Missed opportunities: a qualitative study of views and experiences of smoking cessation amongst adults in substance misuse treatment

Walsh, Hannah; Duaso, María; McNeill, Ann

doi:10.1080/16066359.2018.1441403

Cited by 4 publications

(4 citation statements)

References 32 publications

(35 reference statements)

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“…Barriers identified by clinicians include limited time, difficulty in engaging smokers, and the perception that clients are not interested 37,38 . Nevertheless, people accessing SUD programs who smoke are motivated to quit but frequently perceive a lack of support from professionals 39 , and this generates missed opportunities to quit 40 . The current study offers an additional point of view on the scarceness of systematic provision of tobacco cessation counseling in SUD programs, related to the contrast between staff and client opinions.…”

Section: Discussionmentioning

confidence: 99%

Comparing client and staff reports on tobacco-related knowledge, attitudes, beliefs and services provided in substance use treatment

Martínez¹,

Lisha²,

McCuistian³

et al. 2023

Tob. Induc. Dis.

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INTRODUCTION Smoking is highly prevalent in substance use disorder (SUD) programs, but few studies have explored the tobacco-related attitudes of staff and clients in the same program. The aim of this study was to compare staff and client reports on 10 tobacco-related items and associate them with tobacco measures implemented in the programs. METHODS A cross-sectional survey was conducted in 18 residential SUD programs from 2019 to 2020. Overall, 534 clients and 183 clinical staff self-reported their tobacco use, knowledge, attitudes, beliefs, and practices/services regarding smoking cessation. Ten comparable items were asked of both clients and staff. Differences in their responses were tested using bivariate analyses. We examine the association between selected tobacco-related items on making a quit attempt and planning to quit in the next 30 days. RESULTS In all, 63.7% of clients were current cigarette users versus 22.9% of staff. About half of clinicians (49.4%) said they had the skills to help patients quit smoking, while only 34.0% of clients thought their clinicians had these skills (p=0.003). About 28.4% of staff reported encouraging their patients to use nicotine replacement treatment (NRT), and 23.4% of patients said they had been encouraged to use these products. Client reports of planning a quit attempt were positively correlated with whether both staff and clients reported that the use of NRT was encouraged (clients: r=0.645 p=0.004; staff: r=0.524 p=0.025). CONCLUSIONS A low level of tobacco-related services was provided by staff and received by clients. In programs where smokers were encouraged to use NRT, a higher percentage of smokers planned a quit attempt. Tobacco-related training among staff, and communication about tobacco use with clients, should be improved to make tobacco services more visible and accessible in SUD treatment.

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Section: Discussionmentioning

confidence: 99%

Comparing client and staff reports on tobacco-related knowledge, attitudes, beliefs and services provided in substance use treatment

Martínez¹,

Lisha²,

McCuistian³

et al. 2023

Tob. Induc. Dis.

View full text Add to dashboard Cite

show abstract

“…This is in contrast with specialist substance misuse services, where any reduction in problematic drug and alcohol use by the client is seen as beneficial as part of a positive trajectory towards a more stable and better-quality life. Evidence shows that the pressure to achieve abstinence quickly (within the first two weeks of a standard programme) is difficult and demotivating for people who are in recovery from problematic substance use and can result in disengagement [ 10 ]. This study will develop and test a tailored, trauma-informed, harm reduction intervention that will support people recovering from problematic substance use to reduce or stop smoking.…”

Section: Discussionmentioning

confidence: 99%

“…Smoking is, therefore, an important contributory factor to the poor health of current and former PDA users, but it is rarely addressed using theoretically informed and evidence-based approaches. Despite existing research showing the willingness of people with PDA to address their tobacco smoking (especially for those who are further into their recovery journey), there remains an unfounded concern that this may be to the detriment of their recovery [ 10 ]. Existing evidence on effective interventions to support this population is limited and predominately from Australia and the USA [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

DASHES Protocol: Development and Feasibility Testing of a Tailored Community Programme to Support People in Recovery from Problematic Alcohol and Drug Use to Cut Down or Stop Smoking Using Co-Creation

Dobbie

Miller

Kam

et al. 2022

IJERPH

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Background: Despite the continued global decline in adult tobacco prevalence, rates continue to be significantly higher in groups with problematic drug or alcohol use (PDA). It is estimated that people with alcohol, drug or mental health problems account for approximately half of all smoking deaths. In the UK, there are free stop smoking services for the general population. However, these services have been criticized as unsuitable for people in recovery from PDA due to their design, time-limited support, strict requirement for smoking abstinence and lack of consideration of harm reduction approaches. This has led to calls for alternative approaches to support this marginalized and underserved group. This research study seeks to respond to this call by co-creating and feasibility testing a tailored, trauma-informed service specifically for people seeking help for PDA, who are not in immediate crisis, and who may also want to reduce or stop their tobacco smoking. Methods: The mixed-method study design has two parts. The development study (part one) will use participatory peer research methods to work with the target client group and key stakeholders involved in service delivery, commissioning, and policy to design the service (intervention). The feasibility study (part two) will test the delivery of the intervention protocol and capture data that will enable the assessment of whether progression to a future pilot randomized control trial is merited. Conclusions: The outcome of this study will be a theoretically informed, co-created intervention with the potential to improve population health by supporting people with problematic drug or alcohol use to cut down or stop tobacco smoking.

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“…However, there is also increasing use of the model to map patients’ perspectives ( 42 , 43 ). The framework has also been used in studies on smoking cessation among patients with alcohol and illicit drug use ( 44 ) and in a review of smoking cessation interventions ( 35 ).…”

Section: Introductionmentioning

confidence: 99%

A qualitative study on people with opioid use disorders’ perspectives on smoking and smoking cessation interventions

et al. 2023

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IntroductionSmoking-related diseases are major contributors to disability and shorter life expectancy among opioid-dependent patients. Smoking prevalence is considerably higher for opioid-dependent persons than among the general population, and only a minority quit smoking in treatment settings. Studies show that pharmacological smoking cessation interventions have modest success rates. This study aimed to investigate patients’ receiving opioid agonist therapy perspectives on factors affecting behavior and decisions related to smoking cessation, and their experiences with smoking cessation.MethodsThis is a qualitative study using semi-structured individual interviews. The participants were asked, among others, to elaborate on the participants’ thoughts about smoking, previous attempts to quit tobacco use, and what could prompt a smoking cessation attempt. We analyzed the transcripts with systematic text condensation. The Standards for Reporting Qualitative Research and the Consolidated Criteria for Reporting Qualitative Research guidelines were followed. Opioid-dependent patients receiving opioid agonist therapy in outpatient clinics were invited to participate using a purposive sampling method. In total, fourteen individuals participated in this study.ResultsWe identified six themes which were: (1) reflections on how smoking affected decisions, (2) smoking and its impact on physical and mental health, (3) the economy as a motivator to stop smoking, (4) emotions, desires, and habits related to smoking, (5) knowledge of smoking, smoking cessation, and quit attempts, and (6) social factors influencing the participants’ choices and activities. The participants were well informed about the consequences of smoking and had some knowledge and experience in quitting. The participants’ pulmonary health was an important motivational factor for change. Withdrawal symptoms, anxiety, and fear of using other substances discouraged several from attempting to quit smoking. In contrast, social support from partners and access to meaningful activities were considered important factors for success. Few reported being offered help from health professionals to make a smoking cessation attempt.DiscussionExperiencing social support, being encouraged to quit smoking, and patients’ concerns for their physical health were important reasons for wanting to quit smoking. Smoking cessation interventions based on patient preferences and on the behavior change wheel may enable a higher success rate among patients receiving opioid agonist therapy.

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Missed opportunities: a qualitative study of views and experiences of smoking cessation amongst adults in substance misuse treatment

Cited by 4 publications

References 32 publications

Comparing client and staff reports on tobacco-related knowledge, attitudes, beliefs and services provided in substance use treatment

Comparing client and staff reports on tobacco-related knowledge, attitudes, beliefs and services provided in substance use treatment

DASHES Protocol: Development and Feasibility Testing of a Tailored Community Programme to Support People in Recovery from Problematic Alcohol and Drug Use to Cut Down or Stop Smoking Using Co-Creation

A qualitative study on people with opioid use disorders’ perspectives on smoking and smoking cessation interventions

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