Smoking Cessation Outcomes and Predictors Among Individuals With Co-occurring Substance Use and/or Psychiatric Disorders

Abstract

Tobacco cessation treatment for individuals with co-occurring substance use and psychiatric disorders is likely to be as effective as for smokers with either disorder alone. Treatment duration predicts success among these smokers so strategies to enhance engagement and retention are needed.

Excess mortality among people who report lifetime use of illegal drugs in the United States: A 20-year follow-up of a nationally representative survey

“…These factors, which include current cigarette smoking, heavy alcohol use, physical inactivity, and obesity, are among the leading preventable causes of death in the United States (Mokdad et al, 2004) and contribute to the development of chronic medical conditions. Engaging individuals who use illegal drugs in health promotion activities has been found to result in positive health outcomes (Okoli and Khara, 2014), including decreased illegal drug use (Weinstock et al, 2008; Winhusen et al, 2014). …”

Quitline Outcomes for Smokers in 6 States: Rates of Successful Quitting Vary by Mental Health Status

“…27 Quitlines have not historically created cessation protocols for persons with psychiatric mental health conditions, similar to what many have for other at-risk populations such as pregnant smokers. For the MH+ population, a greater length and intensity of treatment, 14,48,49 and calls of shorter duration may better match MH+ callers' cognitive functioning. 33 But a necessary first next step is to determine if certain diagnostic groups are over-represented among quitline callers, so that quitlines might potentially tailor counseling and pharmacotherapy to the needs of these specific callers.…”

“…As a salient example, there is gathering evidence that the poor outcomes among persons with mental illnesses might be in part due to low cessation rates among smokers with anxiety. 22,48 Anxiety has been recognized as having a complex association with smoking and associated with more severe withdrawal and risk for tobacco cessation failure, 50 and more intensive treatment may be necessary.…”

Secondary analysis of an RCT on Emergency Department- Initiated Tobacco Control: Repeatedly assessed point-prevalence abstinence up to 12 months and extension of results through a 10-year follow-up

“…Although attrition status was not differentially associated with randomization status, the Laocoon-study follow-up participants were documentably not representative of the original study sample. Overall, compared to non-participants, participants in the Laocoon study were more often characterized by ‘protective’ characteristics such as older age (younger age was shown to impede the impact of individual tobacco counseling in different settings) 26-29 , lower nicotine dependence/fewer cigarettes smoked (a strong predictor for cessation success in various settings) 26,30-32 , more years of attained education (a known predictor of both success after smoking cessation 33 as well as higher study adherence in various settings including tobacco control studies) 26,34-36 . In univariable comparisons (Table 3), this bias was not taken into account and thus, the results have to be interpreted with caution.…”