BACKGROUND: Youth with psychiatric disorders are at increased risk of tobacco use. Outpatient mental health settings have received little investigation for delivering tobacco treatment. This study obtained formative data to guide development of a tobacco cessation program for transitional age youth with co-occurring psychiatric disorders with a focus on outpatient mental health settings. METHODS: Applying qualitative methods, we analyzed transcripts from interviews with 14 mental health clients (aged 16-23) and 8 mental health providers. RESULTS: The youth identified internal (nicotine addiction and mood), social, parental, and media influences to their use of tobacco. Providers' viewed youth tobacco use as a normative developmental process, closely tied to management of psychiatric symptoms, supported by parents, and of lower priority relative to youth alcohol and illicit drug use. Youth and providers believed that clinicians can do more to address tobacco use in practice and emphasized nonjudgmental support and nondirective approaches. Top recommended quitting strategies, however, differed notably for the youth (cold turkey, support from friends, physical activity, hobbies) and providers (cessation pharmacotherapy, cessation groups, treatment referrals). CONCLUSIONS: Mental health providers' greater prioritization of other substances and view of youth smoking as developmentally normative and a coping strategy for psychopathology are likely contributing to the general lack of attention to tobacco use currently. Integrating care within mental health settings would serve to reach youth in an arena where clinical rapport is already established, and study findings suggest receptivity for system improvements. Of consideration, however, is the apparent disconnect between provider and youth recommended strategies for supporting cessation.
BACKGROUND: Youth with psychiatric disorders are at increased risk of tobacco use. Outpatient mental health settings have received little investigation for delivering tobacco treatment. This study obtained formative data to guide development of a tobacco cessation program for transitional age youth with co-occurring psychiatric disorders with a focus on outpatient mental health settings. METHODS: Applying qualitative methods, we analyzed transcripts from interviews with 14 mental health clients (aged 16-23) and 8 mental health providers. RESULTS: The youth identified internal (nicotine addiction and mood), social, parental, and media influences to their use of tobacco. Providers' viewed youth tobacco use as a normative developmental process, closely tied to management of psychiatric symptoms, supported by parents, and of lower priority relative to youth alcohol and illicit drug use. Youth and providers believed that clinicians can do more to address tobacco use in practice and emphasized nonjudgmental support and nondirective approaches. Top recommended quitting strategies, however, differed notably for the youth (cold turkey, support from friends, physical activity, hobbies) and providers (cessation pharmacotherapy, cessation groups, treatment referrals). CONCLUSIONS: Mental health providers' greater prioritization of other substances and view of youth smoking as developmentally normative and a coping strategy for psychopathology are likely contributing to the general lack of attention to tobacco use currently. Integrating care within mental health settings would serve to reach youth in an arena where clinical rapport is already established, and study findings suggest receptivity for system improvements. Of consideration, however, is the apparent disconnect between provider and youth recommended strategies for supporting cessation.
Authors: R A Brown; S E Ramsey; D R Strong; M G Myers; C W Kahler; C W Lejuez; R Niaura; U E Pallonen; A N Kazura; M G Goldstein; D B Abrams Journal: Tob Control Date: 2003-12 Impact factor: 7.552
Authors: Sarah A Berg; Alena M Sentir; Richard L Bell; Eric A Engleman; R Andrew Chambers Journal: Psychopharmacology (Berl) Date: 2014-11-13 Impact factor: 4.530
Authors: Judith J Prochaska; Sebastien C Fromont; Danielle E Ramo; Kelly C Young-Wolff; Kevin Delucchi; Richard A Brown; Sharon M Hall Journal: Nicotine Tob Res Date: 2015-04 Impact factor: 4.244
Authors: Mary F Brunette; Joelle C Ferron; Delbert Robinson; Daniel Coletti; Pamela Geiger; Timothy Devitt; Vanessa Klodnick; Jennifer Gottlieb; Haiyi Xie; Mary Ann Greene; Douglas Ziedonis; Robert E Drake; Gregory J McHugo Journal: Nicotine Tob Res Date: 2018-09-04 Impact factor: 4.244
Authors: Sharon Lawn; Joseph Van Agteren; Sara Zabeen; Sue Bertossa; Christopher Barton; James Stewart Journal: Int J Environ Res Public Health Date: 2018-02-03 Impact factor: 3.390
Authors: Kristin V Carson; Malcolm P Brinn; Thomas A Robertson; Rachada To-A-Nan; Adrian J Esterman; Matthew Peters; Brian J Smith Journal: Subst Abuse Date: 2013-05-23