Cigarette smoking cessation services in outpatient substance abuse treatment programs in the United States
Received 13 October 2006; received in revised form 17 January 2007; accepted 16 February 2007. published online 21 May 2007.
Abstract
Objective
The objective of this study was to estimate the prevalence and determinants of cigarette smoking cessation treatment in U.S. outpatient substance abuse treatment (OSAT) units.
Methods
Program directors and clinical supervisors from a national sample of 550 OSAT units in the United States were surveyed in 2004–2005. Supervisors reported the availability of cigarette smoking assessment, and individual or group counseling and pharmacotherapy for smoking cessation. This analysis examines whether institutional and resource factors influence the delivery of these services.
Results
Of OSAT programs in the United States, 41% offer smoking cessation counseling or pharmacotherapy, 38% offer individual/group counseling, and 17% provide quit-smoking medication. In multivariate models, hospital affiliation, service breadth, the priority given to physical health, the availability of medication to treat addictive problems, assessment of cigarette smoking, and a greater perception of the proportion of patients who smoke were associated with the delivery of smoking cessation services. Program size and medical staffing also influenced the availability of quit-smoking medication.
Conclusions
Of U.S. OSAT programs, two in five offer behavioral treatment for smoking cessation, but fewer than one in five provide access to pharmacotherapy. Substance abuse treatment programs that are medically oriented, provide more comprehensive services, and recognize the burden of tobacco smoking among their patients are more likely to deliver evidence-based smoking cessation services.
aProgram to Integrate Psychosocial and Health Services, Research Service, Providence Veterans Affairs Medical Center, Providence, RI, USA
bDivision of General Internal Medicine, Departments of Medicine and Community Health, Brown Medical School and Rhode Island Hospital, Providence, RI, USA
cDepartment of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, KS, USA
Corresponding author. Division of General Internal Medicine, Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903, USA. Tel.: +1 401 444 3347; fax: +1 401 444 5040.
The views expressed in this article are those of the authors and do not necessarily reflect those of the National Institute on Drug Abuse, the Department of Veterans Affairs, or the Robert Wood Johnson Foundation.
ABSTRACT