Combination Extended Smoking Cessation Treatment Plus Home Visits for Smokers With Schizophrenia: A Randomized Controlled Trial

Autor: Arthur L. Brody, Paulina Young, Charles McCreary, Shabnam Balali, Gerhard Hellemann, Ryutaro Enoki, Robert Hubert, Sarah S. Kawasaki, Todd Zorick, Paul F Abraham, Lizette Y. Garcia
Rok vydání: 2016
Předmět:
Dual (Psychiatry)
Male
medicine.medical_treatment
Smoking Prevention
law.invention
0302 clinical medicine
Randomized controlled trial
law
Diagnosis
Dual
030212 general & internal medicine
Original Investigation
media_common
Marketing
education.field_of_study
Standard treatment
Smoking
Tobacco Use Disorder
Middle Aged
Combined Modality Therapy
Tobacco Use Cessation Devices
House Calls
Cognitive Therapy
Diagnosis
Dual (Psychiatry)

Public Health and Health Services
Schizophrenic Psychology
Public Health
Adult
Nicotine
medicine.medical_specialty
Nicotine patch
media_common.quotation_subject
Clinical Sciences
Population
03 medical and health sciences
Internal medicine
mental disorders
medicine
Humans
education
Psychiatry
Bupropion
Aged
Cognitive Behavioral Therapy
Random assignment
business.industry
Public Health
Environmental and Occupational Health

Abstinence
030227 psychiatry
Smoking cessation
Smoking Cessation
Nicotine lozenge
Tobacco Use Cessation Products
business
Zdroj: Brody, AL; Zorick, T; Hubert, R; Hellemann, GS; Balali, S; Kawasaki, SS; et al.(2017). Combination extended smoking cessation treatment plus home visits for smokers with schizophrenia: A randomized controlled trial. Nicotine and Tobacco Research, 19(1), 68-76. doi: 10.1093/ntr/ntw190. UC San Diego: Retrieved from: http://www.escholarship.org/uc/item/41g2t960
Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, vol 19, iss 1
ISSN: 1469-994X
1462-2203
Popis: Author(s): Brody, Arthur L; Zorick, Todd; Hubert, Robert; Hellemann, Gerhard S; Balali, Shabnam; Kawasaki, Sarah S; Garcia, Lizette Y; Enoki, Ryutaro; Abraham, Paul; Young, Paulina; McCreary, Charles | Abstract: IntroductionThe majority of people with schizophrenia have a diagnosis of tobacco dependence during their lifetime. A major obstacle to reducing the burden of cigarette smoking in this population is that these smokers have lower quit rates when undergoing standard treatment compared to smokers with no mental illness. We sought to determine if combination extended treatment (COMB-EXT) and home visits (HV) would lead to improved outcomes in smokers with schizophrenia.MethodsThirty-four cigarette smokers with schizophrenia completed either COMB-EXT with HV, COMB-EXT without HV, or treatment as usual (TAU) (random assignment). COMB-EXT consisted of group cognitive-behavioral therapy (CBT), bupropion, nicotine patch, and nicotine lozenge, which were initiated within 2 weeks and continued for 26 weekly visits. HV consisted of biweekly visits to the home with assessment of secondhand smoke (SHS) exposure and brief behavioral therapy with participants and others in the home environment. TAU consisted of group CBT plus serial single or combination medication trials as per standard care.ResultsSmokers with schizophrenia who received COMB-EXT (with or without HV) had greater reductions in cigarettes per day than those treated with TAU (both ps l .01). In addition, 7-day point prevalence abstinence rates for the three groups were 45%, 20%, and 8%, respectively, which was significantly higher for COMB-EXT plus HV than TAU (χ2(1) = 4.8, p = .03). Groups did not differ significantly in the number of adverse events, and HV were easily scheduled.ConclusionCOMB-EXT improves outcomes for smokers with schizophrenia. HV appeared to provide additional benefit for smoking cessation in this treatment-resistant population.ImplicationsThe clear benefit found here of rapidly initiated, combination, extended treatment over TAU suggests that aggressive and extended treatment should be considered in clinical practice for smokers with schizophrenia. Furthermore, HV to address SHS exposure showed initial promise for assisting smokers with schizophrenia in maintaining abstinence, indicating that this intervention may be worthy of future research.
Databáze: OpenAIRE