Self-initiated tobacco cessation and substance use outcomes among adolescents entering substance use treatment in a managed care organization.

Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, California 94612, USA.
Addictive behaviors (Impact Factor: 2.25). 11/2008; 34(2):171-9. DOI: 10.1016/j.addbeh.2008.10.002
Source: PubMed

ABSTRACT Adolescents with substance use (SU) problems have high rates of tobacco use, yet SU treatment has historically ignored treatment for tobacco use. Barriers to such efforts include the belief that tobacco cessation could compromise other SU abstinence. This study examines self-initiated tobacco cessation and 12-month alcohol and drug abstinence in adolescents entering SU treatment in a private, managed care organization.
Self-initiated tobacco cessation at 6 months, and at both 6 and 12 months, were related to higher odds of drug abstinence but not alcohol abstinence.
Self-initiated tobacco cessation was not related to poor SU outcomes, and may be important to maintaining drug abstinence. Implementing tobacco cessation efforts in SU treatment can be challenging, but comprised SU outcomes may not be a barrier. The positive associations for drug abstinence and lack of associations for alcohol abstinence could be due to differences in motivation, medical conditions, or to the illicit nature of drug use. Tobacco use has serious long-term health consequences, and tobacco cessation efforts in adolescent SU treatment programs need further research.

  • Journal of Dual Diagnosis 01/2012; · 0.80 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To examine the role of family environment and peer networks in abstinence outcomes for adolescents 1 year after intake to alcohol and other drug (AOD) treatment. Survey of 419 adolescents 13 to 18 years of age at consecutive intakes to AOD treatment programs at four sites of a large health system, with telephone follow-up survey 1 year after intake. Examined association of 1-year abstinence with baseline characteristics. Using logistic regression, we examined characteristics predicting 1-year abstinence and predicting having fewer than four substance-using friends at 1 year. We found that family environment scores related to family conflict, limit setting, and positive family experiences, were not related to abstinence outcomes, but peer networks were related. Adolescents with fewer (less than four) AOD-using friends were more likely to be abstinent than those with four or more AOD-using friends (65% vs. 41%, p= .0002). Having fewer than four AOD-using friends at intake predicted abstinence at 1 year (odds ratio [OR]= 2.904, p= .0002) and also predicted having fewer than four AOD-using friends at 1 year (OR= 2.557, p= 0.0007). Although family environment is an important factor in the development of AOD problems in adolescents, it did not play a significant role in treatment success. The quality of adolescent peer networks did independently predict positive outcomes. For physicians, advanced practice registered nurses, and other primary and behavioral care providers who screen and care for adolescents with AOD and other behavioral problems, our finding suggest the importance of focusing on improving the quality of their peer networks.
    Journal of Nursing Scholarship 03/2012; 44(1):36-44. · 1.61 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective: Co-occurring disorders are important to consider in planning smoking cessation interventions with adolescents. We identify factors associated with smoking and predictors for smoking cessation readiness in a group of adolescents in a residential addiction treatment program. Methods: We conducted a chart review study of 400 clinical records of adolescents aged 13–18 at a short-term residential addiction treatment program. We examined the relationships of smoking with use of other drugs, psychiatric disorders, and adverse events. Results: The rate of smoking in the total sample was 79%. Smoking onset was positively associated with the onset of alcohol and other drugs of abuse, but followed the onset of cannabis use for over half the sample. Heavy smoking, defined as smoking 10 cigarettes per day on average, is correlated with cocaine and opiate addiction. Over half of the sample (56%) was precontemplative about smoking cessation, whereas 30% were in the contemplative stage (ready to stop in six months); 12% were in preparation stage (ready to stop in 30 days); 2% reported that they already had stopped. Heavy smoking was associated with being precontemplative as was earlier onset of drinking relative to smoking, and bipolar diagnosis. Conclusions: Smoking is common in adolescents seeking drug and alcohol treatment and is correlated with the onset and progression of other drug use. Increasing motivation for change and addressing the interface of nicotine, other drugs and mental health are important for smoking cessation interventions for adolescents in residential addiction treatment settings.
    Journal of Dual Diagnosis 04/2012; · 0.80 Impact Factor

Full-text (2 Sources)

Available from
Aug 4, 2014