On providing smoking cessation services in alcohol and other drug treatment settings: Results from a U.S. national survey of attitudes among recovering persons.
On providing smoking cessation services in alcohol and other drug treatment settings: Results from a U.S. national survey of attitudes among recovering persons.
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DOI：
10.1016/j.jsat.2020.108057
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发表时间：
2020-10
影响因子：
3.9
通讯作者：
Bergman BG
中科院分区：
文献类型：
--
作者：
Kelly JF;Greene MC;Hoffman LA;Hoeppner BB;Bergman BG
吸烟导致的尼古丁成瘾在患有酒精和其他药物（AOD）问题的个人中非常普遍，并且仍然是发病率、死亡率和医疗保健利用的一个突出风险因素。尽管大多数人都认为向这一弱势群体提供戒烟服务至关重要，但提供这种服务的时机一直存在激烈的争论，包括是否应排除此类服务，是否应提供（但不提供），是否应提供或完全纳入AOD治疗环境。这场辩论的重要利益相关者是那些从AOD问题中恢复过来的人，他们除了自己经常是AOD治疗的患者外，还经常持有有影响力的临床、研究或政策立场，因此可以影响提供SCS的可能性。本研究旨在了解这一重要利益相关者群体在AOD治疗环境中提供SCS的态度。我们评估了从AOD问题中恢复的个体的全国横截面样本（n = 1973）是否应该排除SCS: a.排除；b .可用;c提供;d.集成到AOD服务中。我们使用多项逻辑回归估计了参与者人口统计学、临床和康复支持服务使用史与SCS态度变量之间的关联。支持每种态度立场的比例大致相等（23.5%排除，25%可用，24.6%提供，26.9%整合）。黑人对SCS实施持积极态度；除酒精以外的主要物质，以前或最近吸烟的强度较大，参加互助组织的次数较少；在30 - 40年前康复的老年人对整合SCS的态度也更为积极。大约一半的受访者要么反对在AOD环境中纳入SCS，要么赞成只提供SCS，而不是提供或整合SCS。这种对立模式在有酗酒史的人和参加互助组织的人中尤为突出。鉴于吸烟对健康的负面影响是众所周知的，更多地了解某些康复人群可能支持这种立场的确切原因是一个值得进一步调查的领域，因为它可能揭示在AOD治疗环境中实施SCS的潜在障碍。
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.
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