Gentry Sarah, Craig Jean, Holland Richard, Notley Caitlin
Norwich Medical School, University of East Anglia, Norwich, United Kingdom.
Norwich Medical School, University of East Anglia, Norwich, United Kingdom.
Drug Alcohol Depend. 2017 Nov 1;180:178-192. doi: 10.1016/j.drugalcdep.2017.07.043. Epub 2017 Sep 1.
Smoking prevalence among those in substance misuse treatment remains much higher than the general population, despite evidence for effective cessation interventions that do not negatively impact substance misuse outcomes. This systematic review summarises qualitative data on barriers and facilitators to smoking cessation for people in substance misuse treatment, participants' and providers' perceptions about effects of smoking cessation on substance misuse treatment, timing of intervention delivery and aspects of interventions perceived to be effective.
Systematic review of qualitative studies and thematic synthesis of published qualitative data.
10939 records and 132 full texts were screened. 22 papers reporting on 21 studies were included. Key themes identified were: strong relationships between smoking and other substance misuse; environmental influences; motivation; mental health; aspects of interventions perceived to be effective/ineffective; barriers and facilitators to intervention implementation; smoking bans/restrictions; and relationships with professionals. Many service users were motivated toward smoking cessation but were not offered support. Some felt interventions should be delivered after substance misuse treatment, whilst others felt concurrent/dual interventions would be beneficial, due to strong associations between smoking and other substances. Treatment providers felt they lacked training and resources for supporting smoking cessation, and were concerned about impact on substance misuse outcomes.
Many substance misusers who also smoke are motivated to quit but perceive a lack of support from professionals. Additional training and resources are required to enable professionals to provide the support needed. More research is required to develop enhanced packages of care for this deprived group of smokers.
尽管有证据表明有效的戒烟干预措施不会对药物滥用治疗结果产生负面影响，但在接受药物滥用治疗的人群中，吸烟率仍远高于普通人群。本系统评价总结了关于药物滥用治疗患者戒烟的障碍和促进因素的定性数据、参与者和提供者对戒烟对药物滥用治疗影响的看法、干预措施的实施时机以及被认为有效的干预措施的各个方面。
对定性研究进行系统评价，并对已发表的定性数据进行主题综合分析。
筛选了10939条记录和132篇全文。纳入了22篇报告21项研究的论文。确定的关键主题包括：吸烟与其他药物滥用之间的紧密关系；环境影响；动机；心理健康；被认为有效/无效的干预措施的各个方面；干预措施实施的障碍和促进因素；吸烟禁令/限制；以及与专业人员的关系。许多服务使用者有戒烟的动机，但未得到支持。一些人认为干预措施应在药物滥用治疗后实施，而另一些人则认为同时进行/双重干预会有益，因为吸烟与其他药物之间存在密切关联。治疗提供者认为他们缺乏支持戒烟的培训和资源，并担心对药物滥用治疗结果的影响。
许多同时吸烟的药物滥用者有戒烟的动机，但认为缺乏专业人员的支持。需要额外的培训和资源，以使专业人员能够提供所需的支持。需要开展更多研究，为这群处于不利地位的吸烟者制定强化的护理方案。
