EFFECT OF TREATMENT FOR NICOTINE DEPENDENCE ON ALCOHOL AND DRUG-TREATMENT OUTCOMES
EFFECT OF TREATMENT FOR NICOTINE DEPENDENCE ON ALCOHOL AND DRUG-TREATMENT OUTCOMES
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DOI：
10.1016/0306-4603(93)90017-4
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发表时间：
1993-11-01
影响因子：
4.4
通讯作者：
ANDERSON, H
中科院分区：
文献类型：
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作者：
JOSEPH, AM;NICHOL, KL;ANDERSON, H
本研究旨在探讨禁止吸烟政策和戒烟干预对酒精和药物治疗结果的影响。我们比较了因药物滥用治疗而住院的两组患者的长期酒精和药物治疗结果，并在两个时期内接受了不同的吸烟政策和戒烟干预措施。该研究包括 314 名年龄在 18-65 岁之间的男性患者。干预队列接受全面的医院禁烟以及同时进行的药物和尼古丁依赖治疗，并要求在住院期间戒除尼古丁。对照组是根据允许在指定区域吸烟的政策住院的，没有具体的戒烟干预措施。目前的酒精、药物和烟草使用情况是通过治疗完成后 8-21 个月对患者进行随访采访来确定的。干预组 (n = 92) 的缓解率为 60%，对照组 (n = 105) 的缓解率为 66%。在受访者中，干预组和对照组在酒精、可卡因或大麻使用或这些药物组合使用的“改善”率上没有显着差异，尽管干预组中存在“改善”程度较低的不显着趋势。当将无应答者视为治疗失败进行分析时，干预组中可卡因使用者的“改善”率明显较差，但其他吸毒者或所有患者的总体情况并非如此。干预组中有 10% 的患者报告戒烟，而对照组只有 4%（差异不显着）。尽管患者抵制吸烟干预的强制性，但许多持续吸烟者在随访时要求提供戒烟信息和转介。这些数据表明，对尼古丁依赖的同时干预并没有显着损害使用酒精或大麻作为首选药物的患者的治疗结果。由于这个方向的趋势，应该在随机对照试验中研究这种可能性。干预措施与自我报告的戒烟人数小幅增加有关。该患者群体对完成治疗后戒烟非常感兴趣。
This study was designed to examine the effect of a policy banning smoking and a smoking-cessation intervention on alcohol and drug treatment outcomes. We compared long-term alcohol and drug treatment outcomes in two cohorts hospitalized for substance use treatment, subjected to different smoking policies and cessation interventions in two periods. The study included 314 male patients, aged 18-65. The intervention cohort was subjected to a total hospital smoking ban and concurrent drug and nicotine dependency treatment, with a requirement for nicotine abstinence during hospitalization. The control cohort was hospitalized under a policy permitting smoking in designated areas, with no specific smoking-cessation intervention. Current alcohol, drug, and tobacco use were ascertained by follow-up interview with patients 8-21 months after completion of treatment. There was a 60% response rate in the intervention group (n = 92) and a 66% response rate in the control group (n = 105). Among respondents, there were no significant differences between intervention and control groups in rates of ''improvement'' for alcohol, cocaine, or marijuana use, or for these drugs combined, although there was a nonsignificant trend toward less ''improvement'' in the intervention group. When nonrespondents were analyzed as treatment failures, the rate of ''improvement'' was significantly worse for cocaine users in the intervention group, but not for other drug users or for all patients combined. Ten percent of patients reported quitting smoking in the intervention group compared to 4% in the control group (difference not significant). Although patients resisted the mandatory nature of the smoking intervention, many continuing smokers requested information and referral for smoking cessation at the time of follow-up. These data suggest that concurrent intervention for nicotine dependence did not significantly harm treatment outcomes of patients using alcohol or marijuana as their drug of first choice. Due to a trend in this direction, this possibility should be investigated in randomized, controlled trials. The intervention was associated with a small increase in self-reported smoking cessation. There is considerable interest in this patient population in smoking cessation after completion of treatment.