This article reviews and comments on studies of treatment and prevention of cigarette smoking in individuals with comorbid psychiatric and non-nicotine substance abuse disorders. Despite a high prevalence of cigarette smoking in these populations and interest in quitting, treatment interventions and studies of these interventions are sparse. Multiple barriers to implementation of interventions exist. Existing data suggest that provision of cigarette-smoking interventions in substance abuse treatment patients is efficacious and does not appear to interfere with abstinence from alcohol or illicit drugs, but more research is needed. There are few studies in populations with psychiatric disorders, with the exception of studies of individuals with a history of major depressive disorder. The available data suggest at least moderate efficacy and little evidence of exacerbation of these disorders. Integration of interventions into existing treatment clinics appears desirable. Despite the identification of subgroups that are especially likely to adopt cigarette smoking, there have been no targeted prevention efforts. Further research is recommended in both the treatment and prevention of cigarette smoking in individuals with psychiatric and substance abuse disorders. It is reasonable to offer existing treatments to these subgroups of smokers, since there is some evidence of efficacy and little evidence of harm.
Department of Health Psychology, University of California, San Francisco, San Francisco, California
Address correspondence and reprint requests to: Sharon M. Hall, PhD, University of California, San Francisco, 401 Parnassus Avenue, Box 0984, San Francisco CA 94143-0984.
ABSTRACT