Advertisement

Proactive Tobacco Treatment in a Behavioral Health Home

  • Sandra J. JapuntichEmail author
  • Eugene M. Dunne
  • Naomi H. Krieger
  • Patricia M. Ryan
  • Erin Rogers
  • Scott E. Sherman
  • Steven S. Fu
Brief Report
  • 5 Downloads

Abstract

Tobacco use is rarely addressed in community mental healthcare despite high patient smoking prevalence. Community mental health centers have systems in place that could be used to comprehensively address tobacco use. This study tested feasibility of, satisfaction with, and safety of proactive tobacco treatment (tobacco outreach to offer connection to tobacco cessation treatment). Behavioral health home patients who smoke were randomly assigned to usual care (UC; N = 11) or proactive care (PC; N = 9). All participants were called 3-months post-randomization for follow-up. PC patients reported high satisfaction with the program and experienced no adverse events or mental health symptom exacerbation during treatment. PC patients reported greater reductions in cigarettes per day, more quit attempts, and more cessation medication utilization than UC patients. Proactive outreach for tobacco cessation is feasible in a behavioral health home, acceptable to patients, and may reduce smoking heaviness and promote quit attempts.

Keywords

Smoking cessation Serious mental illness Intervention Randomized controlled trial 

Notes

Acknowledgements

We would like to acknowledge the participation of the staff and patients at the Gateway Health Behavioral Health Home in Pawtucket, RI, for their participation in this research.

Funding

This study was funded by a Medical Research Fund Grant from the Rhode Island Foundation (#20164393).

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

References

  1. Anthenelli, R. M., Benowitz, N. L., West, R., St Aubin, L., McRae, T., Lawrence, D.,… Evins, A. E. (2016). Neuropsychiatric safety and efficacy of varenicline, bupropion, and nicotine patch in smokers with and without psychiatric disorders (EAGLES): A double-blind, randomised, placebo-controlled clinical trial. Lancet, 387(10037), 2507–2520.  https://doi.org/10.1016/s0140-6736(16)30272-0.
  2. Baker, A. L., Richmond, R., Kay-Lambkin, F. J., Filia, S. L., Castle, D., Williams, J. M.,… Weaver, N. (2015). Randomized controlled trial of a healthy lifestyle intervention among smokers with psychotic disorders. Nicotine Tobacco Research, 17(8), 946–954.  https://doi.org/10.1093/ntr/ntv039.
  3. Dickerson, F., Stallings, C. R., Origoni, A. E., Vaughan, C., Khushalani, S., Schroeder, J., et al. (2013). Cigarette smoking among persons with schizophrenia or bipolar disorder in routine clinical settings, 1999–2011. Psychiatric Services, 64(1), 44–50.  https://doi.org/10.1176/appi.ps.201200143.CrossRefGoogle Scholar
  4. Evins, A. E., Cather, C., & Laffer, A. (2015). Treatment of tobacco use disorders in smokers with serious mental illness: Toward clinical best practices. Harvard Review of Psychiatry, 23(2), 90–98.  https://doi.org/10.1097/hrp.0000000000000063.CrossRefGoogle Scholar
  5. Fiore, M. C., Jean, C. R., Baker, T. B., Ailey, W. C., Benowitz, N. L., & BCurry, S. (2008). Treating tobacco use and dependence: 2008 update. Rockville, MD: US Department of Health and Human Services. Public Health Service.Google Scholar
  6. Fu, S. S., van Ryn, M., Nelson, D., Burgess, D. J., Thomas, J. L., Saul, J.,… Joseph, A. M. (2016). Proactive tobacco treatment offering free nicotine replacement therapy and telephone counselling for socioeconomically disadvantaged smokers: A randomised clinical trial. Thorax, 71(5), 446–453.  https://doi.org/10.1136/thoraxjnl-2015-207904.
  7. Fu, S. S., van Ryn, M., Sherman, S. E., Burgess, D. J., Noorbaloochi, S., Clothier, B., et al. (2014). Proactive tobacco treatment and population-level cessation: A pragmatic randomized clinical trial. JAMA Internal Medicine, 174(5), 671–677.  https://doi.org/10.1001/jamainternmed.2014.177.CrossRefGoogle Scholar
  8. Heatherton, T. F., Kozlowski, L. T., Frecker, R. C., & Fagerstrom, K. O. (1991). The fagerstrom test for nicotine dependence: A revision of the Fagerstrom Tolerance Questionnaire. British Journal of Addiction, 86(9), 1119–1127.CrossRefGoogle Scholar
  9. Kessler, R. C., Green, J. G., Gruber, M. J., Sampson, N. A., Bromet, E., Cuitan, M.,… Zaslavsky, A. M. (2010). Screening for serious mental illness in the general population with the K6 screening scale: Results from the WHO World Mental Health (WMH) survey initiative. International Journal of Methods in Psychiatric Research, 19(Suppl 1), 4–22.  https://doi.org/10.1002/mpr.310.
  10. Nguyen, T. D., Attkisson, C. C., & Stegner, B. L. (1983). Assessment of patient satisfaction: Development and refinement of a service evaluation questionnaire. Evaluation and Program Planning, 6(3–4), 299–313.CrossRefGoogle Scholar
  11. Prochaska, J. J. (2010). Failure to treat tobacco use in mental health and addiction treatment settings: A form of harm reduction? Drug and Alcohol Dependence, 110, 177–182.  https://doi.org/10.1016/j.drugalcdep.2010.03.002.CrossRefGoogle Scholar
  12. Rogers, E. S., Fu, S. S., Krebs, P., Noorbaloochi, S., Nugent, S. M., Gravely, A., et al. (2018). Proactive tobacco treatment for smokers using veterans administration mental health clinics. American Journal of Preventive Medicine, 54(5), 620–629.  https://doi.org/10.1016/j.amepre.2018.02.011.CrossRefGoogle Scholar
  13. Rogers, E. S., & Sherman, S. (2014). Tobacco use screening and treatment by outpatient psychiatrists before and after release of the American Psychiatric Association treatment guidelines for nicotine dependence. American Journal of Public Health, 104(1), 90–95.  https://doi.org/10.2105/ajph.2013.301584.CrossRefGoogle Scholar
  14. Rogers, E. S., Smelson, D. A., Gillespie, C. C., Elbel, B., Poole, S., Hagedorn, H. J.,… Sherman, S. E. (2016). Telephone smoking-cessation counseling for smokers in mental health clinics: A patient-randomized controlled trial. American Journal of Preventive Medicine, 50(4), 518–527.  https://doi.org/10.1016/j.amepre.2015.10.004.
  15. Silfen, S. L., Cha, J., Wang, J. J., Land, T. G., & Shih, S. C. (2015). Patient characteristics associated with smoking cessation interventions and quit attempt rates across 10 community health centers with electronic health records. American Journal of Public Health, 105(10), 2143–2149.  https://doi.org/10.2105/ajph.2014.302444.CrossRefGoogle Scholar
  16. Smith, D., Roche, E., O’Loughlin, K., Brennan, D., Madigan, K., Lyne, J.,… O’Donoghue, B. (2014). Satisfaction with services following voluntary and involuntary admission. Journal of Mental Health, 23(1), 38–45.  https://doi.org/10.3109/09638237.2013.841864.
  17. Steinberg, M. L., Williams, J. M., & Li, Y. (2015). Poor mental health and reduced decline in smoking prevalence. American Journal of Preventive Medicine, 49(3), 362–369.  https://doi.org/10.1016/j.amepre.2015.01.016.CrossRefGoogle Scholar
  18. Tidey, J. W., & Miller, M. E. (2015). Smoking cessation and reduction in people with chronic mental illness. BMJ, 351, h4065.  https://doi.org/10.1136/bmj.h4065.CrossRefGoogle Scholar
  19. Williams, J. M., Steinberg, M. L., Kenefake, A. N., & Burke, M. V. (2016). An argument for change in tobacco treatment options guided by the ASAM criteria for patient placement. Journal of Addiction Medicine, 10(5), 291–299.  https://doi.org/10.1097/adm.0000000000000239.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Hennepin Healthcare Research InstituteMinneapolisUSA
  2. 2.Centers for Behavioral and Preventive MedicineThe Miriam HospitalProvidenceUSA
  3. 3.Department of Psychiatry and Human BehaviorThe Alpert Medical School of Brown UniversityProvidenceUSA
  4. 4.Gateway HealthcareProvidenceUSA
  5. 5.VA New York Harbor Healthcare SystemNew York CityUSA
  6. 6.Department of Population HealthNew York University School of MedicineNew YorkUSA
  7. 7.VA HSR&D Center for Chronic Disease Outcomes Research, Minneapolis VA Health Care SystemMinneapolisUSA
  8. 8.Department of MedicineUniversity of Minnesota Medical SchoolMinneapolisUSA

Personalised recommendations