Abstract: Short-Term Naturalistic Treatment Outcomes in Cigarette Smokers with Substance Abuse and/or Mental Illness

The majority of cigarette smokers have a lifetime diagnosis of substance abuse and/or mental illness, and treatment outcomes for smokers with these comorbidities are generally reported to be worse than for smokers without co-morbidities. We sought to examine the effect of specific substance abuse/mental illness diagnoses compared to one another on treatment outcomes.


A retrospective chart review of naturalistic treatment for Tobacco Dependence was performed on male smokers (n= 231) who enrolled in the Greater Los Angeles Veterans Affairs Mental Health Clinic Smoking Cessation Program over a 1.5 year period. Subjects in this program underwent comprehensive treatment for Tobacco Dependence (including, but not limited to, group psychotherapy, nicotine replacement therapy, and bupropion HCl). Quitting smoking was defined as a report of at least 1 week of abstinence and an exhaled carbon monoxide less than 8 parts per million at the final clinic visit.


Of the total group, 36.4% (84/231) quit smoking at the end of treatment. Quit rates were affected by the presence of specific diagnoses, with smokers with a history of Alcohol Abuse/Dependence or Schizophrenia/Schizoaffective Disorder having poorer response rates than smokers without such diagnoses. Other substance abuse and mental illness diagnoses did not affect quit rates.


Lower quit rates among patients with Alcohol Abuse/Dependence or Schizophrenia/Schizoaffective Disorder may be due to the severity of these conditions, and suggests that specialized treatment is needed for these populations of smokers. Smokers with most co-morbid diagnoses are successfully treated with standard treatment methods.

Read the full article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2893593/