Evaluating the Associations Between Exposure to Tobacco Interventions During Inpatient Treatment and Substance Use Outcomes: Findings From a Natural Experiment
| Autor: | Mary Jean Costello, Dominique Bruce, Isabella Romano, Don Roth, Sarah Sousa, James MacKillop, Yao Li, Brian Rush |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Natural experiment Substance-Related Disorders media_common.quotation_subject Psychological intervention Treatment as usual 01 natural sciences Tobacco Use 03 medical and health sciences 0302 clinical medicine Internal medicine Tobacco medicine Humans Pharmacology (medical) 030212 general & internal medicine 0101 mathematics Generalized estimating equation media_common Inpatients business.industry 010102 general mathematics Odds ratio Abstinence Confidence interval Psychiatry and Mental health Smoking Cessation Substance use business |
| Zdroj: | Journal of Addiction Medicine. 15:201-210 |
| ISSN: | 1935-3227 1932-0620 |
| DOI: | 10.1097/adm.0000000000000737 |
| Popis: | OBJECTIVE In this study, we took advantage of a natural experiment that occurred within a substance use disorders (SUD) treatment setting which first saw the implementation of an evidence-based practice (EBP) for tobacco cessation, followed by the implementation of a tobacco-free policy (TFP) that included a campus-wide tobacco ban. We sought to examine how implementation of the EBP and TFP was associated with substances use outcomes, in addition to tobacco use, up to 3-months posttreatment. METHODS Data were collected from patients in a substance use disorders treatment program at baseline, discharge, 1-, and 3-months posttreatment. Using a quasi-experimental design and generalized estimating equations, we modelled how patients' (N = 480) exposure to one of 3 interventions (1: treatment as usual [TAU], 2: EBP, and 3: EBP + TFP) was associated with overall abstinence from tobacco, alcohol, and other substances over time. Measures of tobacco use frequency, amount, and quit attempts were also modelled among a sub-sample of participants who self-reported using tobacco before treatment. RESULT Exposure to the EBP + TFP was associated with increased tobacco abstinence (odds ratio [OR] = 1.93, 95% confidence interval [CI] [1.29, 2.90]) over time, including decreases in tobacco use frequency (OR = 0.78, 95% CI [0.68, 0.89]) and amount (OR = 0.80, 95% CI [0.67, 0.96]), and increased in likelihood of making a quit attempt (OR = 1.75, 95% CI [1.10, 2.80]) compared to TAU. Exposure was not associated with alcohol and/or other substance use. CONCLUSIONS Comprehensive tobacco interventions that include EBP + TFP can promote tobacco cessation and reduced tobacco use following inpatient SUD treatment, without adversely affecting the use of other substances. |
| Databáze: | OpenAIRE |
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