The Effectiveness of a Telephone Smoking Cessation Program in Mental Health Clinic Patients by Level of Mental Well-Being and Functioning: A Secondary Data Analysis of a Randomized Clinical Trial

Author:

Swong Sarah1,Nicholson Andrew1,Smelson David2,Rogers Erin S.1,El-Shahawy Omar1,Sherman Scott E.3

Affiliation:

1. New York University Grossman School of Medicine

2. University of Massachusetts School of Medicine

3. VA New York Harbor Healthcare System

Abstract

Abstract Background Few studies have examined the effectiveness of telephone smoking cessation interventions by severity of behavioral health symptoms. Using data from a telephone counseling study, we examined whether abstinence rates varied by level of behavioral health symptoms. Methods The parent study recruited adults who smoke cigarettes (N = 577) referred by mental health providers at six Veterans Health Administration facilities. Participants were randomized to specialized telephone counseling (intervention) or state Quitline referral (control). Participants completed assessments at baseline and 6 months, including the BASIS-24, a self-report measure of behavioral health symptoms and functioning. We used the BASIS-24 median to dichotomize participants as having high or low scores. The primary outcome was 30-day self-reported abstinence at 6 months. We compared groups on outcomes by logistic regression and performed an interaction effect analysis between treatment assignment and groups. Results At baseline, those with high behavioral health symptoms scores reported heavier nicotine dependence and more sedative and/or antidepressant use. At 6 months, participants with low behavioral health symptoms scores in the intervention reported higher rates of 30-day abstinence compared to those in the control arm (26% vs 13%, OR = 2.3, 95% CI = 1.8, 2.9). People with high behavioral health symptoms scores reported no difference in 30-day abstinence between the treatment assignments at 6 months (12% vs. 13%, OR = 1.1, 95% CI = 0.6, 2.0). Conclusions Only participants with low behavioral health symptoms scores reported higher abstinence rates in the intervention compared to the state Quitline. Future research can examine alternative approaches for people with worse mental well-being and functioning. Trial registration The parent study is registered at www.clinicaltrials.govNCT00724308.

Publisher

Research Square Platform LLC

Reference35 articles.

1. 1Substance Abuse and Mental Health Services Administration. Adults with mental illness or substance use disorder account for 40 percent of all cigarettes smoked. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2013.

2. 2Ziedonis D, Hitsman B, Beckham JC et al. Tobacco use and cessation in psychiatric disorders: National Institute of Mental Health report. Nicotine Tob Res. 2008;10(12):1691 – 715.

3. 3Pettey D, Aubry T. Tobacco use and smoking behaviors of individuals with a serious mental illness. Psychiatr Rehabil J. 2018;41(4):356–360.

4. 4National Institute on Drug Abuse. Do people with mental illness and substance use disorders use tobacco more often? National Institute on Drug Abuse website. Updated May 2022. Accessed December 14., 2022. https://nida.nih.gov/publications/research-reports/tobacco-nicotine-e-cigarettes/do-people-mental-illness-substance-use-disorders-use-tobacco-more-often.

5. 5Sung HY, Prochaska JJ, Ong MK et al. Cigarette smoking and serious psychological distress: a population-based study of California adults. Nicotine Tob Res. 2011;13(12):1183-92.

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