Smokers With Behavioral Health Comorbidity Should Be Designated a Tobacco Use Disparity Group

Williams, Jill M.; Steinberg, Marc L.; Griffiths, Kim; Cooperman, Nina A.

doi:10.2105/ajph.2013.301232

Cited by 127 publications

(120 citation statements)

References 62 publications

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“…21 The documented intersection of tobacco and mental illness has led to calls for recognition of smokers with co-occurring psychiatric disorders as a disparity group in need of national surveillance, research, and treatment. 22,23 The 2008 update of the U.S. Clinical Practice Guidelines for tobacco cessation was informed by nearly 8,800 research articles; yet fewer than two-dozen trials have been conducted with smokers with mental illness, of which only one was conducted with adolescents. Brown et al 24 recruited 191 smokers aged 13-17 years from an inpatient psychiatry unit and evaluated a motivational-interviewing intervention combined with NRT patch relative to usual care.…”

Section: Gender Differences In a Randomized Controlled Trial Treatingmentioning

confidence: 99%

Gender Differences in a Randomized Controlled Trial Treating Tobacco Use Among Adolescents and Young Adults With Mental Health Concerns

Prochaska

Fromont

Ramo

et al. 2015

Nicotine & Tobacco Research

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Introduction: Treatment of tobacco use in mental health settings is rare despite high rates of comorbidity. With a focus on early intervention, we evaluated a tobacco treatment intervention among adolescents and young adults recruited from outpatient, school-based, and residential mental health settings and tested for gender differences. Methods: Intervention participants received computerized motivational feedback at baseline, 3 months, and 6 months and were offered 12 weeks of cessation counseling and nicotine patches. Usual care participants received a self-help guide and brief cessation advice. We examined 7-day point prevalence abstinence with biochemical confirmation at 3, 6, and 12 months; smoking reduction; and 24-hr quit attempts. Results: At baseline, the sample (N = 60, 52% female, mean age = 19.5 ± 2.9 years, 40% non-Hispanic Caucasian) averaged 7 ± 6 cigarettes/day, 62% smoked daily, 38% smoked ≤ 30 min of waking, 12% intended to quit in the next month, 47% had a parent who smoked, and 3 of 5 of participants' closest friends smoked on average. During the 12-month study, 47% of the sample reduced their smoking, 80% quit for 24 hr, and 11%, 13%, and 17% confirmed 7-day point prevalence abstinence at 3-, 6-, and 12-month follow-up, respectively, with no differences by treatment condition (ps > .400). Over time, abstinence was greater among girls (adjusted odds ratio [AOR] = 8.9) than among boys, and abstinence was greater for lighter smokers than heavier smokers (AOR = 4.5) (p < .05). No mental health or other measured variables predicted abstinence. Conclusions: Adolescent and young adult smokers with mental health concerns are a challenging group to engage and to effectively treat for tobacco addiction, particularly heavier smokers and boys. Innovative approaches are needed.

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Section: Gender Differences In a Randomized Controlled Trial Treatingmentioning

confidence: 99%

Gender Differences in a Randomized Controlled Trial Treating Tobacco Use Among Adolescents and Young Adults With Mental Health Concerns

Prochaska

Fromont

Ramo

et al. 2015

Nicotine & Tobacco Research

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“…Lack of health insurance and reduced access to affordable smoking cessation treatments potentially contribute to elevated smoking prevalence among persons with BHCs (19,20). Tobacco cessation treatments, including brief advice to quit, behavioral counseling, and pharmacotherapy, are evidence based and cost-effective, and they decrease the likelihood of tobacco relapses (21).…”

mentioning

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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“…21 Some experts in the United States have argued strongly that tobacco use by people with a mental illness continues to be insufficiently prioritized for policy and program attention, and that this population group should be more strongly identified as a "tobacco use disparity group," particularly at a national level. 56 While there was no difference in the amount of intervention research over time, there was some indication of progression in terms of the level of evidence provided by the intervention research undertaken, with a modest rise in the number and proportion of systematic reviews/meta-analyses and RCTs between 1993-1995 and 2013-2015. The increasing tendency toward synthesizing research findings through systematic review/ meta-analyses perhaps also suggests an increased acknowledgement of the importance of this public health issue.…”

Section: Discussionmentioning

confidence: 99%

Smoking and Mental Illness: A Bibliometric Analysis of Research Output Over Time

Metse¹,

Wiggers²,

Wye³

et al. 2016

NICTOB

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Introduction: The prevalence of smoking among persons with a mental illness has remained unchanged, being 2-3 times higher than the general population in high-income countries. Assessment of the volume and characteristics of research output over time can assist in identifying research priorities to promote progress within a field. The aim of this study was to undertake such an assessment in the field of smoking and mental illness. Methods: A descriptive repeat cross-sectional study was conducted of peer-reviewed publications in Medline and PsycINFO for the periods 1993-1995, 2003-2005, and 2013-2015. Publications were classified as data-or non-data-based; data-based publications were further categorized by study type, population, setting, and for intervention-focused publications by level of evidence and research translation phase. Results: Included were 547 articles published in 1993-1995 (n = 65), 2003-2005 (n = 153), and 2013-2015 (n = 329). The number and proportion of data-based publications significantly increased over time, although their focus remained predominantly descriptive (≥83%); less than 14% of publications in any period had an intervention focus. The proportion of publications reporting on study populations with multiple diagnostic categories and recruiting from nonmental health settings, significantly increased from 1993-1995 to 2003-2005, however then plateaued by 2013-2015. The level of evidence provided by intervention-focused publications was suggested to increase over time, however there was no evident variation in translation phase. Conclusions: Research has increased over time to characterize smoking among those with a mental illness; however more is needed to inform the development and implementation of effective cessation interventions for this group. Implications: This is the first study to examine the volume and characteristics of research publications in the field of smoking and mental illness over time. The number of publications increased fivefold between

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Smokers With Behavioral Health Comorbidity Should Be Designated a Tobacco Use Disparity Group

Cited by 127 publications

References 62 publications

Gender Differences in a Randomized Controlled Trial Treating Tobacco Use Among Adolescents and Young Adults With Mental Health Concerns

Gender Differences in a Randomized Controlled Trial Treating Tobacco Use Among Adolescents and Young Adults With Mental Health Concerns

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

Smoking and Mental Illness: A Bibliometric Analysis of Research Output Over Time

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