title: Self-initiated tobacco cessation and substance use outcomes among adolescents entering substance use treatment in a managed care organization.
abstract: OBJECTIVE
  Adolescents with substance use (SU) problems have high rates of tobacco use, yet SU treatment has historically ignored treatment for tobacco use. Barriers to such efforts include the belief that tobacco cessation could compromise other SU abstinence. This study examines self-initiated tobacco cessation and 12-month alcohol and drug abstinence in adolescents entering SU treatment in a private, managed care organization.
  
  
  RESULTS
  Self-initiated tobacco cessation at 6 months, and at both 6 and 12 months, were related to higher odds of drug abstinence but not alcohol abstinence.
  
  
  CONCLUSIONS
  Self-initiated tobacco cessation was not related to poor SU outcomes, and may be important to maintaining drug abstinence. Implementing tobacco cessation efforts in SU treatment can be challenging, but comprised SU outcomes may not be a barrier. The positive associations for drug abstinence and lack of associations for alcohol abstinence could be due to differences in motivation, medical conditions, or to the illicit nature of drug use. Tobacco use has serious long-term health consequences, and tobacco cessation efforts in adolescent SU treatment programs need further research.
authors.affiliation: Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, California 94612, USA. cynthia.i.campbell@kp.org
authors.forename: Cynthia I
authors.initials: CI
authors.lastname: Campbell
authors.forename: Felicia
authors.initials: F
authors.lastname: Chi
authors.forename: Stacy
authors.initials: S
authors.lastname: Sterling
authors.forename: Carolynn
authors.initials: C
authors.lastname: Kohn
authors.forename: Constance
authors.initials: C
authors.lastname: Weisner
mesh_terms: D000293:Adolescent; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D009042:Motivation; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D012648:Self Care; D012931:Social Environment; D016320:Substance Abuse Treatment Centers; D019966:Substance-Related Disorders / Q000523:psychology / Q000628:therapy*; D020340:Tobacco Use Cessation / Q000523:psychology*; D016896:Treatment Outcome