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International Journal of Emergency Mental Health and Human Resilience | ISSN: 1522-4821 | Volume 20
November 26-27, 2018 | Los Angeles, USA
Psychiatry, Mental Health Nursing and Healthcare
World Summit on
Applied Psychology, Psychiatry and Mental Health
International Conference on
&
Differences in remission from nicotine use disorder by tobacco treatment services among people with
severe mental illness
Hamzah Alghzawi, Carla Storr, Shijun Zhu, Alison Trinkoff, Fernando Wagner
and
Debra Scrandis
University of Maryland, USA
Objective:
People living with mental illnesses are two to four times more likely to be dependent on nicotine and have more
difficulty remitting from nicotine use disorder (NUD). A growing body of evidence supports pharmacological interventions
to assist smoking cessation in people with severe mental illness (SMI; i.e. lifetime major depressive disorder, bipolar disorders,
or schizophrenia). Little is known about whether non-pharmacological treatment services are also associated with high
probability of remission from NUD and whether the time from NUD onset until full remission from NUD differs by tobacco
treatment services (pharmacological services, non-pharmacological services, or both services).
Methods:
A population sample of 726 American lifetime adult smokers with SMI and a history of NUD who had a history of
seeking tobacco treatment services were identified in a limited public use dataset of the 2012-2013 National Epidemiologic
Survey on Alcohol and Related Conditions (NESARC-III). Individuals who did not meet any DSM 5 criteria other than craving
in the past year were classified as having remitted. Participants self-reported ages of NUD onset and remission (individuals
not in remission were censored at their current age). Survival analysis was used to compare the probability of remission from
NUD and the time needed for full remission from NUD by tobacco treatment services. The analysis took into account the
complex sampling design and controlled for possible confounders (i.e. sociodemographics) and covariates (i.e. comorbidity
with another mental illness).
Results:
The study sample was primarily female (61.2%), non-Hispanic White (84.4%), between 45 to 65 years of age (51.4%),
from the south (32.0%) residing in urban areas (75.3%). Out of those who sought tobacco treatment services, only 32.3% had
remitted (6%had used pharmacological treatment services, 41.7%had used non-pharmacological treatment services and 52.3%
had used both). The proportion that remitted with a history of pharmacological treatment services was 17.6%. Remission was
more frequent among those using non-pharmacological treatment services (28.5%) or when both types of tobacco treatment
services were used (19.6%). In models controlling for confounders and covariates, the probability of remission from NUD was
higher among those who had non-pharmacological services (HR=1.95, 95%CI: 1.93, 1.97) or those who had both treatment
services (HR=1.52, 95%CI: 1.52, 1.55) compared to those who only had pharmacological services. The average time needed
for full remission from NUD was 35 years (95%CI: 32.2, 37.6) among the smokers who had non-pharmacological treatment
services, compared to 37 years (95%CI: 32.1, 42.3) among those who had pharmacological services and 47 years (95%CI: 43.9,
49.8) among those who had both treatment services.
Conclusions:
The current study suggests a clinical need for non-pharmacological interventions to promote the probability of
remission from NUD among smokers with SMI. Psychiatric nurses could play a role in educating and encouraging smokers
with SMI to seek and utilize non-pharmacological treatment services that might improve the probability of remission from
NUD and facilitate prolonged abstinence.
Acknowledgments:
NESARC-III is funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) with support
from the intramural program and National Institutes of Health.
hamzahjordan87@umaryland.eduHamzah Alghzawi et al., Int J Emerg Ment Health, Volume 20
DOI: 10.4172/1522-4821-C5-024