Hasmeena Kathuria1, Ryan G Seibert2, Vinson Cobb3, Nicole Herbst2, Zoe M Weinstein4, Minda Gowarty3, Reha Jhunjhunwala5, Eric D Helm3, Renda Soylemez Wiener6. 1. The Pulmonary Center, Boston University School of Medicine, Boston, MA, United States of America. Electronic address: hasmeena@bu.edu. 2. Division of General Internal Medicine, Boston University School of Medicine, Boston, MA, United States of America. 3. The Pulmonary Center, Boston University School of Medicine, Boston, MA, United States of America. 4. Section of General Internal Medicine, Clinical Addiction Research and Education (CARE) Unit, Boston University School of Medicine/Boston Medical Center, Boston, MA, United States of America. 5. Program of Clinical Investigation, Boston University School of Medicine, Boston, MA, United States of America. 6. The Pulmonary Center, Boston University School of Medicine, Boston, MA, United States of America; Center for Healthcare Organization & Implementation Research, ENRM VA Hospital, Bedford, MA, United States of America.
Abstract
AIMS: Smoking cessation may promote long-term recovery in patients with substance use disorders (SUD). Yet smoking rates remain alarmingly high in this population. Using a sequential explanatory mixed methods approach, we examined smoking rates among hospitalized patients with SUD at a large safety-net hospital, and then characterized factors associated with smoking behaviors both quantitatively and qualitatively. METHOD: We abstracted data from all hospital admissions (7/2016-6/2017) and determined demographics, substance use type, and other characteristics associated with cigarette use among those with SUD. We then conducted semi-structured qualitative interviews with 20 hospitalized SUD smokers. We analyzed transcripts to characterize factors that affect patients' smoking habits, focusing on the constructs of the Health Belief Model. RESULTS: The prevalence of cigarette smoking among hospitalized smokers with SUD was three times higher than those without SUD. Qualitative analyses showed that patients perceived that smoking cigarettes was a less serious concern than other substances. Some patients feared that quitting cigarettes could negatively impact their recovery and perceived that clinicians do not prioritize treating tobacco dependence. Almost all patients with heroin use disorder described how cigarette use potentiated their heroin high. Many SUD patients are turning to vaping and e-cigarettes to quit smoking. CONCLUSION: Hospitalized patients with SUD have disproportionately high smoking rates and perceive multiple barriers to quitting cigarettes. When designing and implementing smoking cessation interventions for hospitalized patients with SUD, policymakers should understand and take into account how patients with SUD perceive smoking-related health risks and how that influences their decision to quit smoking.
AIMS: Smoking cessation may promote long-term recovery in patients with substance use disorders (SUD). Yet smoking rates remain alarmingly high in this population. Using a sequential explanatory mixed methods approach, we examined smoking rates among hospitalized patients with SUD at a large safety-net hospital, and then characterized factors associated with smoking behaviors both quantitatively and qualitatively. METHOD: We abstracted data from all hospital admissions (7/2016-6/2017) and determined demographics, substance use type, and other characteristics associated with cigarette use among those with SUD. We then conducted semi-structured qualitative interviews with 20 hospitalized SUD smokers. We analyzed transcripts to characterize factors that affect patients' smoking habits, focusing on the constructs of the Health Belief Model. RESULTS: The prevalence of cigarette smoking among hospitalized smokers with SUD was three times higher than those without SUD. Qualitative analyses showed that patients perceived that smoking cigarettes was a less serious concern than other substances. Some patients feared that quitting cigarettes could negatively impact their recovery and perceived that clinicians do not prioritize treating tobacco dependence. Almost all patients with heroin use disorder described how cigarette use potentiated their heroin high. Many SUD patients are turning to vaping and e-cigarettes to quit smoking. CONCLUSION: Hospitalized patients with SUD have disproportionately high smoking rates and perceive multiple barriers to quitting cigarettes. When designing and implementing smoking cessation interventions for hospitalized patients with SUD, policymakers should understand and take into account how patients with SUD perceive smoking-related health risks and how that influences their decision to quit smoking.
Authors: Matthew Taing; Vijay Nitturi; Tzuan A Chen; Bryce Kyburz; Isabel Martinez Leal; Virmarie Correa-Fernández; Ezemenari M Obasi; Teresa Williams; Kathleen Casey; Daniel P O'Connor; Litty Koshy; Maggie Britton; Kelli Drenner; Lorraine R Reitzel Journal: Int J Environ Res Public Health Date: 2021-12-26 Impact factor: 4.614