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On providing smoking cessation services in alcohol and other drug treatment settings: Results from a U.S. national survey of attitudes among recovering persons.

Authors
  • Kelly, John F1
  • Greene, M Claire2
  • Hoffman, Lauren A3
  • Hoeppner, Bettina B3
  • Bergman, Brandon G3
  • 1 Recovery Research Institute, Massachusetts General Hospital, Harvard Medical School, 151 Merrimac Street, Boston, MA 02114, United States of America. Electronic address: [email protected] , (United States)
  • 2 Department of Psychiatry, Columbia University & New York State Psychiatric Institute, New York, NY, United States of America. , (United States)
  • 3 Recovery Research Institute, Massachusetts General Hospital, Harvard Medical School, 151 Merrimac Street, Boston, MA 02114, United States of America. , (United States)
Type
Published Article
Journal
Journal of substance abuse treatment
Publication Date
Oct 01, 2020
Volume
117
Pages
108057–108057
Identifiers
DOI: 10.1016/j.jsat.2020.108057
PMID: 32811636
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Nicotine addiction through cigarette use is highly prevalent among individuals suffering from alcohol and other drug (AOD) problems and remains a prominent risk factor for morbidity, mortality, and healthcare utilization. Whereas most people agree that providing smoking cessation services (SCS) to this vulnerable population is vitally important, the timing of such service provision has been hotly debated, including whether such services should be excluded, available (but not offered), offered, or fully integrated into AOD treatment settings. Important stakeholders in this debate are those in recovery from AOD problems who, in addition to having often been AOD treatment patients themselves, frequently hold influential clinical, research or policy positions and thus can influence the likelihood of SCS provision. This study sought to understand the attitudes of this important stakeholder group in providing SCS in AOD treatment settings. We assessed a national cross-sectional sample of individuals in recovery from an AOD problem (n = 1973) on whether SCS should be: a. excluded; b. available; c. offered; or d. integrated into AOD services. We estimated associations between participants' demographic, clinical, and recovery support service use history, and SCS attitude variables, using multinomial logistic regression. Roughly equal proportions endorsed each attitudinal position (23.5% excluded, 25% available, 24.6% offered; 26.9% integrated). Correlates of holding more positive SCS implementation attitudes were Black race; primary substance other than alcohol, greater intensity of former or recent smoking, and less mutual-help organization participation; older individuals achieving recovery between 30 and 40 years ago also had more positive attitudes toward integrating SCS. About half of those sampled were either against SCS inclusion in AOD settings or were in favor of making it "available" only, but not in offering it or integrating it. This oppositional pattern was accentuated particularly among those with primary alcohol problem histories and those participating in mutual-help organizations. Given the universally well-known negative health effects of smoking, understanding more about the exact reasons why certain groups of recovering persons may endorse such positions is an area worthy of further investigation, as it may uncover potential barriers to SCS implementation in AOD treatment settings. Copyright © 2020 Elsevier Inc. All rights reserved.

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