[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...