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Utilization of Evidence-Based Smoking Cessation Treatments by Psychiatric Inpatient Smokers With Depression

Strong, David R. PhD; Uebelacker, Lisa PhD; Fokas, Kathryn BS; Saritelli, Jennifer BA; Matsko, Stephen BA; Abrantes, Ana M. PhD; Schonbrun, Yael PhD

doi: 10.1097/ADM.0000000000000027
Original Research

Objectives. Although smoking is a major health issue among depressed psychiatric inpatients and interest in quitting is high, successful quit rates remain low among this population. We sought to understand preferences that depressed inpatient smokers may have for cessation treatments.

Methods. Eighty smokers (60% women, mean age 38.75 ± 11.20) with major depressive disorder and nicotine dependence receiving psychiatric inpatient services provided information on current depressive symptoms, smoking status and nicotine dependence, quit attempts, perceived barriers to quitting, and smoking consequences.

Results. Almost half (46%) of participants endorsed a past-year quit attempt. Emotional barriers to quitting were uniquely associated with fewer past-year quit attempts, and depression severity was related to greater emotional barriers to quitting. Nicotine dependence severity was related to a variety of emotional, financial, weight concern, and self-efficacy barriers, but only weight gain concern was associated with decreased odds of making a past-year quit attempt. The number of lifetime quit attempts was positively associated with negative smoking consequences. With regard to interest in smoking cessation treatment, 86% and 92% of smokers reported a willingness to try behavioral counseling and nicotine replacement products, respectively, but fewer smokers reported a willingness to try medication, print or Web-based materials, or an unaided quit attempt.

Conclusions. Although half of our sample reported recent quit attempts, many people did not make an attempt using an evidence-based treatment. On the basis of consumer preferences identified herein, clinical recommendations for reinforcing the use of evidence-based smoking cessation treatments for depressed psychiatric inpatient smokers are provided.

From the Department of Family and Preventive Medicine (DRS), University of California, San Diego; Alpert Medical School of Brown University (LU, AMA, YS), Providence, RI; and Butler Hospital (LU, KF, JS, SM, AMA, YS), Providence, RI.

Send correspondence and reprint requests to David R. Strong, PhD, Department of Family and Preventive Medicine, University of California, San Diego, 9500 Gilman Drive 0813, La Jolla, CA 92093. E-mail:

Supported by a Research Scholar Award from the American Cancer Society (RSGPB-08-145-01-CPPB).

All authors have no conflicts of interest to declare.

Received October 29, 2013

Accepted August 03, 2013

© 2014 American Society of Addiction Medicine