NICOTINE TREATMENT AT THE DRUG DEPENDENCY PROGRAM OF THE MINNEAPOLIS-VA-MEDICAL-CENTER - A RESEARCHERS PERSPECTIVE

Substance use disorder treatment professionals historically have been reluctant to address tobacco dependence in their patients, despite a h igh prevalence of smoking, unique health effects, and evidence of phys ical addiction to nicotine. We performed two prospective studies to ex amine (1) the feasibility of a smoke-free policy and nicotine treatmen t program in an inpatient drug and alcohol treatment program, and (2) the impact of this intervention on long-term treatment outcomes. In bo th studies we used self-reported data from two groups of patients, one hospitalized after the implementation of the intervention and a histo rical control. The first set of data indicated that patients were more interested in quitting smoking and were more likely to abstain from s moking after the policy was implemented than before. They did not feel quitting smoking would threaten abstinence, and the policy did not in crease early discharges. The second study failed to show that the chan ge in policy was associated with an adverse effect on drug and alcohol treatment outcomes. A small but significant positive effect was demon strated for smoking cessation. These studies also showed that many pat ients regard smoking as different from the primary drug that brought t hem to treatment. Randomized clinical trials testing a variety of smok ing intervention techniques are desperately needed in this population to scientifically determine effective methods to decrease smoking.