Smoking Cessation Outcomes among Individuals with Substance Use and/or Psychiatric Disorders

Objectives: The population of individuals with substance use (SUD) and/or psychiatric disorders (PD) has a high prevalence of smoking and a consequent increase in tobacco-related morbidity and mortality when compared to the general population. The aim of this study is to examine the outcomes of a program in a real-life setting which takes a tailored approach to smoking cessation among individuals with SUD and/or PD. Methods: A retrospective chart review of tailored tobacco dependence treatment was performed on individuals with histories of SUD and/or PD attending a Tobacco Dependence Clinic (TDC) program in Vancouver, British Columbia, Canada. Participants of the TDC received a combination of behavioural counselling and pharmacotherapy for smoking cessation. Data from 540 participants enrolled in the TDC between September 2007 and May 2011 was reviewed. Outcome measures included seven-day point-prevalence abstinence (validated by expired carbon monoxide) and program completion rates. Results: For individuals who completed the program the abstinence rate was 41.1% (167/406). Significant predictors of successful smoking cessation were: a) a lower expired carbon monoxide level at baseline (OR=.98, 95%CI=.96-1.00), and b) a longer duration of treatment (OR=1.09, 95%CI=1.05-1.12). Significant predictors of program completion were: a) being female (OR=1.86, 95%CI=1.21-2.87). Discussion: Tailored smoking cessation among individuals with SUD and/or PD yields modest end-of-treatment smoking cessation rates and can be an effective approach to reducing the burden of tobacco use in substance use and mental health treatment settings