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.

Our findings support the use of CBT plus nicotine patch plus bupropion as well as CBT plus nicotine patch plus gum in samples with high rates of medical, psychiatric, and addiction disorders. These findings support those of previous studies in the general population. Pharmacological treatment associated with group CBT based on cognitive-behavioral concepts and combined with ongoing MD treatment seems to be the best option for smoking cessation treatment among patients with MD. Units that deal with patients with MD, such as CAPS in Brazil, should be encouraged to treat smoking addiction in this population. Future studies should investigate retention rates in other samples of patients with MD.

Psychosocial units in Brazil (CAPS) provide access to mental health and addiction patients, who are not routinely treated for nicotine dependence. The present study analysed predictors of retention of a 6-week treatment provided by a CAPS unit to 367 smokers with a high rate of psychiatric disorders and addictions for the period 2007-2010. Several baseline variables were collected. Retention was defined as the presence of the individual in all four medical consultations and six group sessions. Multivariate discrete time Cox survival regression models were used to test for the outcome of interest. Timetables were used to explore in which moment of the treatment each predictor was important. Time to smoking the first cigarette (TTFC) 5 min or later after waking and nicotine patch use (nicotine replacement therapy, NRT) were associated with retention. The present study supports the importance of the variables TTFC and NRT when used in treatment retention for a sample with a high rate of psychiatric and alcohol disorders. NRT seems to be very important in the beginning of the treatment, probably because of withdrawal symptoms. Individuals currently undergoing psychiatric treatment and with alcohol problems had good retention rates comparable to the other individuals.

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Introduction Despite the results of epidemiological and psychometric studies reporting comparable levels of tobacco dependence among males and females, some clinical studies have detected disparities. Some smoking cessation studies based on clinical setting programs reported poorer outcomes among women than men. Methods This retrospective cohort study aimed to compare treatment success and retention between men and women on a smoking cessation program (n = 1,014) delivered at a CAPS-AD unit in Brazil. The psychological intervention lasted 6 weeks for each group of 15 patients. Each patient had to participate in weekly group cognitive-behavioral therapy (CBT) sessions and individual medical appointments during this period. These appointments were focused on the possibility of prescribing pharmacological treatment (i.e., nicotine replacement therapy, bupropion, or nortriptyline) as adjuvants to group therapy. Results The women had lower smoking severity at baseline, more clinical symptoms, and lower prevalence of alcohol and drug use disorders and were older than the men. Females had significantly higher levels of success (36.6% vs. 29.7%) and retention (51.6% vs. 41.4%) than males. Sensitivity analysis showed that female gender was significantly associated with both retention and success, among those without drug use disorders only. Conclusion Depending on the smoking cessation setting (i.e., low and middle-income countries and mental health and addiction care units), females can achieve similar and even higher quit rates than males. Previous drug use disorder was an important confounding variable in the gender outcomes analyses. Future studies should try to replicate these positive smoking cessation effects of CBT-based group therapy plus pharmacotherapy in women.