Predictors of Tobacco Use Among New York State Addiction Treatment Patients

Abstract

Objectives. We used admissions data from the New York State addiction treatment system to assess patient self-reported tobacco use and factors associated with tobacco use. Methods. We compared prevalence of tobacco use in the state addiction treatment system with that of a national sample of people receiving addiction treatment and with that of the New York general population in 2005 to 2008. A random effects logistic model assessed relationships between patient- and program-level variables and tobacco use. Results. Prevalence of tobacco use in the New York treatment system was similar to that in national addiction treatment data and was 3 to 4 times higher than that in the general population. Co-occurring mental illness, opiate use, methadone treatment, and being a child of a substance-abusing parent were associated with higher rates of tobacco use. Conclusions. We call on federal leadership to build capacity to address tobacco use in addiction treatment, and we call on state leadership to implement tobacco-free grounds policies in addiction treatment systems.

Smoking-related outcomes and associations with tobacco-free policy in addiction treatment, 2015–2016

“…While there is a continuing decline in smoking in the U.S. general population in recent years (Jamal et al, 2016), we observe no such decline in persons enrolled in addiction treatment. Together with previous reports, these findings suggest no decrease in smoking prevalence among persons enrolled in publicly-funded addiction treatment from 1987 through 2016 (Guydish et al, 2016a; Guydish et al, 2011a; Guydish et al, 2015). …”

“…Among all admissions to addiction treatment in New York State, annual smoking rates ranged from 69.5% in 2007 to 71.2% in 2012 (Guydish et al, 2015). A 2015 survey of persons enrolled in 24 addiction treatment programs reported a smoking rate of 77.9% (Guydish et al, 2016b).…”

Tobacco-related mortality among persons with mental health and substance abuse problems

“…While public health and tobacco control efforts have contributed to significant reductions in smoking at the population level, smoking prevalence remains high in substance abuse and mental health populations. Since Dreher and Fraser reported elevated rates of smoking among persons in alcohol treatment in 1967, [42] literature reviews [7] and analyses of state treatment data [43] and national epidemiologic data [7] demonstrate very high smoking prevalence in substance abuse treatment populations. Much less has been reported, however, about how elevated smoking prevalence is related to downstream morbidity and mortality in this population.…”

Implementation of smoking cessation treatment in substance use disorder treatment settings: a review

“…About 70-80% of individuals in SUD treatment smoke (3)(4)(5)(6)(7)(8)(9)(10)(11)(12), which exceeds the smoking rate of 16.8% in the general adult population (13). Smoking rates among individuals in SUD treatment have shown no meaningful decrease over the past two decades, despite a 20% reduction in the adult smoking rate since 2005 (13).…”