Course of Smoking and Quit Attempts Among Clients With Co-occurring Severe Mental Illness and Substance Use Disorders
Course of Smoking and Quit Attempts Among Clients With Co-occurring Severe Mental Illness and Substance Use Disorders
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DOI：
10.1176/ps.62.4.pss6204_0353
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发表时间：
2011-04-01
影响因子：
3.8
通讯作者：
Drake, Robert E.
中科院分区：
文献类型：
--
作者：
Ferron, Joelle C.;Brunette, Mary F.;Drake, Robert E.
目的：大约四分之三的患有严重精神疾病的人吸烟，而同时患有药物滥用障碍的人中这一比例甚至更高。这项纵向研究探讨了患有并发疾病的心理健康客户的吸烟模式和戒烟尝试。方法：在 11 年的时间里，每年对参与共存疾病纵向研究的客户 (N=174) 进行吸烟和戒烟行为、精神症状和其他物质使用以及社会、职业和其他特征的评估。使用广义线性混合效应模型来检查戒烟结果。结果：89% 的参与者在基线时是当前吸烟者。在该研究的 11 年中，75% 的参与者至少尝试戒烟一次，但没有人接受尼古丁替代疗法或安非他酮。在 11 年的随访中，只有 17% 的人没有吸烟。慢性全身健康状况的存在预示着过去一年不吸烟的时间会更长。具有高中或更高学历的男性与更多的戒烟尝试、简明精神病评定量表的激活子量表得分更高、与不吸毒的朋友更多的社交接触以及更多的日常活动相关。结论：尽管每年都有许多同时患有严重精神疾病和物质使用障碍的客户尝试戒烟，但很少有人实现持续戒烟，也没有人使用循证干预措施（尼古丁替代疗法或安非他酮）。治疗提供者需要实施循证干预措施来帮助人们成功戒烟。 （精神科服务 62：353-359，2011 年）
Objective: Approximately three-quarters of people with severe mental illnesses smoke cigarettes, and the rate is even higher among those with co-occurring substance use disorders. This longitudinal study explored patterns of cigarette use and cessation attempts among mental health clients with co-occurring disorders. Methods: Clients participating in a longitudinal study of co-occurring disorders (N=174) were assessed yearly over 11 years for smoking and smoking cessation behaviors, psychiatric symptoms, and other substance use, as well as social, occupational, and other characteristics. Generalized linear mixed-effects models were used to examine smoking cessation outcomes. Results: Eighty-nine percent of participants were current smokers at baseline. Seventy-five percent of participants tried to quit at least once over the 11 years of the study, although none received nicotine replacement therapy or bupropion. Only 17% were not smoking at the 11-year follow-up. The presence of a chronic general medical condition predicted a longer duration of not smoking in the past year. Being male and having a high school education or higher were associated with more attempts to quit smoking, as were higher scores on the activation subscale of the Brief Psychiatric Rating Scale, more social contact with non-substance-using friends, and more daily activities. Conclusions: Although many clients with co-occurring serious mental illness and substance use disorders tried to quit each year, few achieved sustained abstinence and none used evidence-based interventions (nicotine replacement therapy or bupropion). Treatment providers need to administer evidence-based interventions to help people quit successfully. (Psychiatric Services 62: 353-359, 2011)