Medical and mental health status among drug dependent patients participating in a smoking cessation treatment study.

Substance abusers have a large number of medical and psychiatric problems, and 70-90% are smokers. The aim of this CTN ancillary investigation was to examine the prevalence and correlates of medical and psychiatric problems in this sample of drug dependent patients who were participants in a multi-site study of smoking cessation interventions while engaged in substance abuse treatment (protocol CTN-0009, “Smoking Cessation Treatment at Community-Based Substance Abuse Rehabilitation Programs”). Descriptive analyses showed at baseline, 72.8% of participants had at least one medical problem and 64.1% had at least one psychiatric diagnosis. Medical problems correlated strongly with age, smoking severity, and pack-years; psychiatric problems correlated with gender and ethnicity. Smoking cessation treatment was associated with a moderate reduction in the ASI Medical composite score.

Conclusions: More research is needed on the possible effects of combined treatment of substance abuse and concurrent medical and psychiatric problems. Offering smoking cessation in conjunction with primary care may be a way to address the health needs of this population. Targeting smoking cessation might be an opportunity to promote engagement with comprehensive medical care, as well as an end in itself. The addiction treatment system is unique in that it is largely separate from the medical and psychiatric care delivery systems, and nicotine dependence tends to be ignored in all three. Integration of treatment could result in significant improvement in medical, psychiatric, and addiction outcomes and save costs, thus having far reaching implications for public health.

Related protocols: CTN-0009