Smoking status and quit behaviors among health center patients with substance use disorders: A national study

Danielle R Fine; Benjamin I Bearnot; Nancy A Rigotti; Travis P Baggett

doi:10.1016/j.drugalcdep.2019.05.004

Smoking status and quit behaviors among health center patients with substance use disorders: A national study

Drug Alcohol Depend. 2019 Sep 1:202:6-12. doi: 10.1016/j.drugalcdep.2019.05.004. Epub 2019 Jun 29.

Authors

Danielle R Fine¹, Benjamin I Bearnot², Nancy A Rigotti³, Travis P Baggett⁴

Affiliations

¹ Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, 100 Cambridge Street, 16thfloor, Boston, MA, 02114, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA. Electronic address: drfine@mgh.harvard.edu.
² Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, 100 Cambridge Street, 16thfloor, Boston, MA, 02114, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA. Electronic address: bbearnot@partners.org.
³ Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, 100 Cambridge Street, 16thfloor, Boston, MA, 02114, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA. Electronic address: nrigotti@partners.org.
⁴ Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, 100 Cambridge Street, 16thfloor, Boston, MA, 02114, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA; Institute for Research, Quality, and Policy in Homeless Health Care, Boston Health Care for the Homeless Program, 780 Albany Street, Boston, MA, 02118, USA. Electronic address: tbagget@mgh.harvard.edu.

PMID: 31279257
DOI: 10.1016/j.drugalcdep.2019.05.004

Abstract

Background: Despite a high prevalence of smoking among individuals with substance use disorders, tobacco dependence in this vulnerable population is undertreated.

Methods: We analyzed data from 5592 adult (≥18 years old) respondents to the 2014 Health Center Patient Survey, a nationally representative cross-sectional survey of individuals who receive care at U.S. Federally Qualified Health Centers. We evaluated self-reported smoking status, smoking-related quit behaviors (having quit, wanting or attempting to quit in the past year, and planning to quit in the next 6 months), and receipt of advice to quit smoking among participants with and without alcohol use disorder (AUD) and drug use disorder (DUD).

Results: Current smoking was common among individuals with AUD (64.3%) and DUD (55.0%). Few patients with AUD or DUD had quit smoking (16.7% and 24.0%, respectively). Smokers with AUD had higher odds of wanting to quit smoking in the past year (adjusted odds ratio = 2.88; 95% confidence interval = 1.19, 7.05), but were not more likely to have made a past-year quit attempt. DUD was not significantly associated with smoking-related quit behaviors. Smokers with AUD or DUD, as well as those who engaged in treatment for AUD or DUD, did not differ significantly from other smokers in receipt of advice to quit smoking.

Conclusions: Smokers with AUD and DUD were unlikely to have quit smoking despite interest in quitting. Our findings suggest a need for individualized tobacco treatment approaches in patients with AUD and DUD and missed opportunities to provide tobacco cessation counseling during addiction treatment.

Keywords: Alcohol-related disorders; Smoking; Smoking cessation; Substance-related disorders; Tobacco use disorder; Vulnerable populations.

MeSH terms

Adolescent
Adult
Alcoholism / epidemiology*
Alcoholism / psychology
Cross-Sectional Studies
Female
Health Facilities / statistics & numerical data*
Humans
Male
Middle Aged
Odds Ratio
Prevalence
Smoking / epidemiology*
Smoking / psychology
Smoking Cessation / psychology
Smoking Cessation / statistics & numerical data*
Substance-Related Disorders / epidemiology*
Substance-Related Disorders / psychology
Surveys and Questionnaires
United States / epidemiology
Young Adult