Sandra J Japuntich1, Scott E Sherman2, Anne M Joseph3, Barbara Clothier4, Siamak Noorbaloochi5, Elisheva Danan4, Diana Burgess5, Erin Rogers2, Steven S Fu5. 1. Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, United States; Department of Psychiatry and Human Behavior, The Alpert Medical School of Brown University, Providence, RI, United States. Electronic address: Sandra.japuntich@lifespan.org. 2. VA New York Harbor Healthcare System, New York City, NY, United States; New York University School of Medicine, Department of Population Health, New York City, NY, United States. 3. University of Minnesota Medical School, Department of Medicine, Minneapolis, MN, United States. 4. VA HSR&D Center for Chronic Disease Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, United States. 5. University of Minnesota Medical School, Department of Medicine, Minneapolis, MN, United States; VA HSR&D Center for Chronic Disease Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, United States.
Abstract
INTRODUCTION: Individuals with (vs. without) mental illness use tobacco at higher rates and have more difficulty quitting. Treatment models for smokers with mental illness are needed. METHODS: This secondary analysis of the Victory Over Tobacco study [a pragmatic randomized clinical trial (N=5123) conducted in 2009-2011 ofProactive Care (proactive outreach plus connection to smoking cessation services) vs. Usual Care] tests the effectiveness of treatment assignment in participants with and without a mental health diagnosis on population-level, 6month prolonged abstinence at one year follow-up. RESULTS: Analyses conducted in 2015-6 found that there was no interaction between treatment group and mental health group on abstinence (F(1,3300=1.12, p=0.29)). Analyses stratified by mental health group showed that those without mental illness, assigned to Proactive Care, had a significantly higher population-level abstinence rate than those assigned to Usual Care (OR=1.40, 95% CI=1.17-1.67); in those with mental illness, assignment to Proactive Care produced a non-significant increase in abstinence compared to Usual Care (OR=1.18, 95% CI=0.98-1.41). Those with mental illness reported more medical visits, cessation advice and treatment (p<0.001), similar levels of abstinence motivation (p>0.05), but lower abstinence self-efficacy (p<0.001). CONCLUSIONS: Those with a mental health diagnosis benefitted less from proactive outreach regarding tobacco use. VA primary care patients with mental illness may not need additional outreach because they are connected to cessation resources during medical appointments. This group may also require more intensive cessation interventions targeting self-efficacy to improve cessation rates. Clinicaltrials.gov registration # NCT00608426.
RCT Entities:
INTRODUCTION: Individuals with (vs. without) mental illness use tobacco at higher rates and have more difficulty quitting. Treatment models for smokers with mental illness are needed. METHODS: This secondary analysis of the Victory Over Tobacco study [a pragmatic randomized clinical trial (N=5123) conducted in 2009-2011 of Proactive Care (proactive outreach plus connection to smoking cessation services) vs. Usual Care] tests the effectiveness of treatment assignment in participants with and without a mental health diagnosis on population-level, 6month prolonged abstinence at one year follow-up. RESULTS: Analyses conducted in 2015-6 found that there was no interaction between treatment group and mental health group on abstinence (F(1,3300=1.12, p=0.29)). Analyses stratified by mental health group showed that those without mental illness, assigned to Proactive Care, had a significantly higher population-level abstinence rate than those assigned to Usual Care (OR=1.40, 95% CI=1.17-1.67); in those with mental illness, assignment to Proactive Care produced a non-significant increase in abstinence compared to Usual Care (OR=1.18, 95% CI=0.98-1.41). Those with mental illness reported more medical visits, cessation advice and treatment (p<0.001), similar levels of abstinence motivation (p>0.05), but lower abstinence self-efficacy (p<0.001). CONCLUSIONS: Those with a mental health diagnosis benefitted less from proactive outreach regarding tobacco use. VA primary care patients with mental illness may not need additional outreach because they are connected to cessation resources during medical appointments. This group may also require more intensive cessation interventions targeting self-efficacy to improve cessation rates. Clinicaltrials.gov registration # NCT00608426.
Authors: Erin S Rogers; David A Smelson; Colleen C Gillespie; Brian Elbel; Senaida Poole; Hildi J Hagedorn; David Kalman; Paul Krebs; Yixin Fang; Binhuan Wang; Scott E Sherman Journal: Am J Prev Med Date: 2015-12-17 Impact factor: 5.043
Authors: Steven S Fu; Michelle van Ryn; Scott E Sherman; Diana J Burgess; Siamak Noorbaloochi; Barbara Clothier; Anne M Joseph Journal: BMC Public Health Date: 2012-03-06 Impact factor: 3.295
Authors: Erin S Rogers; Steven S Fu; Paul Krebs; Siamak Noorbaloochi; Sean M Nugent; Radha Rao; Carolyn Schlede; Scott E Sherman Journal: BMC Public Health Date: 2014-12-17 Impact factor: 3.295
Authors: Patrick J Hammett; Sandra J Japuntich; Scott E Sherman; Erin S Rogers; Elisheva R Danan; Siamak Noorbaloochi; Omar El-Shahawy; Diana J Burgess; Steven S Fu Journal: Psychol Trauma Date: 2020-07-02