An Opt-out Tobacco Treatment Group Intervention Within an Intensive Substance Use Disorders Treatment Program: Initial Outcomes in the Veterans Health Administration.

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  • Additional Information
    • Source:
      Publisher: Oxford University Press Country of Publication: England NLM ID: 9815751 Publication Model: Print Cited Medium: Internet ISSN: 1469-994X (Electronic) Linking ISSN: 14622203 NLM ISO Abbreviation: Nicotine Tob Res Subsets: MEDLINE
    • Publication Information:
      Publication: <2009->: Oxford : Oxford University Press
      Original Publication: Abingdon, Oxfordshire, UK : Carfax Pub. and Society for Research on Nicotine and Tobacco, c1999-
    • Subject Terms:
      Substance-Related Disorders*/therapy ; Tobacco Use Disorder*/therapy ; United States Department of Veterans Affairs*; Humans ; Female ; Male ; United States ; Middle Aged ; Adult ; Smoking Cessation/methods ; Treatment Outcome ; Veterans/statistics & numerical data ; Veterans/psychology
    • Abstract:
      Introduction: Despite steadily declining rates of tobacco use in the United States, individuals suffering from substance use disorders (SUD) and other mental illnesses continue to use tobacco at alarmingly high rates, resulting in increased mortality. Given the synergistic consequences to those who suffer from both tobacco use disorders (TUD) and other SUD, embedding tobacco treatment into structured SUD programs using an opt-out approach may yield a greater impact. The current study compares clinical outcomes (ie, quit attempts and prescription of tobacco cessation medications) for an opt-out versus opt-in approach to tobacco treatment.
      Aims and Methods: Tobacco use information was collected prior to and after implementation of an opt-out, eight-session, tobacco group treatment intervention. Patient self-report and medical chart review were utilized to identify individuals who began a tobacco cessation medication during treatment as well as those who reported quitting tobacco, defined as sustained tobacco abstinence for at least 7 days. The analysis includes a total of N = 332 Veterans who enrolled in the intensive outpatient program.
      Results: Those enrolled in the opt-out tobacco treatment group reported a significantly higher rate of quitting tobacco (24.57%) than those in the opt-in group (2.55%; p < .001). Likewise, the opt-out group was prescribed tobacco cessation medications at a significantly higher rate than the opt-in group (55.00% compared to 14.65%; p < .001).
      Conclusions: An opt-out treatment approach to TUD in SUD treatment settings produced improved outcomes, including significantly more patients engaged in TUD treatment and a higher overall rate of SUD treatment completion.
      Implications: Given the disproportionately high rate of tobacco use among those seeking treatment for SUD, enhanced tobacco cessation interventions could result in both improved tobacco as well as other substance use outcomes. The implementation of an opt-out tobacco treatment intervention embedded into SUD programming is supported by our findings of reduced tobacco use among patients.
      (Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco 2024.)
    • Grant Information:
      Minneapolis VA Health Care System
    • Publication Date:
      Date Created: 20240531 Date Completed: 20241223 Latest Revision: 20241223
    • Publication Date:
      20241223
    • Accession Number:
      10.1093/ntr/ntae134
    • Accession Number:
      38818765