Perceived barriers to smoking cessation among adults with substance use disorders

Abstract

The majority of adults seeking substance use disorder treatment also smoke. Smoking is associated with greater substance use disorder severity, poorer treatment outcome, and increased mortality among those with substance use disorders. Yet, engaging this population in smoking cessation treatment is a significant challenge. The aim of this study was to examine perceived barriers to smoking cessation among treatment-seeking adults with alcohol or opioid use disorder. Additionally, we examined whether anxiety sensitivity--a known risk factor for barriers to smoking cessation in the general population--was associated with more barriers to smoking cessation in this sample. A sample of 208 adults was recruited for a one-time study and completed self-report measures of anxiety sensitivity and perceived barriers to smoking cessation. Results indicated that the most common barriers were anxiety (82% of the sample), tension/irritability (76%), and concerns about the ability to maintain sobriety from their primary substance of abuse (64%). Those who reported more barriers also reported lower confidence in the ability to change their smoking behavior. Higher anxiety sensitivity was associated with more perceived barriers to smoking cessation, even when controlling for nicotine dependence severity. These results suggest that there are several perceived barriers to smoking cessation among treatment-seeking adults with substance use disorders. In addition to psychoeducational interventions aimed to modify negative beliefs about smoking cessation, anxiety sensitivity may be a promising therapeutic target in this population.

Cigarette use is increasing among people with illicit substance use disorders in the United States, 2002–14: emerging disparities in vulnerable populations

“…Further, the belief that it is more difficult for people in SUD treatment to quit smoking is associated with poorer quit outcomes for these patients . Therefore, it would be important to address barriers and self‐defeating beliefs about quitting smoking held by SUD patients . Having staff work with patients to integrate smoking cessation into treatment plans may be beneficial, as a recent study of 683 patients receiving SUD treatment found that participants who reported that quitting smoking was part of their treatment plan were more likely to quit smoking than participants without quitting as a goal .…”

Differences in tobacco use prevalence, behaviors, and cessation services by race/ethnicity: A survey of persons in addiction treatment

“…Finally, current smokers were asked “When is the best point to stop smoking in drug treatment?” Response options were: “as soon as treatment begins; after six months of treatment; after one year of treatment; never.” This question was included due to the widespread belief among clients that quitting smoking during treatment may increase the chances of alcohol or other drug use relapse, a belief which can affect motivation to quit (McHugh et al, 2017).…”

A Comparison of Mental and Behavioral Health Risks Factors Associated With Current Dual Use of Electronic Cigarette and Conventional Tobacco Cigarettes With Exclusive Tobacco Cigarette Use and Nonuse Among Adults in the United States

“…Further, smoking cessation is often associated with mental distress. Anxiety, tension, and frustration are some of the self‐reported barriers to smoking cessation 30 . In current dual users, the use of alcohol and other substances may exacerbate their psychological distress and negatively impact quit attempts.…”