A cross‐sectional analysis of factors associated with the intention to engage in tobacco treatment among inpatients in a state psychiatric hospital

Abstract

Introduction Hospitalized tobacco users with mental illnesses (MI) may face several barriers to stopping smoking. However, motivational factors that affect the intention to engage in tobacco treatment have been shown to predict actual engagement. Aim To use the Theory of Planned Behavior to assess intentions to and prior experiences of engaging in evidence-based tobacco treatment among hospitalized individuals with MI. Method A cross-sectional survey was conducted among 115 patients in a state psychiatric hospital. Multivariate analyses were used to examine associations with the intentions and prior experiences of engaging in tobacco treatment. Results After controlling for demographic and smoking history, attitudes, subjective norms and perceived behavioural control towards engaging in tobacco treatment were significantly associated with intentions towards treatment engagement. Only higher scores on perceived behavioural control and lower education levels were associated with reported prior experiences of tobacco treatment. Discussion The low prior treatment engagement scores, but relatively higher intention to engage scores among participants suggests the need for deliberate support for evidence-based tobacco treatment during psychiatric hospitalizations. Implications for practice Clinician training in tobacco treatment can promote self-efficacy to engage patients while supporting patients' control so that tobacco treatment is an expected component of psychiatric care.

Quit and win contests in community‐dwelling mental and behavioral health populations: A systematic review and pilot feasibility findings

“…To verify tobacco use status, participants were assessed using an expired carbon monoxide (expired CO) monitor with a level greater than or equal to 6 parts per milliliter (ppm) indicating current smoking (Deveci et al., 2004). The only exclusion criterion was impaired consent capacity, assessed using a 10‐item Consent Confirmation Questionnaire (CCQ; Okoli et al., 2018). The CCQ is based on true versus false responses that assessed an individual's capacity to understand the procedures and rights as a participant in the study.…”

Efficacy and safety of pharmacotherapies for smoking cessation in anxiety disorders: Subgroup analysis of the randomized, active‐ and placebo‐controlled EAGLES trial

“…Individuals with anxiety disorders (ADs) smoke tobacco at rates 2-3 fold higher than those without mental health conditions (Cougle, Zvolensky, Fitch, & Sachs-Ericsson, 2010;Lasser et al, 2000;McCabe et al, 2004). Like other smokers with mental health conditions (Evins, Cather, & Laffer, 2015), smokers with AD typically smoke more heavily (Kelly, Jensen, & Sofuoglu, 2015a), are more severely nicotine-dependent (Okoli, Otachi, Manuel, & Woods, 2018), and experience earlier and more severe nicotine-withdrawal symptoms (Piper, Cook, Schlam, Jorenby, & Baker, 2011) than smokers without mental health conditions, making quitting smoking more challenging (Kelly et al, 2015b). Despite this high rate of co-occurrence and greater difficulty quitting, relatively few randomized controlled trials (RCTs) have evaluated the safety and efficacy of the front-line smoking cessation pharmacotherapies in smokers with AD.…”

Análise prognóstica de um programa de tabagismo entre pacientes com comorbidade psiquiátrica

“…De fato, estudam corroboram estes dados indicando prevalência elevada de tabagismo entre indivíduos internados em instituições psiquiátricas (Okoli et al, 2018).…”

“…Fatores culturais associados aos contextos de internação pioram estas estatísticas, pois a maioria das instituições psiquiátricas ainda permite o consumo do cigarro, que é usado como reforço de comportamentos adequados ou para favorecer a aderência ao tratamento (Flitter et al, 2019). Por outro lado, a proibição do fumo em instituições pode levar à redução de prejuízos associados à saúde, para ambos os fumantes e os não-fumantes (Prochaska, 2011;Flitter et al, 2019;Okoli;Seng, 2019). Com base em princípios de promoção de saúde, a situação de hospitalização deveria oferecer ao fumante acesso restrito ao cigarro, a oportunidade de motivar-se para abandonar o consumo e auxílio para isso (Srivastava et al, 2019).…”

“…A autora expõe de forma detalhada os contrapontos a estes argumentos e vários outros estudos expostos aqui confirmam o aspecto não científico dos mitos citados. Autores enfatizam a importância de conceber a internação como uma oportunidade para intervir sobre o comportamento de fumar e oferecer auxílio medicamentoso de forma monitorada para esta finalidade (Prochaska, 2011;Okoli et al, 2018;Okoli;Seng, 2019;Srivastava et al, 2019)…”