Integrating Tobacco Cessation Into Mental Health Care for Posttraumatic Stress Disorder&lt;subtitle&gt;A Randomized Controlled Trial&lt;/subtitle&gt;

McFall, Miles; Saxon, Andrew J.; Malte, Carol A.; Chow, Bruce K.; Bailey, Sara; Baker, Dewleen G.; Beckham, Jean C.; Boardman, Kathy D.; Carmody, Timothy P.; Joseph, Anne M.; Smith, Mark W.; Shih, Mei Chiung; Lü, Ying; Holodniy, Mark; Lavori, Philip W.

doi:10.1001/jama.2010.1769

Cited by 200 publications

(180 citation statements)

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“…Patients who suffer from PTSD may present special challenges and may particularly benefit from such efforts. For example, integrated treatment of smoking and PTSD has demonstrated more success than conventional smoking cessation treatment in achieving 12-mo smoking abstinence (McFall et al 2010).…”

Section: Discussionmentioning

confidence: 99%

Smoking and Posttraumatic Stress Disorder Symptomatology in Orofacial Pain

et al. 2016

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To explore the impact of interactions between smoking and symptoms of posttraumatic stress disorder (PTSD) on pain intensity, psychological distress, and pain-related functioning in patients with orofacial pain, a retrospective review was conducted of data obtained during evaluations of 610 new patients with a temporomandibular disorder who also reported a history of a traumatic event. Pain-related outcomes included measures of pain intensity, psychological distress, and pain-related functioning. Main effects of smoking status and PTSD symptom severity on pain-related outcomes were evaluated with linear regression analyses. Further analyses tested interactions between smoking status and PTSD symptom severity on pain-related outcomes. PTSD symptom severity and smoking predicted worse pain-related outcomes. Interaction analyses between PTSD symptom severity and smoking status revealed that smoking attenuated the impact of PTSD symptom severity on affective distress, although this effect was not found at high levels of PTSD symptom severity. No other significant interactions were found, but the present results identifying smoking as an ineffective coping mechanism and the likely role of inaccurate outcome expectancies support the importance of smoking cessation efforts in patients with orofacial pain. Smoking is a maladaptive mechanism for coping with pain that carries significant health-and pain-related risks while failing to fulfill smokers' expectations of affect regulation, particularly among persons with orofacial pain who also have high levels of PTSD symptom severity. Addressing smoking cessation is a critical component of comprehensive treatment. Further research is needed to develop more effective ways to help patients with pain and/or PTSD to replace smoking with more effective coping strategies.

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Section: Discussionmentioning

confidence: 99%

Smoking and Posttraumatic Stress Disorder Symptomatology in Orofacial Pain

et al. 2016

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“…Behavioral health professionals are well positioned to deliver tobacco treatments, and patients with BHCs would be served by embedding tobacco cessation treatment within substance use and psychiatry specialty clinics. Research has found that integrating tobacco treatments into mental health care and substance use treatment results in higher quit rates compared with stand-alone tobacco treatments (22,38). Patients see behavioral health providers more frequently compared with other providers, thereby increasing opportunities to reinforce tobacco treatment, and even brief advice to quit smoking from a health care provider improves the likelihood that smokers will quit smoking (21).…”

Section: Discussionmentioning

confidence: 99%

Smoking Trends Among Adults With Behavioral Health Conditions in Integrated Health Care: A Retrospective Cohort Study

Young-Wolff

Kline-Simon

Das

et al. 2016

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Objective: Individuals with behavioral health conditions (BHCs) smoke at high rates and have limited success with quitting, despite impressive gains in recent decades in reducing the overall prevalence of smoking in the United States. This study examined smoking disparities among individuals with BHCs within an integrated health care delivery system with convenient access to tobacco treatments. Methods:The sample consisted of patients in an integrated health care delivery system in 2010-a group (N=155,733) with one or more of the five most prevalent BHCs (depressive disorders, anxiety disorders, substance use disorders, bipolar and related disorders, and attention-deficit hyperactivity disorder) and a group (N=155,733) without BHCs who were matched on age, sex, and medical home facility. The odds of smoking among patients with BHCs versus without BHCs were examined over four years using logistic regression generalized estimating equation models.Tobacco cessation medication utilization among a subset of smokers in 2010 was also examined.Results: Although smoking prevalence decreased from 2010 to 2013 overall, the likelihood of smoking decreased significantly more slowly among patients with BHCs compared with patients without BHCs (p,.001), most notably among patients with substance use and bipolar and related disorders. Tobacco cessation medication use was low, and smokers with BHCs were more likely than smokers without BHCs to utilize these products (6.2% versus 3.6%, p,.001). Conclusions:Smoking decreased more slowly among individuals with BHCs compared with individuals without BHCs, even within an integrated health care system, highlighting the need to prioritize smoking cessation within specialty behavioral health treatment.

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“…Five trials provided information about adverse events in the results section but had missing or incomplete information about how the data was collected [24][25][26][27], or how the adverse events were defined [28]. Four reports only briefly stated in the results section [29], methods section [30,31] or the discussion [32] that no adverse events occurred or were observed, without providing information about how these adverse events were defined or monitored.…”

Section: Accepted M Manuscriptmentioning

confidence: 99%