Smoking cessation service in US methadone maintenance facilities
Smoking cessation service in US methadone maintenance facilities
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DOI：
10.1176/appi.ps.55.11.1258
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发表时间：
2004-11-01
影响因子：
3.8
通讯作者：
Ahluwalia, JS
中科院分区：
文献类型：
--
作者：
Richter, KP;Choi, WS;Ahluwalia, JS
目的：大多数药物治疗患者吸烟。本研究确定了美国美沙酮和其他阿片类药物治疗诊所提供的尼古丁依赖服务的流行程度和类型。方法：对美国所有门诊美沙酮维持诊所进行横断面调查。每个诊所的一位领导被调查。这项20分钟的调查是通过电话、传真或邮件收集的，根据受访者的喜好。结果：59%的诊所（697家诊所中的408家）做出了回应。该样本在规模、地区和所有权方面与美国所有门诊美沙酮维持诊所非常相似。在调查前30天，受访者报告他们的诊所至少为一名患者提供以下服务：73%的人提供简短的戒烟建议，18%的人提供个人或团体戒烟咨询，12%的人开尼古丁替代疗法。然而，提供这些服务的病人非常少。有书面指导方针要求他们解决吸烟问题的诊所比没有指导方针的诊所更有可能提供服务。私立营利性诊所治疗尼古丁依赖的可能性明显低于公立或私立非营利诊所。大多数受访者（77%）报告说，他们的员工有兴趣接受尼古丁依赖治疗方面的培训，一半以上（56%）至少有一名员工（“冠军”）对治疗尼古丁依赖有浓厚兴趣。结论：绝大多数美沙酮患者吸烟；然而，在调查前的30个星期里，只有三分之一的机构为任何患者提供咨询，只有十分之一的机构为任何患者开尼古丁替代疗法。要求诊所提供全面的尼古丁依赖服务和培训员工提供这些服务的双重策略，可为美沙酮设施广泛采用尼古丁依赖治疗提供必要的激励和支持。
Objectives: Most patients in drug treatment smoke cigarettes. This study established the prevalence and types of nicotine dependence services offered in methadone and other opioid treatment clinics, in the United States. Methods: A cross-sectional survey Was conducted of all outpatient methadone maintenance clinics in the United States. One person in a leadership position from each clinic was surveyed. The 20-minute survey was collected by phone, fax, or mail, according to responder preference. Results: Fifty-nine percent of the clinics (408 of 697 clinics) responded. The sample was very similar to all outpatient methadone maintenance clinics in the United States in size, region, and ownership. In the 30 days before the survey, respondents reported that their clinics provided the following services to at least one patient: 73 percent provided brief advice to quit, 18 percent offered individual or group smoking cessation counseling, and 12 percent prescribed nicotine replacement therapy. However, the services were provided to very few patients. Clinics with written guidelines that required them to address smoking were much more likely to provide services than those without guidelines. Private for-profit clinics were significantly less likely than public or private nonprofit clinics to treat nicotine dependence. Most respondents (77 percent) reported that their staff were interested in receiving training in nicotine dependence treatment, and more than half (56 percent) had at least one staff member ("champion") with a strong interest in treating nicotine dependence. Conclusions: A vast majority of methadone patients smoke; yet in the 30 jays before the survey only one out of three facilities provided counseling to any patients and only one out of ten prescribed nicotine replacement therapy to any patients. A dual strategy of requiring clinics to provide comprehensive nicotine dependence services and training staff to provide these services may provide the incentive and support necessary for the widespread adoption of treatment for nicotine dependence in methadone facilities.