Does Smoking Intervention Influence Adolescent Substance Use Disorder Treatment Outcomes?

Psychology Service, V.A. San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA 92161, USA.
Substance Abuse (Impact Factor: 2.1). 02/2008; 29(2):81-8. DOI: 10.1080/08897070802093361
Source: PubMed


Although tobacco use is reported by the majority of substance use disordered (SUD) youth, little work has examined tobacco focused interventions with this population. The present study is an initial investigation of the effect of a tobacco use intervention on adolescent SUD treatment outcomes. Participants were adolescents in SUD treatment taking part in a cigarette smoking intervention efficacy study, assessed at baseline and followed up at 3- and 6-months post-intervention. Analyses compared treatment and control groups on days using alcohol and drugs and proportion abstinent from substance use at follow up assessments. Adolescents in the treatment condition reported significantly fewer days of substance use and were somewhat more likely to be abstinent at 3-month follow up. These findings suggest that tobacco focused intervention may enhance SUD treatment outcome. The present study provides further evidence for the value of addressing tobacco use in the context of treatment for adolescent SUD's.

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Available from: Judith J Prochaska, Jan 02, 2014
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    • "Recent data show extremely high incidence of smoking among adolescents for B&H, and the established incidence of 35% of males and 16% of females are consuming cigarettes on a daily basis, is one of the highest reported prevalence levels among European countries (Sekulic et al., 2012). Because smoking in adolescence is directly related to smoking in adulthood, investigators have monitored the smoking status of adolescents worldwide (Arcan et al., 2011; Chang et al., 2011; Key & Marsh, 2002; Myers & Prochaska, 2008), and studies have attempted to identify different factors that influence cigarette smoking among adolescents (Becerra & Castillo, 2011; Shi & Mao, 2011). Parental monitoring has generally been found to be a protective factor against cigarettes, and the studies are consistent with regard to this finding, regardless of differences in the study subjects (Bachman et al., 2011). "
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    ABSTRACT: Previous studies reported particularly high incidence of cigarette smoking among adolescents in Bosnia and Herzegovina (B&H) but there is evident lack of investigations which systematically investigated the potential protective/risk factors of smoking in B&H and surrounding countries. The aim of this study was to examine the gender-specific protective/risk factors (predictors) for daily smoking among adolescents, residents of Herzegovina-Neretva County in B&H. The study sample comprised 1036 17- to 18-year-old adolescents (435 boys and 601 girls, all of whom were in their last year of high school). The predictors included factors of parental monitoring, parents’ educational level, sport factors and religiosity of the participants. A forward stepwise conditional logistic regression analysis with single dichotomous criterion (daily smoking vs. non-smoking) was applied. Regression model revealed lower maternal education (OR: 0.69; CI: 0.53–0.91), lower level of conflict with parents (OR: 1.44; CI: 1.12–1.83) and advanced individual sport participation (OR: 0.66; CI: 0.48–0.92) as protective factors of smoking; while advance team sport participation was strong risk factor of daily smoking for boys (OR: 2.17; CI: 1.53–3.10). Among girls, the higher level of conflict with parents is found to be a factor of increased risk for daily smoking (OR: 2.17; CI: 1.61–2.91). Further studies are needed to explain the issue for the entire geographic territory while observing some possible confounding factors (i.e. school monitoring of smoking, financial status, etc.)
    Journal of Substance Use 02/2014; 19(1-2). DOI:10.3109/14659891.2012.734544 · 0.48 Impact Factor
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    • "Our findings of greater perceived difficulty with staying quit from tobacco among youth using marijuana and lower perceived success with quitting among youth with other illicit drug use indicate that concurrent use of tobacco and other substances may be an important factor to address to increase anticipated success with quitting and cessation goal setting. Previous research with adults and youth indicates that treating both tobacco and other substance use simultaneously may have an increased positive effect on abstinence from both substances (Brown et al., 2009; Myers and Prochaska, 2008; Prochaska et al., 2004a). Of the contextual correlates examined in the present study, peer smoking was identified as a perceived barrier to quitting, whereas parental smoking and secondhand smoke exposure were not associated with measures of motivation to quit. "
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    ABSTRACT: Young people with mental health concerns are at high-risk for initiation and continuation of tobacco use. To inform treatment needs, the current study sought to describe tobacco dependence, motivations to quit and associated sociodemographic factors among young people seen in mental health settings. Sixty adolescent and young adult smokers (age mean=19.5 years, range 13-25) receiving outpatient mental health treatment completed measures of tobacco dependence, motivation to quit smoking, mental health, and social environmental factors. Participants averaged 8.0 cigarettes per day (SD=6.6) and moderate nicotine dependence (mFTQ M=4.8, SD=1.6). Participants' mean rating (10-point scales) of perceived difficulty with avoiding relapse during a quit attempt was significantly higher (M=6.7, SD=2.6), than ratings of desire (M=5.1, SD=2.6) and perceived success (M=4.6, SD=2.6) with quitting. Over half (52%) did not intend to quit smoking in the next 6 months, and few (11%) were prepared to quit in the next 30 days. Mental health treatment and symptomatology measures were unrelated to level of dependence or motivation to quit. Among the social environmental factors, having close friends who smoke was associated with greater perceived difficulty with avoiding relapse during a quit attempt (r=0.25, p<0.01). In this sample of adolescent and young adult smokers in mental health treatment, moderate levels of tobacco dependence and motivation to quit were observed and found to be unrelated to mental health measures. Over half of the sample was not intending to quit smoking in the near future, supporting the need for treatment strategies aimed at increasing motivation.
    Drug and alcohol dependence 05/2012; 125(1-2):127-31. DOI:10.1016/j.drugalcdep.2012.04.005 · 3.42 Impact Factor
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    • "Each study has used a different analytic approach to examine the relationship between tobacco use and alcohol and drug use after treatment. For example, Myers and Prochaska (2008) found that adolescents involved in a tobacco cessation intervention while they were in substance abuse treatment had fewer days of substance use (i.e., alcohol and/or drugs) at follow-up. Examining individuals who were adolescents at baseline when they entered substance abuse treatment, the young adults who had quit using tobacco at the 4-year follow-up reported higher alcohol and drug use (Myers & Brown, 1997). "
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    ABSTRACT: Adolescents in substance abuse treatment have approximately four times higher rates of tobacco use compared with adolescents in the general population, yet many substance abuse treatment programs do not provide tobacco cessation interventions. This study examined change in tobacco use among 151 adolescents in state-funded substance abuse treatment from intake to 12-month follow-up in relation to psychiatric comorbidity and substance use. Most adolescents (67.5%) used tobacco at intake and follow-up. Having a diagnosis of a mood, anxiety, or behavioral disorder was significantly associated with change in tobacco use. Individuals with a psychiatric disorder were less likely to be nonusers of tobacco than to be individuals who continued tobacco use (adjusted odds ratio [OR] = 0.153, 95% confidence interval [CI] = 0.040-0.587, p < .01), and they were less likely to have initiated tobacco use at follow-up than individuals who continued tobacco use (adjusted OR = 0.320, 95% CI = 0.105-0.970, p < .05). Contrary to the hypothesis, alcohol use and drug use during the 12-month follow-up was not significantly related to change in tobacco use. Adolescents in substance abuse treatment with comorbid psychiatric disorders may be particularly vulnerable to continuing tobacco use.
    Journal of substance abuse treatment 12/2011; 43(1):20-9. DOI:10.1016/j.jsat.2011.10.024 · 2.90 Impact Factor
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