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Efficacy of Initiating Tobacco Dependence Treatment in Inpatient Psychiatry: A Randomized Controlled Trial
Open accessAbstract
Objectives. We evaluated the efficacy of a motivational tobacco cessation treatment combined with nicotine replacement relative to usual care initiated in inpatient psychiatry. Methods. We randomized participants (n = 224; 79% recruitment rate) recruited from a locked acute psychiatry unit with a 100% smoking ban to intervention or usual care. Prior to hospitalization, participants averaged 19 (SD = 12) cigarettes per day; only 16% intended to quit smoking in the next 30 days. Results. Verified smoking 7-day point prevalence abstinence was significantly higher for intervention than usual care at month 3 (13.9% vs 3.2%), 6 (14.4% vs 6.5%), 12 (19.4% vs 10.9%), and 18 (20.0% vs 7.7%; odds ratio [OR] = 3.15; 95% confidence interval [CI] = 1.22, 8.14; P = .018; retention > 80%). Psychiatric measures did not predict abstinence; measures of motivation and tobacco dependence did. The usual care group had a significantly greater likelihood than the intervention group of psychiatric rehospitalization (adjusted OR = 1.92; 95% CI = 1.06, 3.49). Conclusions. The findings support initiation of motivationally tailored tobacco cessation treatment during acute psychiatric hospitalization. Psychiatric severity did not moderate treatment efficacy, and cessation treatment appeared to decrease rehospitalization risk, perhaps by providing broader therapeutic benefit.
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“Another study reported after this review randomised people with serious mental illness to cessation support or usual care.It showed that cessation support reduced readmissions for worsening mental illness.38”
From Change in mental health after smoking cessation: systematic review and meta-analysis (2014) · cites this paper as [38]
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“With a similar intervention approach tested in inpatient psychiatry (95), the mean cost of smoking cessation services was $189 in the treatment group and $37 in the usual care condition.”
BackgroundMethodInfluentialSelf-citationCombined pharmacotherapy and behavioural interventions for smoking cessation
Stead, L. F., Koilpillai, P., Fanshawe, T. R., & Lancaster, T. (2016) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd008286.pub3 · Cited by 829
Metadata
- Authors
- Prochaska, J. J., Hall, S. E., Delucchi, K., & Hall, S. M.
- Affiliations
- University of California, San Francisco (US)
- Venue
- American Journal of Public Health
- Publisher
- American Public Health Association
- Published
- 2014-08
- Volume
- 104
- Issue
- 8
- Pages
- 1557-1565
- ISSN
- 0090-0036 (ISSN-L)
- 1541-0048
- PMC
- PMC4103208
- OpenAlex
- W2118226787
- Cited by
- 149
- References
- 58
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 8 · 2023: 4 · 2022: 14 · 2021: 15 · 2020: 7 · 2019: 14 · 2018: 14 · 2017: 11 · 2016: 19 · 2015: 17 · 2014: 13
- FWCI
- 12.30
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Public Health (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institutes of Health (5k05da016752-10)
- National Institute on Drug Abuse (K23DA018691, P-50 DA-09253, K05 DA-016752, P50DA009253)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Smoking Behavior and Cessation
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Keywords
- tobacco cessation, tobacco dependence treatment, nicotine replacement therapy, motivational interviewing, tobacco dependence, psychiatric inpatients, acute psychiatric hospitalization, smoking abstinence, psychiatric rehospitalization
- MeSH terms
- Adult, Mental Disorders, Female, Humans, Inpatients, Male, Patient Compliance, Patient Readmission, Psychiatric Department, Hospital, Smoking Cessation, Treatment Outcome
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