Cookson Camilla, Strang John, Ratschen Elena, Sutherland Gay, Finch Emily, McNeill Ann
National Addiction Centre, Institute of Psychiatry, King's College London, Addiction Sciences Building, 4, Windsor Walk, Denmark Hill, London SE5 8AF, UK.
BMC Health Serv Res. 2014 Jul 14;14:304. doi: 10.1186/1472-6963-14-304.
High smoking prevalence has been observed among those misusing other substances. This study aimed to establish smoking behaviours and attitudes towards nicotine dependence treatment among clients and staff in substance abuse treatment settings.
Cross-sectional questionnaire survey of staff and clients in a convenience sample of seven community and residential addiction services in, or with links to, Europe's largest provider of mental health care, the South London and Maudsley NHS Foundation Trust. Survey items assessed smoking behaviour, motivation to quit, receipt of and attitudes towards nicotine dependence treatment.
Eighty five percent (n = 163) and 97% (n = 145) response rates of clients and staff were achieved. A high smoking prevalence was observed in clients (88%) and staff (45%); of current smokers, nearly all clients were daily smokers, while 42% of staff were occasional smokers. Despite 79% of clients who smoked expressing a desire to quit and 46% interested in receiving advice, only 15% had been offered support to stop smoking during their current treatment episode with 56% reported never having been offered support. Staff rated smoking treatment significantly less important than treatment of other substances (p < 0.001), and only 29% of staff thought it should be addressed early in a client's primary addiction treatment, compared with 48% of clients.
A large unmet clinical need is evident with a widespread failure to deliver smoking cessation interventions to an extraordinarily high prevalence population of smokers in addiction services. This is despite the majority of smokers reporting motivation to quit. Staff smoking and attitudes may be a contributory factor in these findings.
在滥用其他物质的人群中，吸烟率较高。本研究旨在确定药物滥用治疗机构中服务对象和工作人员的吸烟行为以及对尼古丁依赖治疗的态度。
对欧洲最大的精神卫生保健机构——南伦敦和莫兹利国民保健服务基金会信托的七个社区和住院成瘾服务机构（或与之有联系的机构）的服务对象和工作人员进行便利抽样问卷调查。调查项目评估吸烟行为、戒烟动机、接受尼古丁依赖治疗的情况以及对治疗的态度。
服务对象和工作人员的应答率分别为85%（n = 163）和97%（n = 145）。服务对象（88%）和工作人员（45%）的吸烟率较高；在当前吸烟者中，几乎所有服务对象都是每日吸烟者，而42%的工作人员是偶尔吸烟者。尽管79%吸烟的服务对象表示有戒烟意愿，46%的人有兴趣接受建议，但在当前治疗期间，只有15%的人得到了戒烟支持，56%的人表示从未得到过支持。工作人员认为吸烟治疗的重要性明显低于其他物质的治疗（p < 0.001），只有29%的工作人员认为应在服务对象的主要成瘾治疗早期就解决吸烟问题，而服务对象的这一比例为48%。
在成瘾服务机构中，未能为吸烟率极高的人群提供戒烟干预措施的情况普遍存在，这显然表明存在大量未得到满足的临床需求。尽管大多数吸烟者表示有戒烟动机，但工作人员的吸烟情况和态度可能是导致这些结果的一个因素。
