Shi Yuyan, Cummins Sharon E
The authors are with the Department of Family Medicine and Public Health, University of California, San Diego, La Jolla (e-mail:
Psychiatr Serv. 2015 Jun;66(6):610-6. doi: 10.1176/appi.ps.201400328. Epub 2015 Feb 17.
The high prevalence of cigarette smoking among substance-abusing patients has raised concern. This study assessed the prevalence of and factors related to smoking cessation services and smoke-free policies in substance abuse treatment facilities in the United States.
Facility-level data were obtained from the 2012 National Survey of Substance Abuse Treatment Services (N=13,094). Multivariate logistic regressions were used to examine institutional- and state-level factors associated with use of smoking cessation services and smoking bans.
Of all facilities, 46.8% offered behavioral counseling or pharmacotherapy services for smoking cessation, and 35.2% banned smoking on the property. Programs were more likely to offer smoking cessation services and to ban smoking if they had the following characteristics: they offered inpatient services, accepted government insurance, were licensed by state mental health departments, or were located in metropolitan areas, states with comprehensive smoke-free laws, or states where >30% of substance abuse treatment facilities were smoke free. Public programs were more likely than private for-profit organizations to offer smoking cessation services and to ban smoking. Providing a greater number of services was positively associated with delivery of smoking cessation services but negatively associated with smoking bans. Larger programs were more likely to provide smoking cessation services but less likely to ban smoking.
Institutional characteristics and state environments influenced provision of smoking cessation services and smoke-free policies at substance abuse treatment facilities. These factors could be used to design comprehensive programs for dissemination of smoking cessation treatment and promotion of smoking bans at these facilities.
药物滥用患者中吸烟率居高不下引发了人们的关注。本研究评估了美国药物滥用治疗机构中戒烟服务和无烟政策的普及情况及相关因素。
机构层面的数据来自2012年全国药物滥用治疗服务调查(N = 13,094)。采用多变量逻辑回归分析来研究与使用戒烟服务和禁烟相关的机构及州层面因素。
在所有机构中,46.8%提供戒烟行为咨询或药物治疗服务,35.2%在场所内禁烟。具备以下特征的项目更有可能提供戒烟服务并实施禁烟:提供住院服务、接受政府保险、由州心理健康部门颁发执照,或位于大都市地区、有全面无烟法律的州,或药物滥用治疗机构无烟率超过30%的州。与私立营利性组织相比,公共项目更有可能提供戒烟服务并实施禁烟。提供更多服务与提供戒烟服务呈正相关,但与禁烟呈负相关。规模较大的项目更有可能提供戒烟服务,但实施禁烟的可能性较小。
机构特征和州环境影响了药物滥用治疗机构中戒烟服务和无烟政策的提供。这些因素可用于设计综合项目,以在这些机构推广戒烟治疗和促进禁烟。