How is tobacco treatment provided during drug treatment?

Abstract

The purpose of this study was to obtain descriptions of tobacco treatment services across different substance abuse treatment settings. We conducted mixed-method assessments in 8 facilities among 8 directors, 25 staff, 29 clients, and 82 client charts. Measures included systems assessment, chart reviews, and semi-structured interviews. Although many programs reported they offer key components of evidence-based treatment, few actually provided any treatment and none did so systematically. Many addressed tobacco as part of drug education or part of a health promotion session. Chart reviews suggested that provision of tobacco treatment is rare. By many reports, clients had to specifically request treatment and few staff reported encouraging unmotivated smokers to quit. Systems to facilitate consistent, evidence-based tobacco treatment and to implement quality improvement were nonexistent. The findings imply that drug treatment facilities may need to build capacity in several domains in order to deliver care that is consistent with national guidelines.

Use of Smoking Cessation Methods Among Patients Receiving Office-based Buprenorphine Maintenance Treatment

“…This low quit ratio is even more concerning given the well-documented gaps in the provision of evidence-based smoking cessation treatments and general lack of treatment provision in opioid treatment settings (Friedmann et al, 2008; Hunt et al, 2012; Knudsen et al, 2010; Nahvi et al, 2014). Thus, interventions to improve treatment provision at the systems level, as well as to employ a more aggressive treatment approach at the patient level, are necessary.…”

Barriers to Telephone Quitline Use Among Methadone-Maintained Smokers

“…9,10 Despite the need, there is limited provision of smoking cessation services in drug treatment programs. 11,12 Telephone quitlines have a decentralized and flexible structure, and broad population reach. Quitlines may reduce treatment barriers, including transportation and cost, and have the potential to address the limited smoking cessation treatment capacity in substance abuse treatment systems.…”

Tobacco smoking interferes with GABA A receptor neuroadaptations during prolonged alcohol withdrawal

“…Alcohol-dependent smokers who quit drinking but continue smoking may have a reduced severity of alcohol withdrawal and relapse risk (2) compared with alcohol-dependent smokers who stop smoking and drinking at the same time (3)(4)(5). This has led to some complacency in the field about treating the addiction to nicotine in alcohol-dependent smokers, and few treatment settings provide any systematic tobacco treatment (6). However, a large part of the morbidity and mortality from alcohol dependence can be attributed to concurrent tobacco smoking (7), and a large number of alcohol-dependent individuals in treatment express a desire to quit smoking (8).…”