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Park E, Choi SH, Duffy SA. The Effect of Re-randomization in a Smoking Cessation Trial. Am J Health Behav 2016; 40:667-74. [PMID: 27561870 DOI: 10.5993/ajhb.40.5.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES The purpose of this sub-study was to determine whether operating engineers (heavy equipment operators) who failed to quit smoking in a randomized controlled trial would benefit from re-exposure to the interventions one year later. METHODS Operating Engineers attending workplace safety training groups during the winters of 2010 to 2012 were randomized by training group to either to the Tobacco Tactics Web-based intervention or the 1-800-QUIT-NOW telephone line. Of the 145 original participants, 41 reappeared in training groups one year later and were re-randomized with their group. Seven-day point prevalence quit rates at 30-days and 6-months post-intervention were analyzed using the chi-square test and Fisher's exact test. RESULTS At 30-day follow-up, an additional 9.8% (4/41) of repeaters had quit smoking. At 6-month follow-up, 12.2% (5/41) of repeaters had quit smoking. At 30-day follow-up, increased quitting was more common among those re-randomized to the intervention group than among those who received the control treatment, although this was not statistically significant and was no longer true at 6-month follow-up. CONCLUSIONS Because many smokers make multiple attempts to quit smoking, re-enrollment of participants in smoking cessation trials may produce additional quitters.
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Affiliation(s)
- Eunhee Park
- University at Buffalo, School of Nursing, Buffalo, NY, USA
| | - Seung Hee Choi
- Michigan State University, College of Nursing, East Lansing, MI, USA
| | - Sonia A Duffy
- Ohio State University, School of Nursing, Columbus, OH, USA.
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Cooperman NA, Lu SE, Richter KP, Bernstein SL, Williams JM. Influence of Psychiatric and Personality Disorders on Smoking Cessation Among Individuals in Opiate Dependence Treatment. J Dual Diagn 2016; 12:118-28. [PMID: 27064523 PMCID: PMC5079427 DOI: 10.1080/15504263.2016.1172896] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE We aimed to evaluate how psychiatric and personality disorders influence smoking cessation goals and attempts among people with opiate dependence who smoke. This information could aid the development of more effective cessation interventions for these individuals. METHODS Participants (N = 116) were recruited from two methadone clinics, completed the Millon Clinical Multiaxial Inventory-III, and were asked about their smoking behavior and quitting goals. We used the Least Absolute Shrinkage and Selection Operator (LASSO) method, a technique commonly used for studies with small sample sizes and large number of predictors, to develop models predicting having a smoking cessation goal, among those currently smoking daily, and ever making a quit attempt, among those who ever smoked. RESULTS Almost all participants reported ever smoking (n = 115, 99%); 70% (n = 80) had made a serious quit attempt in the past; 89% (n = 103) reported current daily smoking; and 59% (n = 61) had a goal of quitting smoking and staying off cigarettes. Almost all (n = 112, 97%) had clinically significant characteristics of a psychiatric or personality disorder. White race, anxiety, and a negativistic personality facet (expressively resentful) were negative predictors of having a cessation goal. Overall, narcissistic personality pattern and a dependent personality facet (interpersonally submissive) were positive predictors of having a cessation goal. Somatoform disorder, overall borderline personality pattern, and a depressive personality facet (cognitively fatalistic) were negative predictors of ever making a quit attempt. Individual histrionic (gregarious self-image), antisocial (acting out mechanism), paranoid (expressively defensive), and sadistic (pernicious representations) personality disorder facets were positive predictors of ever making a quit attempt. Each model provided good discrimination for having a smoking cessation goal or not (C-statistic of .76, 95% CI [0.66, 0.85]) and ever making a quit attempt or not (C-statistic of .79, 95% CI [0.70, 0.88]). CONCLUSIONS Compared to existing treatments, smoking cessation treatments that can be tailored to address the individual needs of people with specific psychiatric disorders or personality disorder traits may better help those in opiate dependence treatment to set a cessation goal, attempt to quit, and eventually quit smoking.
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Affiliation(s)
- Nina A. Cooperman
- Division of Addiction Psychiatry, Rutgers Robert Wood Johnson Medical School
| | - Shou-En Lu
- Department of Biostatistics, Rutgers School of Public Health,
| | - Kimber P. Richter
- Department of Preventive Medicine and Public Health, University of Kansas Medical Center,
| | | | - Jill M. Williams
- Division of Addiction Psychiatry, Rutgers Robert Wood Johnson Medical School,
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Weinberger AH, Esan H, Hunt MG, Hoff RA. A review of research on smoking behavior in three demographic groups of veterans: women, racial/ethnic minorities, and sexual orientation minorities. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2015; 42:254-68. [DOI: 10.3109/00952990.2015.1045978] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
| | - Hannah Esan
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY
| | - Marcia G. Hunt
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
- VISN 1 Mental Illness Research Education and Clinical Care Center (MIRECC); VA CT Healthcare Center, West Haven, CT
| | - Rani A. Hoff
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
- VISN 1 Mental Illness Research Education and Clinical Care Center (MIRECC); VA CT Healthcare Center, West Haven, CT
- Department of Public Health, Yale University School of Medicine, New Haven, CT USA
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Duffy SA, Kilbourne AM, Austin KL, Dalack GW, Woltmann EM, Waxmonsky JA, Noonan D. Risk of smoking and receipt of cessation services among veterans with mental disorders. Psychiatr Serv 2012; 63:325-32. [PMID: 22337005 PMCID: PMC3323716 DOI: 10.1176/appi.ps.201100097] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The purpose of this study was to determine rates of smoking and receipt of provider recommendations to quit smoking among patients with mental disorders treated in U.S. Department of Veterans Affairs (VA) treatment settings. METHODS The authors conducted a secondary analysis of the yearly, cross-sectional 2007 Veterans Health Administration Outpatient Survey of Healthcare Experiences of Patients (N=224,193). Logistic regression was used to determine the independent association of mental health diagnosis and the dependent variables of smoking and receipt of provider recommendations to quit smoking. RESULTS Patients with mental disorders had greater odds of smoking, compared with those without mental disorders (p<.05). Those with various mental disorders reported similar rates of receiving services (more than 60% to 80% reported receiving selected services), compared with those without these disorders, except that those with schizophrenia had more than 30% lower odds of receiving advice to quit smoking from their physicians (p<.05). Moreover, those who had co-occurring posttraumatic stress disorder or substance use disorders had significantly greater odds of reporting that they received advice to quit, recommendations for medications, and physician discussions of quitting methods, compared with those without these disorders (p<.05). Older patients, male patients, members of ethnic minority groups, those who were unmarried, those who were disabled or unemployed, and those living in rural areas had lower odds of receiving selected services (p<.05). CONCLUSIONS The majority of patients with mental disorders served by the VA reported receiving cessation services, yet their smoking rates remained high, and selected groups were at risk for receiving fewer cessation services, suggesting the continued need to disseminate cessation services.
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Affiliation(s)
- Sonia A. Duffy
- Dr. Duffy, Dr. Kilbourne, Ms. Austin, and Dr. Woltmann are affiliated with the VA Ann Arbor Center for Clinical Management Research, Serious Mental Illness Treatment Resource and Evaluation Center 2215 Fuller Rd., Ann Arbor, MI 48105 (). Dr. Duffy, Dr. Kilbourne, and Dr. Dalack are with the Department of Psychiatry, University of Michigan, Ann Arbor, MI. Dr. Duffy is with the Department of Otolaryngology, University of Michigan, Ann Arbor, MI. Dr. Waxmonsky is with the Depression Center and the Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO. Dr. Duffy and Dr. Noonan are with the School of Nursing, University of Michigan, Ann Arbor, MI
| | - Amy M. Kilbourne
- Dr. Duffy, Dr. Kilbourne, Ms. Austin, and Dr. Woltmann are affiliated with the VA Ann Arbor Center for Clinical Management Research, Serious Mental Illness Treatment Resource and Evaluation Center 2215 Fuller Rd., Ann Arbor, MI 48105 (). Dr. Duffy, Dr. Kilbourne, and Dr. Dalack are with the Department of Psychiatry, University of Michigan, Ann Arbor, MI. Dr. Duffy is with the Department of Otolaryngology, University of Michigan, Ann Arbor, MI. Dr. Waxmonsky is with the Depression Center and the Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO. Dr. Duffy and Dr. Noonan are with the School of Nursing, University of Michigan, Ann Arbor, MI
| | - Karen L. Austin
- Dr. Duffy, Dr. Kilbourne, Ms. Austin, and Dr. Woltmann are affiliated with the VA Ann Arbor Center for Clinical Management Research, Serious Mental Illness Treatment Resource and Evaluation Center 2215 Fuller Rd., Ann Arbor, MI 48105 (). Dr. Duffy, Dr. Kilbourne, and Dr. Dalack are with the Department of Psychiatry, University of Michigan, Ann Arbor, MI. Dr. Duffy is with the Department of Otolaryngology, University of Michigan, Ann Arbor, MI. Dr. Waxmonsky is with the Depression Center and the Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO. Dr. Duffy and Dr. Noonan are with the School of Nursing, University of Michigan, Ann Arbor, MI
| | - Gregory W. Dalack
- Dr. Duffy, Dr. Kilbourne, Ms. Austin, and Dr. Woltmann are affiliated with the VA Ann Arbor Center for Clinical Management Research, Serious Mental Illness Treatment Resource and Evaluation Center 2215 Fuller Rd., Ann Arbor, MI 48105 (). Dr. Duffy, Dr. Kilbourne, and Dr. Dalack are with the Department of Psychiatry, University of Michigan, Ann Arbor, MI. Dr. Duffy is with the Department of Otolaryngology, University of Michigan, Ann Arbor, MI. Dr. Waxmonsky is with the Depression Center and the Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO. Dr. Duffy and Dr. Noonan are with the School of Nursing, University of Michigan, Ann Arbor, MI
| | - Emily M. Woltmann
- Dr. Duffy, Dr. Kilbourne, Ms. Austin, and Dr. Woltmann are affiliated with the VA Ann Arbor Center for Clinical Management Research, Serious Mental Illness Treatment Resource and Evaluation Center 2215 Fuller Rd., Ann Arbor, MI 48105 (). Dr. Duffy, Dr. Kilbourne, and Dr. Dalack are with the Department of Psychiatry, University of Michigan, Ann Arbor, MI. Dr. Duffy is with the Department of Otolaryngology, University of Michigan, Ann Arbor, MI. Dr. Waxmonsky is with the Depression Center and the Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO. Dr. Duffy and Dr. Noonan are with the School of Nursing, University of Michigan, Ann Arbor, MI
| | - Jeanette A. Waxmonsky
- Dr. Duffy, Dr. Kilbourne, Ms. Austin, and Dr. Woltmann are affiliated with the VA Ann Arbor Center for Clinical Management Research, Serious Mental Illness Treatment Resource and Evaluation Center 2215 Fuller Rd., Ann Arbor, MI 48105 (). Dr. Duffy, Dr. Kilbourne, and Dr. Dalack are with the Department of Psychiatry, University of Michigan, Ann Arbor, MI. Dr. Duffy is with the Department of Otolaryngology, University of Michigan, Ann Arbor, MI. Dr. Waxmonsky is with the Depression Center and the Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO. Dr. Duffy and Dr. Noonan are with the School of Nursing, University of Michigan, Ann Arbor, MI
| | - Devon Noonan
- Dr. Duffy, Dr. Kilbourne, Ms. Austin, and Dr. Woltmann are affiliated with the VA Ann Arbor Center for Clinical Management Research, Serious Mental Illness Treatment Resource and Evaluation Center 2215 Fuller Rd., Ann Arbor, MI 48105 (). Dr. Duffy, Dr. Kilbourne, and Dr. Dalack are with the Department of Psychiatry, University of Michigan, Ann Arbor, MI. Dr. Duffy is with the Department of Otolaryngology, University of Michigan, Ann Arbor, MI. Dr. Waxmonsky is with the Depression Center and the Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO. Dr. Duffy and Dr. Noonan are with the School of Nursing, University of Michigan, Ann Arbor, MI
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