participants had difficulty initiating and maintaining smoking abstinence in that 7-day point prevalence abstinence rates at end of treatment (CBT-I+SC: 1/7, 14%; SC: 2/10, 20%) and follow-up (CBT-I+SC: 1/7, 14%; SC: 0/10, 0%) were low for both conditions. CBT-I+SC participants reported improvements in sleep efficiency, quality, duration and insomnia symptoms. Sleep changes were not associated with the likelihood of achieving smoking abstinence. Conclusions: This randomised pilot study suggests that behavioural interventions may improve sleep among smokers with insomnia, but a larger sample is needed to replicate this finding and evaluate whether these changes facilitate smoking cessation.

scholarly journals Safety Net Provider Attitudes Toward Smoking Cessation Treatment

2021 ◽  
Vol 12 ◽  
Author(s):  
Lindsay R. Meredith ◽  
Wave-Ananda Baskerville ◽  
Theodore C. Friedman ◽  
Brian Hurley ◽  
Tasha Dixon ◽  
...  
Keyword(s):  
Health Care ◽  
Smoking Cessation ◽  
Tobacco Use ◽  
Large Scale ◽  
Safety Net ◽  
Care Providers ◽  
Provider Attitudes ◽  
Smoking Cessation Treatment ◽  
Cessation Treatment ◽  
Treatment Attitudes

Background: Cigarette smoking, which poses significant health risks, is prevalent among vulnerable populations commonly treated by safety net providers. A large-scale implementation science project on specialty tobacco use treatment was launched within the Los Angeles County Health Agency. The first phase of this study seeks to summarize and compare smoking cessation treatment attitudes of providers at the Department of Health Services (DHS) and Department of Mental Health (DMH).Methods: In total, 467 safety net health care providers (DHS = 322; DMH = 145) completed a survey inquiring about attitudes on smoking cessation treatment consisting of locally developed items and those informed by a scale on readiness for organizational change. Descriptive statistics and non-parametric tests were conducted to examine treatment attitudes for DHS and DMH providers.Results: Between agencies, providers largely reported similar attitudes on smoking cessation treatment and expressed positive beliefs regarding the efficacy of smoking cessation aids. Providers slightly or moderately agreed with being prepared to identify and diagnose tobacco use among patients. DMH providers stated that identification of tobacco use was less in line with their job responsibilities (p < 0.0001) and less strongly agreed that varenicline is effective for smoking cessation (p = 0.003), compared with DHS providers.Conclusions: Providers supported smoking cessation aid efficacy but may benefit from additional training on identification and treatment of tobacco use. These findings support the implementation of specialty tobacco cessation treatment programs with training on medications in safety net health care systems, which has the potential to yield large-scale public health benefits.

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