Effectiveness of a Brief Behavioral Smoking Cessation Intervention In A Residential Substance Use Treatment Center

Abstract

Cigarette smoking is the number one preventable cause of death in the United States (American Cancer Society, 2008). Despite decades of awareness on the dangers of cigarette smoking, many smokers have been unable to successfully quit. One population with little access to smoking cessation treatments is inner city drug abusers in residential treatment centers. Smoking rates among polydrug users in treatment approach 100% (Burling & Ziff, 1988), and half of those treated for alcohol or substance abuse will die of smoking-related illnesses (Hurt, et al., 1996). Nonetheless, a recent survey of residential substance abuse treatment centers found that only 31% of centers provided smoking cessation programs (Fuller, et al., 2007). The relative scarcity of smoking cessation programs offered at such centers is alarming. A residential substance-abuse center setting is, theoretically, an ideal location for the implementation of a smoking cessation program, due to the available resources (Bernstein & Stoduto, 1999). Successful completion of a smoking cessation intervention during drug treatment increases illicit drug abstinence rates by 25% at one year (Prochaska, Delucchi, & Hall, 2004). Nonetheless, studies of smoking cessation programs in residential treatment centers have typically showed low rates of success (Friend & Pagano, 2005), although these programs have typically utilized the group modality and not individualized, one-on-one treatment (Currie, Nesbitt, Wood & Lawson, 2003). It is important to measure the effectiveness of smoking cessation programs delivered in a one-on-one modality in residential treatment centers. The smoking cessation intervention employed in the present study was based on prior behavioral interventions. The effectiveness of this intervention on smoking cessation and short-term (one-month) relapse were assessed. Goodness-of-fit analysis revealed significantly greater rates of point-prevalence smoking reduction or cessation in the active treatment condition compared with the placebo condition; however, when smoking cessation rates were examined alone, there was no significant difference in cessation rates across the two conditions. No sex differences were found in smoking cessation or reduction rates across conditions. Hierarchical linear modeling revealed that sex (being male) and nicotine dependence contributed most significantly to CPD following quit day.