Effectiveness of the Tobacco Tactics Program for Psychiatric Inpatient Veterans: An Implementation Study

Duffy, Sonia A.; Noonan, Devon; Karvonen‐Gutierrez, Carrie; Ronis, David L.; Ewing, Lee A; Waltje, Andrea H.; Dalack, Gregory W.; Smith, Patricia M.; Carmody, Timothy P.; Hicks, Thomas; Hermann, Christopher

doi:10.1016/j.apnu.2014.12.002

Cited by 8 publications

(5 citation statements)

References 23 publications

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“…Twenty‐three studies [10,37–58] were RCTs (intervention n = 6593, control n = 5801). Three studies [59–61] were trials, but adopted a non‐randomized design (intervention n = 845, control n = 394). In one study, patients decided which group they wanted to participate in [61], but the remaining studies did not provide further information regarding how participants were allocated to each group [59,60].…”

Section: Resultsmentioning

confidence: 99%

“…Focusing upon long-term effective interventions [39,43,48,49,51,59,61] only, five of the six interventions offered educational materials and counselling during the stay, in addition to pharmacological support and/or further behavioural support post-discharge. A total of 37 of the 93 BCTs were identified in at least one study.…”

Section: Behaviour Change Techniquesmentioning

confidence: 99%

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Supporting smoking cessation and preventing relapse following a stay in a smoke‐free setting: a meta‐analysis and investigation of effective behaviour change techniques

et al. 2021

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Background and Aims Admission to a smoke‐free setting presents a unique opportunity to encourage smokers to quit. However, risk of relapse post‐discharge is high, and little is known about effective strategies to support smoking cessation following discharge. We aimed to identify interventions that maintain abstinence following a smoke‐free stay and determine their effectiveness, as well as the probable effectiveness of behaviour change techniques (BCTs) used in these interventions. Methods Systematic review and meta‐analyses of studies of adult smokers aged ≥ 18 years who were temporarily or fully abstinent from smoking to comply with institutional smoke‐free policies. Institutions included prison, inpatient mental health, substance misuse or acute hospital settings. A Mantel–Haenszel random‐effects meta‐analysis of randomized controlled trials (RCTs) was conducted using biochemically verified abstinence (7‐day point prevalence or continuous abstinence). BCTs were defined as ‘promising’ in terms of probable effectiveness (if BCT was present in two or more long‐term effective interventions) and feasibility (if BCT was also delivered in ≥ 25% of all interventions). Results Thirty‐seven studies (intervention n = 9041, control n = 6195) were included: 23 RCTs (intervention n = 6593, control n = 5801); three non‐randomized trials (intervention n = 845, control n = 394) and 11 cohort studies (n = 1603). Meta‐analysis of biochemically verified abstinence at longest follow‐up (4 weeks–18 months) found an overall effect in favour of intervention [risk ratio (RR) = 1.27, 95% confidence interval (CI) = 1.08–1.49, I2 = 42%]. Nine BCTs (including ‘pharmacological support’, ‘goal‐setting (behaviour)’ and ‘social support’) were characterized as ‘promising’ in terms of probable effectiveness and feasibility. Conclusions A systematic review and meta‐analyses indicate that behavioural and pharmacological support is effective in maintaining smoking abstinence following a stay in a smoke‐free institution. Several behaviour change techniques may help to maintain smoking abstinence up to 18 months post‐discharge.

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Section: Resultsmentioning

confidence: 99%

Section: Behaviour Change Techniquesmentioning

confidence: 99%

Supporting smoking cessation and preventing relapse following a stay in a smoke‐free setting: a meta‐analysis and investigation of effective behaviour change techniques

et al. 2021

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“…Biochemical validation was sent only to those who reported quitting in the follow-up survey. As published in a prior paper [15], there was consistency between self-report and biologically verified status in the 448 participants who were assessed by both methods. Self-report had a sensitivity of 96% and a specificity of 86% relative to tobacco status verified by cotinine.…”

Section: Patient Characteristics and Effectivenessmentioning

confidence: 54%

“…The study protocol, implementation, and effectiveness of the results of the Tobacco Tactics intervention have been previously published [14][15][16]. This study was a pragmatic, quasi-experimental trial in community hospitals in the Michigan Trinity Health system from 2010 through 2015.…”

Section: Designmentioning

confidence: 99%

Cost-effectiveness of a nurse-delivered, inpatient smoking cessation intervention

Ward

Hall

Jordan

et al. 2019

Translational Behavioral Medicine

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Randomized controlled trials have shown that inpatient tobacco cessation interventions are highly efficacious and costeffective. However, the degree to which smoking interventions implemented in nonrandomized, real-world practice settings are effective, and consequently, cost-effective, remains unclear. This study evaluated the cost-effectiveness of a nurse-delivered, inpatient smoking cessation intervention, Tobacco Tactics, compared with usual care within the context of an observational, real-world study design. In this quasiexperimental study, five Michigan hospitals (N = 1,370 patients) were assigned to implement either Tobacco Tactics or usual care during October 2011-May 2013. Statistical analysis was conducted during January 2017-February 2018. Controlling for confounding using stabilized inverse probability of treatment weights, incremental cost-effectiveness ratios were calculated and cost-effectiveness acceptability curves were generated. The per person cost of tobacco cessation services in the intervention group exceeded that of usual care ($175.52 vs. $67.80; p < .001). The intervention group had a higher propensity-adjusted self-reported quit rate compared to the control group (15.7% vs. 7.0%;

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“…They represent the greatest number of health care workers in health institutions. Nurses can provide tobacco cessation interventions for smokers and help increase successful cessation of tobacco use (Duffy et al, 2015). Nurses who work in mental health institutions have a valuable role to play in helping people with MI quit smoking (Hecht et al, 2019; Katz et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

Nursing Staff Attitude, Subjective Norms, Perceived Behavior Control, and Intention to Provide Tobacco Treatment in a Psychiatric Hospital

Abufarsakh

Okoli

2021

J Am Psychiatr Nurses Assoc

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Background: Although the nursing staff is fundamental in assisting individuals with mental illnesses (MI) to stop tobacco use, they often have mixed feelings about providing tobacco treatment (TT) services to people with MI in inpatient psychiatric settings. Objective: Therefore, this study aimed to understand factors associated with nursing staff’s intentions to provide TT interventions for individuals diagnosed with MI in a psychiatric facility using the constructs of the theory of planned behavior (TPB). Method: Secondary data analysis was performed using cross-sectional data collected from 98 nursing staff who worked in a state inpatient psychiatric facility. A 15-item questionnaire was used to assess nursing staff intentions to provide TT services based on TPB constructs, including attitudes (four items), subjective norms (four items), perceived behavioral controls (four items), and intentions (three items) toward providing TT. The mean scores of each subscale ranged from 1 to 7. A logistic regression analysis was used to examine the relationship between TBP constructs and nursing staff intentions to provide TT for people with MI. Results: Nursing staff had an acceptable mean score in the intentions subscale (4.34 ± 2.01). Only two constructs of TPB explained nursing staff intentions to provide TT: subjective norms (OR = 2.14, 95% CI [1.46, 3.13]) and perceived behavioral control (OR = 2.33, 95% CI [1.32, 4.12]). Conclusions: The constructs of the TPB, the subjective norms, and the perceived behavior control were able to predict nurses’ intentions to provide TT for inpatients in a psychiatric setting. Accordingly, we suggest implementing policies that make TT a normative practice while supporting the confidence and competence of nurses to deliver TT in psychiatric facilities.

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Effectiveness of the Tobacco Tactics Program for Psychiatric Inpatient Veterans: An Implementation Study

Cited by 8 publications

References 23 publications

Supporting smoking cessation and preventing relapse following a stay in a smoke‐free setting: a meta‐analysis and investigation of effective behaviour change techniques

Supporting smoking cessation and preventing relapse following a stay in a smoke‐free setting: a meta‐analysis and investigation of effective behaviour change techniques

Cost-effectiveness of a nurse-delivered, inpatient smoking cessation intervention

Nursing Staff Attitude, Subjective Norms, Perceived Behavior Control, and Intention to Provide Tobacco Treatment in a Psychiatric Hospital

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