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Christiansen B, Riemer D, Conner KL, Fiore MC. The Bucket Approach: Developing and Implementing an On-line Training Program in Tobacco Dependence Interventions Tailored for Behavioral Health Clinicians. Community Ment Health J 2023; 59:439-450. [PMID: 36050593 PMCID: PMC9436731 DOI: 10.1007/s10597-022-01021-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 08/14/2022] [Indexed: 11/03/2022]
Abstract
People coping with a mental illness and/or addictive disorders have a very high prevalence of smoking cigarettes. The Bucket Approach, a free online training, tailors evidence-based tobacco dependence interventions for behavioral health clinicians to increase the likelihood that they will also address the tobacco use of their patients. From October 2019 through August 2021, 999 people enrolled in and 447 people completed the training. Individuals who completed the training evaluated it highly with an overall mean score of 8.4 (scale = 1 for very poor to 10 for very good). 3- and 6-month follow-up surveys documented continued impact. The training resulted in substantial changes in beliefs about treating tobacco dependence. For example, before training, 18.3% of trainees strongly agreed with the statement, "The skills currently possessed by behavioral health clinicians can be easily applied to the treatment of tobacco dependence." This increased to 40.7% at the end of training.
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Affiliation(s)
- Bruce Christiansen
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, 1930 Monroe St., Suite 200, Madison, WI 53711 USA
| | - Donna Riemer
- WI Department Health Services, Bureau of Prevention Treatment and Recovery, 1 West Wilson Street, Madison, WI 53703 USA
| | - Karen L. Conner
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, 1930 Monroe St., Suite 200, Madison, WI 53711 USA
| | - Michael C. Fiore
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, 1930 Monroe St., Suite 200, Madison, WI 53711 USA
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Cox CM, Westrick JC, McCarthy DE, Carpenter MJ, Mathew AR. Practice Quit Attempts: Scoping Review of a Novel Intervention Strategy. J Stud Alcohol Drugs 2022; 83:115-125. [PMID: 35040767 PMCID: PMC8819897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE Fostering practice quit attempts (PQAs)--that is, attempts to not smoke for a few hours or days, without pressure to permanently quit--represents a potential means to engage more individuals who smoke in efforts to change their smoking. However, little is known about interventions designed to foster PQAs. We aimed to identify the available evidence on PQA-focused intervention strategies and their impact on quit attempt and cessation outcomes. METHOD We conducted a scoping review of behavioral and pharmacological treatment studies targeting PQAs among adult cigarette smokers. RESULTS The systematic literature search yielded 3,879 articles, and the full-text review was narrowed to 86. Twenty-three studies were deemed relevant, and 5 were added through other sources, yielding 28 studies total. Fifteen studies included behavioral intervention techniques focused on the development and rehearsal of individualized coping skills, whereas eight studies provided brief advice/instruction. More than half of the PQA-focused interventions incorporated sampling of nicotine replacement products, through either guided or ad lib use. Five studies reported on PQA-focused digital health interventions that prompted brief abstinence challenges. Of eight large-scale controlled trials, six demonstrated an increase in quit attempt and cessation outcomes among the PQA-focused intervention group. CONCLUSIONS Fostering PQAs through behavioral and pharmacological interventions offers a promising technique for cessation induction that warrants future research.
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Affiliation(s)
- Chelsea M. Cox
- Department of Psychology, University of Illinois at Chicago, Chicago, Illinois,Correspondence may be sent to Chelsea M. Cox at the Department of Psychology, University of Illinois at Chicago, 1007 West Harrison St., Room 3022, Chicago, IL 60607, or via email at:
| | | | - Danielle E. McCarthy
- Center for Tobacco Research and Intervention, Division of General Internal Medicine, Department of Medicine, University of Wisconsin, School of Medicine and Public Health, Madison, Wisconsin
| | - Matthew J. Carpenter
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina,Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina
| | - Amanda R. Mathew
- Department of Preventive Medicine, Rush University Medical Center, Chicago, Illinois
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Zern A, Seserman M, Dacus H, Wallace B, Friedlander S, Manseau MW, Smalling MM, Smith TE, Williams JM, Compton MT. Screening and Treatment of Tobacco Use Disorder in Mental Health Clinics in New York State: Current Status and Potential Next Steps. Community Ment Health J 2021; 57:1023-1031. [PMID: 33083939 DOI: 10.1007/s10597-020-00726-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 10/05/2020] [Indexed: 11/28/2022]
Abstract
The prevalence of smoking is higher among individuals with serious mental illnesses than the general population. Evidence-based practices exist for tobacco cessation, but little is known about mental health clinics' tobacco cessation treatment practices/protocols. Mental health clinics in New York State were surveyed about their tobacco use treatment protocols and outdoor-smoking policies. One-third of clinics were not providing individual counseling for tobacco use disorder, 39% were not prescribing nicotine replacement therapy, and nearly half reported not prescribing bupropion or varenicline. Even smaller proportions reported implementing other clinical practice guidelines, with only 25.2% providing staff training and 20.3% having a dedicated staff member for coordinating tobacco use disorder treatment. Regarding outdoor smoke-free policies, 38% of clinics reported not allowing any tobacco use anywhere on grounds. Despite some successes, many clinics do not provide evidence-based tobacco use treatments, meaning important opportunities exist for mental health clinics and oversight agencies to standardize practices.
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Affiliation(s)
- Adria Zern
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | | | - Heather Dacus
- New York State Department of Health, Albany, NY, USA
| | | | | | | | | | - Thomas E Smith
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.,New York State Office of Mental Health, Albany, NY, USA.,New York State Psychiatric Institute, New York, NY, USA
| | - Jill M Williams
- Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Michael T Compton
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA. .,New York State Psychiatric Institute, New York, NY, USA.
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Hawes MR, Roth KB, Cabassa LJ. Systematic Review of Psychosocial Smoking Cessation Interventions for People with Serious Mental Illness. J Dual Diagn 2021; 17:216-235. [PMID: 34281493 PMCID: PMC8647929 DOI: 10.1080/15504263.2021.1944712] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Tobacco smoking is a major driver of premature mortality in people with serious mental illness (SMI; e.g., schizophrenia, bipolar disorder). This systematic literature review described randomized control trials of psychosocial smoking cessation interventions for people with SMI, rated their methodological rigor, evaluated the inclusion of racial/ethnic and sexual/gender minorities, and examined smoking cessation outcomes. Methods: Eligible studies included peer-reviewed articles published between 2009 and 2020 that examined psychosocial smoking cessation interventions in people with SMI. We used the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines to conduct our review and the Methodological Quality Rating Scale to evaluate methodological rigor. Results: Eighteen studies were included. Ten were categorized as high methodological rigor given their study characteristics (e.g., longer follow-up) and eight as lower methodological rigor based on their characteristics (e.g., not intent-to-treat). Racial/ethnic and sexual/gender minorities were under-represented in these studies. A range of psychosocial interventions were examined including motivational enhancements, smoking cessation education, cognitive behavioral strategies, and contingency management. Most studies also provided smoking cessation medications (e.g., NRT, bupropion), although provision was not always uniform across treatment conditions. Three studies found the intervention condition achieved significantly higher abstinence from smoking compared to the comparison group. Seven studies found the intervention condition achieved significantly higher reductions in smoking compared to the comparison group. Conclusions: Studies finding significant differences between the intervention and comparison groups shared common evidenced-based components, including providing smoking cessation medications (e.g., NRT, bupropion), motivational enhancement techniques, and cessation education and skills training, but differed in intensity (e.g., number and frequency of sessions), duration, and modality (e.g., group, individual, technology). Methodological limitations and a small number of studies finding significant between-group differences prevent the identification of the most effective psychosocial smoking cessation interventions. Clinical trial designs (e.g., SMART, factorial) that control for the provision of psychosocial medications and allow for the identification of optimal psychosocial treatments are needed. Future studies should also ensure greater inclusion of racial/ethnic and sexual/gender minorities and should be culturally/linguistically adapted to improve treatment engagement and study outcomes.
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Affiliation(s)
- Mark R Hawes
- George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Kimberly B Roth
- Department of Community Medicine, Mercer University School of Medicine, Savannah, Georgia, USA
| | - Leopoldo J Cabassa
- George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, Missouri, USA
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Snell M, Harless D, Shin S, Cunningham P, Barnes A. A longitudinal assessment of nicotine dependence, mental health, and attempts to quit Smoking: Evidence from waves 1-4 of the Population Assessment of Tobacco and Health (PATH) study. Addict Behav 2021; 115:106787. [PMID: 33383566 PMCID: PMC7837319 DOI: 10.1016/j.addbeh.2020.106787] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 12/10/2020] [Accepted: 12/10/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Adult smokers with symptoms of any mental illness (AMI) are highly dependent on nicotine and may face additional difficulty quitting smoking. While there is evidence that adult smokers with AMI have high dependence, there is insufficient evidence regarding the unique role that AMI may play in moderating the relationship between dependence and cessation outcomes over time. METHODS 7290 current established adult smokers at Wave 1 (2013-2014) of the PATH Study also participated in data collection in Waves 2-4 (2014-2018). Linear probability models with individual-level random effects were fit to the data, modeling associations between AMI, nicotine dependence, and the 1) likelihood of achieving cessation during the study period, 2) making a cessation attempt within the previous 12 months, and 3) log of past 30-day total consumption of cigarettes. RESULTS Adults who experienced both AMI symptoms and high dependence were 4.7 percentage points (PP) less likely to achieve cessation at any point during the study period (p < 0.01) and smoked more cigarettes per month (β = 0.214, p < 0.05) than adults with AMI who were not highly dependent, despite being as likely to attempt to quit. Adults with AMI who were not highly dependent were 4.6 PP more likely to report a quit attempt and 1.6 PP more likely to achieve cessation than those with neither AMI nor high dependence. CONCLUSIONS Adults with AMI are particularly affected by the burden of tobacco use, in part because of the likely interaction between nicotine dependence and AMI. Tobacco control efforts that focus on this interplay may provide an opportunity to better target interventions for this vulnerable population.
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Affiliation(s)
- Morgan Snell
- Department of Health Behavior and Policy, Virginia Commonwealth University, 830 East Main St, Richmond 23219, VA, United States.
| | - David Harless
- Department of Economics, Virginia Commonwealth University, Richmond, VA, United States
| | - Sunny Shin
- School of Social Work, Virginia Commonwealth University, Richmond, VA, United States
| | - Peter Cunningham
- Department of Health Behavior and Policy, Virginia Commonwealth University, 830 East Main St, Richmond 23219, VA, United States
| | - Andrew Barnes
- Department of Health Behavior and Policy, Virginia Commonwealth University, 830 East Main St, Richmond 23219, VA, United States
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Ghamri RA. Identification of the most effective pharmaceutical products for smoking cessation: A literature review. JOURNAL OF SUBSTANCE USE 2018. [DOI: 10.1080/14659891.2018.1489010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Ranya A. Ghamri
- Department of Family and Community Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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