Smoking Behavior and Wellness among Individuals in Substance Use Disorder Treatment

ABSTRACT

Tobacco-related morbidity and mortality disproportionately affect people with substance use disorders (SUD). Encouraging overall wellness may support tobacco use cessation. We investigated relationships between wellness (health status, physical activity, sugar-sweetened beverage (SSB) consumption), cigarette smoking, and smoking cessation among SUD treatment patients to inform clinical care. Cross-sectional surveys were conducted with 395 patients in 20 California residential SUD programs. Using multivariate regression, we examined associations between smoking status and wellness. Among smokers, we examined associations between lifetime smoking exposure, cessation behaviors and attitudes, and wellness. Compared to nonsmokers (n = 121), smokers (n = 274) reported more SSB consumption, poorer physical health, and more respiratory symptoms. Among smokers, SSB consumption and respiratory symptoms increased per ten pack-years of smoking. Smokers with respiratory symptoms reported higher motivation to quit and more use of nicotine replacement therapy (NRT). Smokers with more days of poor mental health reported lower motivation to quit. Overall, cigarette smoking was associated with other health-risk behaviors among SUD treatment patients. Respiratory symptoms may increase, and poor mental health may decrease, SUD patients’ intent to quit smoking. To reduce chronic disease risk among SUD patients, treatment programs should consider promoting overall wellness concurrently with smoking cessation.

KEYWORDS:

• Substance use disorder
• treatment
• smoking cessation
• wellness
• nutrition
• physical activity

Acknowledgments

This work was supported by the California Tobacco Related Disease Research Program under Grants 27IR-0040 & 28CP-0038; the California Tobacco Control Program under Contract 18-10025; and the National Institute on Drug Abuse under Grant T32DA007250).

Disclosure statement

Joseph Guydish is Editor, and Caravella McCuistian is Associate Editor, of the Journal of Psychoactive Drugs. These authors recused themselves from the review and decision process for this paper, which was managed by an editor not involved in the paper. Other authors report no conflicts of interest.

Additional information

Funding

This work was supported by the California Department of Public Health [18-10025]; National Institute on Drug Abuse [T32DA007250]; Tobacco-Related Disease Research Program [27IR-0040,28CP-0038].