Transcript Style D 24 by 48 - Drexel University

Integrating Smoking Cessation with Substance Abuse Treatment
Charlotte J. Smith, MD, Jillian Arthur, MD, Annette Gadegbeku, MD
Department of Family, Community & Preventive Medicine, Drexel University College of Medicine, Philadelphia PA
Background
Smoking is the leading cause of preventable death in the United
States. This public health problem is of particular concern among
individuals with substance use disorders in that they smoke at a
greater rate than the general public. Smoking-related illness
represents a major source of preventable death in persons with
drug dependencies. Substance abuse treatment programs harbor a
high percentage of smokers; however nicotine dependence has
historically not been treated as intently as other drug dependencies.
As a result, many persons in these treatment program settings do
not receive opportunities to address their smoking.
Figures
Results
Smoking status at baseline vs >=4 sessions
Baseline Level of Nicotine Dependence
Total # Participants
(9/2014 to 3/2015): 39
Average % new participants
per session: 30%
High dependence
(23%)
Moderate
dependence
(51%)
Low dependence
(26%)
Confidence to quit smoking prior to treatment
80%
70%
Baseline
smoking
status (N=36)
•
•
•
•
0-10 cigs: 56%
11-20 cigs: 36%
21-30 cigs: 5%
31 or more: 3%
50%
60%
40%
50%
30%
40%
Smoking
status in those
attending >=4
sessions
(N=35)
30%
20%
10%
•
•
•
•
•
0-10 cigs: 43%
11-20 cigs: 9%
21-30 cigs: 8%
31 or more: 6%
quit: 34%
Baseline status
after 4 sessions
20%
10%
0%
Quit
0%
Yes
0-10 cigs 11-20 cigs21-30 cigs>= 30 cigs
No
Conclusions
• Smoking rates decreased after a minimum of 4 sessions
Purpose
• Some participants were even able to quit smoking all
together
The aim of this study was to evaluate the effectiveness of the
implementation of a group smoking cessation program among
residents currently enrolled in a substance abuse rehabilitation
program.
• 100% of participants would recommend the smoking
cessation program to their friends and peers.
Feedback
Methods & Study Design
• Participants were all residents of a Salvation Army drug and
alcohol rehabilitation facility that was not currently offering any
other form of formal smoking cessation counseling.
• Bi-monthly didactic and interactive sessions were held using a 4session repeating syllabus. Participation was voluntary.
• In addition to the group sessions, nicotine patches were made
available to participants.
60%
What is the hardest part about quitting?
Nicotine withdrawal
(31%)
Being around smokers
(47%)
Other (16%)
Other:
“being bored”
“breaking routine”
“stress”
“weight gain”
# Prior quit
attempts
Longest
time
without
smoking
• None: 22%
• 1-5: 56%
• 6-10: 17%
• No response: 5%
• <1wk: 17%
• 1wk-1 mon: 11%
• 1-6 mon: 11%
• >6 mon: 30%
• No response: 31%
“Interactive
discussions.”
Would you
recommend this
program to other
Salvation Army
residents?
“Learning
about the
patch.”
YES
“The
suggestions
they give you
to quit.”
Parts of
program
liked:
“Learning
how smoking
affects the
body.”
“Group
support.”