Factors associated with tobacco cessation attempts among inpatients in a psychiatric hospital

Introduction

Several effective evidence-based tobacco treatment approaches can optimize cessation attempts; however, little is known about the utilization of such strategies by people with mental illnesses (MI) during their cessation attempts.

Aims

To examine methods used during and factors associated with tobacco cessation attempts among people with MI.

Methods

Self-administered cross-sectional survey data were obtained from 132 tobacco using inpatients from a psychiatric facility in Kentucky, USA.

Results

Our study found ‘cold turkey’ as the most reported method by inpatient tobacco users with MI in their prior cessation attempts regardless of the psychiatric diagnosis category. Multivariate logistic regression found ethnicity (OR 26.1; 95% CI 2.9–237.1), age at 1st smoke (OR 1.1; 95% CI 1.0–1.1), importance to quit (OR 1.2; 95% CI 1.0–1.4), and receipt of brief tobacco treatment interventions (OR 1.1; 95% CI 1.0–1.3) significantly associated with quit attempt in the past year.

Conclusion

Despite the existence of various evidence-based approaches to enhance tobacco cessation among people with MI, ‘cold-turkey’ was the most preferred method in this sample. In addition, this study highlighted ethnicity, importance to quit, age at 1st smoke, and receipt of brief interventions as important factors to consider when tailoring tobacco cessation in this population. Though ethnicity is a non-modifiable factor, an informed provider may intervene skillfully by addressing socio-cultural barriers specific to an ethnic group. Lower ratings on the motivation ruler and early age of smoking initiation could also inform providers when using motivational interviewing and other evidence-based tobacco-cessation approaches.

BREATHE Team Leaders, including BH WELL's Zim Okoli, Receive FY20-22 Award

 

Please join us in congratulating Ellen Hahn, PhD, RN, FAANZim Okoli, PhD, MPH, MSN, RN, CTTS,  Amanda Fallin-Bennett, PhD, RN , and Melinda Ickes, PhD on their recent, two-year, FY20-22 award totaling $1,474,305 from the Kentucky Department for Public Health for the Kentucky Center for Smoke-free Policy.

Screening Tools

Below are screening tools related to alcohol and other substance use for various populations.


Audit

The Alcohol Use Disorder Identification Test (AUDIT) is a 10-item screening tool developed by the World Health Organization to assess alcohol consumption, behaviors, and related diseases. The purpose of the USAUDIT is to identify individuals with risky patterns of alcohol consumption or an alcohol use disorder. For more information click here.

Brief Screen

This tool was used to accurately identify alcohol and drug use (illicit drug use and nonmedical use of prescription drugs) among patients in a primary care setting. For more information about how this instrument was validated click here. To view the instrument click here.

CRAFFT​

A short clinical assessment tool developed by John R Knight, MD and colleagues at the Center for Adolescent Substance Abuse Research (CeASAR) at Boston Children's Hospital. This instrument is targeting adolescents for substance-use related problems and risks. This tool can be either self-report or administered by the clinician. For more information click here.

ASSIST

An alcohol, smoking, and substance involvement screening test, developed by the Word Health Organization (WHO) as a simple tool for the identification risky use of tobacco, alcohol, and psychoactive substances. This questionnaire covers a variety of substances such as tobacco, alcohol, cannabis, cocaine ... etc. For more information click here.

 

 

Referral to Treatment

Below are resources and referrals to treatment related to stopping tobacco use.


 
 

Your Journey to a Smoke free Life Starts Here. ALA's Freedom From Smoking is Ranked the Most Effective Smoking Cessation Program, based on a Fordham University study of 100 managed care organizations. You'll start by choosing a stop day about three weeks from now and then creating a personalized plan to get ready for it.

1-800-QUIT-NOW is a toll-free number run by the National Cancer Institute. Calling this number will connect you directly to your state’s tobacco quitline where you can be further assisted.

A Quick Tool to Help Choose Nicotine Replacement Equivalencies

You’ve got a busy practice, full day, and need to cover cutting out tobacco. You’ve gone through the 5As and the 5Rs and NOW your patient wants to stop.

5 Question Quiz to See if Patients Want to Cut Tobacco

Ever wonder if someone wants to cut out the tobacco? Take this quick quiz to see if you know how to ask!


1. You're talking to a patient and ask:

  • a. Hey, why don't you just cut out tobacco?
  • b. Have you smoked in the last 30 days?

ANSWER: B