Current perspectives on smoking cessation among substance abusers

Sullivan, Maria A.; Covey, Lirio S.

doi:10.1007/s11920-002-0087-5

Cited by 42 publications

(30 citation statements)

References 70 publications

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“…50 Furthermore, given the high prevalence of drug use in many primary care populations 22,40,50,51 the efficacy of alcohol and tobacco interventions could be compromised if providers are unaware of comorbid drug use. 52,53 Having information about a patient's drug use can thus assist the clinician in carrying out activities that are integral to the quality and safety of the medical care they provide, including safer prescribing, making correct diagnoses, identifying common comorbidities, and engaging patients in management of their other medical conditions. 54 …”

Section: Discussionmentioning

confidence: 99%

A Brief Patient Self-administered Substance Use Screening Tool for Primary Care: Two-site Validation Study of the Substance Use Brief Screen (SUBS)

McNeely

Strauß

Saitz

et al. 2015

The American Journal of Medicine

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Background Substance use screening is widely encouraged in healthcare settings, but the lack of a screening approach that fits easily into clinical workflows has restricted its broad implementation. The Substance Use Brief Screen (SUBS) was developed as a brief, self-administered instrument to identify unhealthy use of tobacco, alcohol, illicit drugs, and prescription drugs. We evaluated the validity and test-retest reliability of the SUBS in adult primary care patients. Methods Adults age 18-65 were enrolled from urban safety net primary care clinics to self-administer the SUBS using touch-screen tablet computers for a test-retest reliability study (n=54) and a two-site validation study (n=586). In the test-retest reliability study, the SUBS was administered twice within a 2-week period. In the validation study, the SUBS was compared to reference standard measures, including self-reported measures and saliva drug tests. We measured test-retest reliability and diagnostic accuracy of the SUBS for detection of unhealthy use and substance use disorder for tobacco, alcohol, and drugs (illicit and prescription drug misuse). Results Test-retest reliability was good or excellent for each substance class. For detection of unhealthy use, the SUBS had sensitivity and specificity of 97.8% (95% CI 93.7 to 99.5) and 95.7% (95% CI 92.4 to 97.8), respectively, for tobacco; and 85.2% (95% CI 79.3 to 89.9) and 77.0% (95% CI 72.6 to 81.1) for alcohol. For unhealthy use of illicit or prescription drugs, sensitivity was 82.5% (95% CI 75.7 to 88.0) and specificity 91.1% (95% CI 87.9 to 93.6). With respect to identifying a substance use disorder, the SUBS had sensitivity and specificity of 100.0% (95% CI 92.7 to 100.0) and 72.1% (95% CI 67.1 to 76.8) for tobacco; 93.5% (95% CI 85.5 to 97.9) and 64.6% (95% CI 60.2 to 68.7) for alcohol; and 85.7% (95% CI 77.2 to 92.0) and 82.0% (95% CI 78.2 to 85.3) for drugs. Analyses of area under the receiver operating curve (AUC) indicated good discrimination (AUC 0.74-0.97) for all substance classes. Assistance in completing the SUBS was requested by 11% of participants. Conclusions The SUBS was feasible for self-administration and generated valid results in a diverse primary care patient population. The 4-item SUBS can be recommended for primary care settings that are seeking to implement substance use screening.

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Section: Discussionmentioning

confidence: 99%

A Brief Patient Self-administered Substance Use Screening Tool for Primary Care: Two-site Validation Study of the Substance Use Brief Screen (SUBS)

McNeely

Strauß

Saitz

et al. 2015

The American Journal of Medicine

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“…Smoking Prevalence in Addiction Treatment: A Review 2009), with many studies reporting ranges of 75%-90% (Gorelick, Simmons, Carriero, & Tashkin, 1997;Kalman, 1998;Kozlowski et al, 1989;Lai, Lai, Page, & McCoy, 2000;Patkar, Sterling, Leone, Lundy, & Weinstein, 2002;Sees & Clark, 1993;Sullivan & Covey, 2002). Papers reporting these estimates often rely on two or three other papers, and there is at present no systematic review of papers reporting smoking prevalence among those in addiction treatment.…”

Section: Reviewmentioning

confidence: 99%

Smoking Prevalence in Addiction Treatment: A Review

Guydish

Passalacqua

Tajima

et al. 2011

Nicotine & Tobacco Research

191

163

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[CDC], 2009a; Department of Health Education and Welfare, 1964). The benefits of this achievement are not spread evenly, however, as people living in poverty, those with lower education, and persons with mental health diagnoses continue to smoke at high rates. As smoking prevalence decreases in the general population but remains high in subgroups, these subgroups bear a disproportionate burden of smoking-related illness and also frame new targets for both smoking cessation intervention and tobacco control.One population with elevated smoking prevalence includes those with substance use disorders. A developed literature indicates that smokers with other addictions smoke more heavily (Hays et al., 1999;J. Hughes, 2002;J. R. Hughes, 1996;Kozlowski, Jelinek, & Pope, 1986;Marks, Hill, Pomerleau, Mudd, & Blow, 1997;Sobell, 2002), are less successful in their attempts to quit smoking (Bobo, Gilchrist, Schilling, Noach, & Schinke, 1987;Drobes, 2002;Joseph, Nichol, & Anderson, 1993;Kozlowski, Skinner, Kent, & Pope, 1989;Sobell, 2002;Zimmerman, Warheit, Ulbrich, & Auth, 1990), and are more likely to die from smoking-related causes than from other substance-related causes (Hser, McCarthy, & Anglin, 1994;Hurt et al., 1996).The National Comorbidity Study (NCS) was a national sample (n = 8,098) of noninstitutionalized U.S. persons aged 15-54 years, designed to estimate national prevalence of mental illness. NCS data reported smoking prevalence of 56.1% among persons with past-month alcohol disorders and 67.9% among those with substance use disorders (Lasser et al., 2000). The National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) is a general population survey (N = 43,093) including noninstitutionalized U.S adults and weighted to be representative of the larger U.S population. NESARC data show that smoking prevalence is 34.5% among those with alcohol disorders and 52.4% among those with substance use disorders (Grant, Hasin, Chou, Stinson, & Dawson, 2004).Smoking prevalence may be even higher among those who seek treatment for their alcohol or other drug addiction. Current literature cites smoking prevalence among addiction treatment clients as ranging between 49% and 98% (Schroeder, AbstractIntroduction: This review explores whether smoking prevalence in addiction treatment samples exceeds that shown in epidemiological data for persons with alcohol or other drug use disorders and whether smoking may have decreased over time in the addiction treatment population as it has done in the general population.Methods: English language papers published between 1987 and 2009 were searched electronically. Forty papers reporting smoking prevalence for addiction treatment samples in the United States were identified, and key predictor variables were abstracted. Random logistic models were used to assess relationships between each individual predictor (year, treatment modality, primary drug treated, government status, and public/ private funding status) and smoking prevalence. Results:The lowest smoking prevalence aggre...

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“…Studies ( Humfl eet, Munoz, Sees, Reus, & Hall, 1999 ;Sullivan & Covey, 2002 ;Torchalla et al, 2011 ) in other populations have shown that these comorbidities make quitting smoking more challenging. However, there are currently no data about the effects of these comorbidities on smoking cessation in homeless populations.…”

Section: Nicotine and Tobacco Researchmentioning

confidence: 99%

Smoking Characteristics and Comorbidities in the Power To Quit Randomized Clinical Trial for Homeless Smokers

Okuyemi

Goldade

Whembolua

et al. 2012

Nicotine & Tobacco Research

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in emergency shelters; nearly half had been homeless for more than a year. Nearly all the participants were daily smokers who smoked an average of 20 cigarettes/day. Nearly 40% had patient health questionnaire-9 depression scores in the moderate or worse range, and more than 80% screened positive for lifetime history of drug abuse or dependence. Conclusions:This study demonstrates the feasibility of enrolling a diverse sample of homeless smokers into a smoking cessation clinical trial. The uniqueness of the study sample enables investigators to examine the infl uence of nicotine dependence as well as psychiatric and substance abuse comorbidities on smoking cessation outcomes. IntroductionDespite progress in reducing cigarette smoking in the general U . S . population, smoking rates and related morbidity remain strikingly high among poor and underserved groups. One underserved group generally unreached by smoking cessation interventions is the 3 million persons annually experiencing homelessness in the U nited S tates . The cigarette smoking rate Abstract Introduction: Smoking prevalence in homeless populations is strikingly high ( ~ 70%); yet, little is known about effective smoking cessation interventions for this population. We conducted a community-based clinical trial, Power To Quit (PTQ), to assess the effects of motivational interviewing (MI) and nicotine patch (nicotine replacement therapy [NRT ]) on smoking cessation among homeless smokers. This paper describes the smoking characteristics and comorbidities of smokers in the study.Methods: Four hundred and thirty homeless adult smokers were randomized to either the intervention arm (NRT + MI) or the control arm (NRT + Brief Advice). Baseline assessment included demographic information, shelter status, smoking history, motivation to quit smoking, alcohol/other substance abuse, and psychiatric comorbidities.Results: Of the 849 individuals who completed the eligibility survey, 578 (68.1%) were eligible and 430 (74.4% of eligibles) were enrolled. Participants were predominantly Black, male, and had mean age of 44.4 years ( S D = 9.9), and the majority were unemployed (90.5%). Most participants reported sleeping

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Current perspectives on smoking cessation among substance abusers

Cited by 42 publications

References 70 publications

A Brief Patient Self-administered Substance Use Screening Tool for Primary Care: Two-site Validation Study of the Substance Use Brief Screen (SUBS)

A Brief Patient Self-administered Substance Use Screening Tool for Primary Care: Two-site Validation Study of the Substance Use Brief Screen (SUBS)

Smoking Prevalence in Addiction Treatment: A Review

Smoking Characteristics and Comorbidities in the Power To Quit Randomized Clinical Trial for Homeless Smokers

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