Treatment of smokers with co-occurring disorders: emphasis on integration in mental health and addiction treatment settings.

Psychiatry Department, University of California-San Francisco, CA 94143, USA.
Annual Review of Clinical Psychology (Impact Factor: 12.92). 02/2009; 5:409-31. DOI: 10.1146/annurev.clinpsy.032408.153614
Source: PubMed

ABSTRACT This article reviews the research on the treatment of cigarette smoking in individuals who have comorbid mental illnesses or non-nicotinic addictions. The prevalence of smoking in mentally ill and substance-abusing populations is presented, as well as reasons for this high prevalence. The historical role of cigarettes and tobacco in mental illness and addiction is reviewed to help the reader better understand the pervasiveness of smoking in these disorders and the relative absence of intervention efforts in mental heath and addiction treatment settings. The article then discusses the several reasons for integrating smoking treatment into mental health and addiction settings. The outcome research for adult and adolescent comorbid smokers is reviewed, and barriers to treatment are discussed. The review closes with a brief discussion of models of integration and thoughts about prevention.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Despite the high prevalence of dual diagnosis in the world and the importance to treatment patients, very little is known about complexity of this phenomenon and the factors associates in this population. Aim: Of delineating the themes to related dual diagnosis. Methods: Integrative review, two investigators independently reviewed the articles. Pubmed, Scopus, CINAHL and LILACS using combinations of the keywords "dual diagnosis" and "drug users". Results: Our search identified 15 papers, showed about two emphases, one on the drug users and other on the professional of mental health. The themes related patients were: psychiatric comorbidity in injecting drug users; reasons for the drug consume; substance use disorders and not substance use disorders in patients with mental illness; dual diagnosis in VIH patients. Other themes were: necessity to train the team of professional mental health; necessity to supervision of professional mental health during their job with the patients with dual diagnosis; necessity to do scientific gap to this patients; need to identify early dual diagnosis in drug users; to work with expanded clinical in the treatment of dual diagnosis in drug users; necessity to beware professionals mental health. Limitations: the search strategy did not rescue any intervention article in dual diagnosis. Conclusion: Given the high prevalence of dual diagnosis, the relative paucity of clinical guidance, and the potential impact that occurrence of dual diagnosis can have on the course of treatment. Implications for nursing and health policy: Nurses care directly from these patients need to know the disease for taking better care of their clients. For public policy contributes to the exhortation need for changes in the operation of mental health services, because they realized that there is dichotomy between mental health policy and alcohol and other drugs that do not include the care of a patient with dual diagnosis.
  • [Show abstract] [Hide abstract]
    ABSTRACT: To examine rates of smoking cessation among persons with last year substance use disorder (SUD) and how these rates differ among those that have ever received SUD treatment, those that have never received treatment, and those that received last year outpatient and/or inpatient treatment. Cross-sectional study based on 2009-2012 National Survey on Drug Use and Health (NSDUH). A total of 12,796 adult lifetime smokers with any last year SUD. The sample is representative of the non-institutionalized U.S. adult population. We described smoking cessation rates by type of SUD and SUD treatment. We used a logistic regression model identifying the association between smoking cessation and lifetime SUD treatment, adjusting for confounders. We also estimated models identifying the association between smoking cessation and last year outpatient and inpatient SUD treatment. Multivariate models identified significantly lower odds of quitting among those with lifetime SUD treatment (OR=0.561, p-value<0.001) compared with those without SUD treatment. Past year inpatient and outpatient SUD treatment was associated with lower odds of quitting in an unadjusted comparison (OR=0.559, p-value=0.043). In multivariate models, associations were suggestive of lower odds of quitting among those in treatment but there were no significant associations between smoking cessation and receiving inpatient and outpatient services (OR=0.753, p-value=0.312), inpatient services only (OR=0.397, p-value=0.192), or outpatient services only (OR=0.689, p-value=0.214). Lifetime smokers with past year substance use disorder who had ever received substance use disorder treatment appear to be less likely to quit smoking than those who have never received treatment. This pattern persists across type of substance use disorder. This article is protected by copyright. All rights reserved.
    Addiction 02/2015; DOI:10.1111/add.12879 · 4.60 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective: This study examined smoking cessation characteristics of smokers who reported seeking mental health treatment Methods: Data for adult current smokers (N=18,939) were combined from the 2000, 2005, and 2010 National Health Interview Survey. Multivariate regressions were used to assess associations between smoking cessation behaviors, cessation-related social norms, and mental health treatment. Results: Smokers (N=1,897) who reported seeing mental health professionals for mental health problems had higher odds of having made attempts to quit in the past year (odds ratio [OR]=1.17), of having used nicotine replacement therapy (OR=1.28), and of using face-to-face counseling (OR=2.40), telephone quit lines (OR=1.81), and support groups (OR=1.63) to assist smoking cessation. They were more likely to have been advised by health professionals to quit smoking (OR=1.62) but less likely to live in a smoke-free home (OR=.78). Use of smoking cessation treatments and prevalence of smoke-free homes increased over the sampling period. Conclusions: Findings highlight the need for tailored efforts to reduce tobacco use among people with mental health problems.
    Psychiatric Services 07/2014; 65(7-7):957-960. DOI:10.1176/ · 1.99 Impact Factor

Full-text (2 Sources)

Available from
Jun 6, 2014