Outcomes of an Intensive Smoking Cessation Program for Individuals with Substance Use Disorders

BACKGROUND: Individuals with substance use disorders (SUD) are disproportionately affected by tobacco use morbidity and mortality. Yet, with adequate intervention, such individuals can be successful in their smoking cessation efforts. The Tobacco Dependence Clinic (TDC) provides tobacco dependence treatment using combined behavioural counseling and pharmacotherapy for clients through the Mental Health and Addiction Services of the Vancouver Coastal Health Authority, British Columbia, Canada. OBJECTIVES: To a) provide smoking cessation outcomes of participants accessing the TDC b) examine predictors of program completion and smoking cessation of participants of the TDC. METHODS: Participants of the TDC receive a structured 8 week group therapy program, with an additional support group of up to 18 weeks. In addition participants receive up to 6 months of tailored pharmacotherapy for smoking cessation. Data from 407 participants enrolled in the TDC between September 2007 and February 2011 and had engaged the program (i.e., attended group session, individual counseling session) more than 2 times were analyzed. Outcome measures include 7-day point-prevalence abstinence (validated by expired carbon monoxide). RESULTS: Based on an intent-to-treat analysis (n = 407), end-of-treatment smoking abstinence rate was 33%. For individuals who completed the program (attended at least 6 sessions and verbalized completion, n = 307), the abstinence rate was 43%. Significant predictors of treatment completion were: a) being female and b) the intervention site. Significant predictors of smoking abstinence were: a) not having an alcohol, heroin, or marijuana use history and b) having a lower CO level at intake. CONCLUSIONS: Smoking cessation among individuals with SUD is an important consideration in reducing the prevalence of smoking and the harms associated with tobacco use in this population. If given access to intensive and tailored tobacco dependence treatment, individuals with SUD can successfully quit smoking at rates similar to the general population