title: Nicotine dependence among clients receiving publicly funded substance abuse treatment.
abstract: BACKGROUND
  Smoking and nicotine dependence (ND) are prevalent among substance abusers but little is known about characteristics of ND in this population. This information would help identify those most in need of smoking cessation programs. This study evaluated the associations of socio-demographic, tobacco- and substance use-related, and health/mental health factors to ND in adults receiving publicly funded substance abuse treatment in Tennessee.
  
  
  METHODS
  All Tennessee residents who received federal block grant-funded substance abuse treatment during July-December, 2004 were invited to participate in a 6 month post-intake telephone follow-up interview. Socio-demographic characteristics, perceived health and mental health, tobacco use history and patterns, and ND, assessed by the Fagerstrom Test of Nicotine Dependence (FTND), were obtained at follow-up. Alcohol and illicit drug use and smoking status prior to treatment were assessed at intake. This paper analyzes data for 855 clients who were current cigarette smokers at both intake and follow-up.
  
  
  RESULTS
  Sixty three percent of smokers were ND (FTND score ≥ 4). Correlates of ND included older age, poorer self-rated overall health, earlier age of onset of cigarette smoking and substance abuse, fewer smoking quit attempts in past year, single substance use (alcohol or illicit drug, vs. multiple substances) at intake, use of opiates/narcotics and sedatives, and past month self-reported depression.
  
  
  CONCLUSIONS
  ND was highly prevalent and correlated with specific types and patterns of substance abuse and depression. These results suggest that intensive smoking cessation interventions, involving behavioral support, pharmacotherapy, and mood management, are needed to effectively assist this population.
authors.affiliation: School of Public Health, The University of Memphis, Memphis, TN, United States. kdward@memphis.edu
authors.forename: Kenneth D
authors.initials: KD
authors.lastname: Ward
authors.forename: Satish
authors.initials: S
authors.lastname: Kedia
authors.forename: Larita
authors.initials: L
authors.lastname: Webb
authors.forename: George E
authors.initials: GE
authors.lastname: Relyea
mesh_terms: D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000150:complications / Q000523:psychology; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000523:psychology; D008603:Mental Health; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D012907:Smoking / Q000453:epidemiology / Q000523:psychology; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000534:rehabilitation*; D013714:Tennessee / Q000453:epidemiology; D014029:Tobacco Use Disorder / Q000150:complications / Q000453:epidemiology*; D055815:Young Adult