title: Long-term abstinence and predictors of tobacco treatment uptake among hospitalized smokers with serious mental illness enrolled in a smoking cessation trial.
abstract: Hospital patients with serious mental illness (SMI) have high rates of smoking. There are few post-discharge treatment models available for this population and limited research on their treatment uptake following discharge. This study is a secondary analysis of an RCT that compared multi-session intensive telephone counseling versus referral to state quitline counseling at two safety net hospitals in New York City. For this analysis, we selected all trial participants with a history of schizophrenia, schizoaffective disorder or bipolar disorder (N = 384) and used multivariable logistic regression to compare groups on self-reported 30-day abstinence at 6 months and to identify patient factors associated with use of tobacco treatment. Analyses found no significant group differences in abstinence 6 months (28% quitline vs. 29% intervention, p > 0.05), use of cessation medications (42% quitline vs. 47% intervention, p > 0.05) or receipt of at least one counseling call (47% quitline vs. 42% intervention, p > 0.05). Patients with hazardous drinking (p = 0.04) or perceived good health (p = 0.03) were less likely to use cessation medications. Homeless patients were less likely to use counseling (p = 0.02). Most patients did not use cessation treatment after discharge, and the intensive intervention did not improve abstinence rates over quitline referral. Interventions are needed to improve use of cessation treatment and long-term abstinence in patients with SMI.
authors.affiliation: Department of Population Health, New York University School of Medicine, 227 East 30th Street, New York, NY, 10016, USA. Erin.rogers@nyumc.org.|VA NY Harbor Healthcare System, New York, NY, 10010, USA. Erin.rogers@nyumc.org.
authors.forename: Erin S
authors.identifier: http://orcid.org/0000-0002-3207-7956
authors.initials: ES
authors.lastname: Rogers
authors.affiliation: Department of Population Health, New York University School of Medicine, 227 East 30th Street, New York, NY, 10016, USA.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Friedes
authors.affiliation: University of Washington, Seattle, WA, 98195, USA.
authors.forename: Annika
authors.initials: A
authors.lastname: Jakes
authors.affiliation: Cambridge Health Alliance, Somerville, MA, 02143, USA.
authors.forename: Ellie
authors.initials: E
authors.lastname: Grossman
authors.affiliation: Department of Population Health, New York University School of Medicine, 227 East 30th Street, New York, NY, 10016, USA.
authors.forename: Alissa
authors.initials: A
authors.lastname: Link
authors.affiliation: Department of Population Health, New York University School of Medicine, 227 East 30th Street, New York, NY, 10016, USA.|VA NY Harbor Healthcare System, New York, NY, 10010, USA.|Department of Psychiatry, NYU School of Medicine, New York, NY, 10016, USA.
authors.forename: Scott E
authors.initials: SE
authors.lastname: Sherman
mesh_terms: D000328:Adult; D003376:Counseling / Q000379:methods*; D005260:Female; D015277:Hotlines; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010351:Patient Discharge; D016540:Smoking Cessation / Q000523:psychology*; D013689:Telephone
keywords: Mental health; Serious mental illness; Smoking; Smoking cessation; Tobacco