Smoking among patients in substance use disorders treatment: associations with tobacco advertising, anti-tobacco messages, and perceived health risks

Abstract

<div class="section"> <a class="named-anchor" id="S1"> <!-- named anchor --> </a> <h5 class="section-title" id="d1644704e141">Background</h5> <p id="P1">Although tobacco control efforts have contributed to an overall decline in smoking, individuals with substance use disorders (SUDs) continue to smoke at high rates and remain targets of advertising to vulnerable groups, including those with mental health disorders and SUDs. </p> </div><div class="section"> <a class="named-anchor" id="S2"> <!-- named anchor --> </a> <h5 class="section-title" id="d1644704e146">Objective</h5> <p id="P2">We examined associations of tobacco advertising exposure and receptivity, anti-tobacco message awareness, and health-risk perception with smoking status and cigarettes-per-day (CPD) in a national sample of SUD treatment patients. </p> </div><div class="section"> <a class="named-anchor" id="S3"> <!-- named anchor --> </a> <h5 class="section-title" id="d1644704e151">Method</h5> <p id="P3">Patients (N=1,113) in 24 programs chosen randomly, stratified by program type, from among publicly funded, adult treatment programs within the National Drug Abuse Treatment Clinical Trials Network completed surveys of smoking, advertising exposure and receptivity, anti-tobacco message awareness and perceived health risks. </p> </div><div class="section"> <a class="named-anchor" id="S4"> <!-- named anchor --> </a> <h5 class="section-title" id="d1644704e156">Results</h5> <p id="P4">Current smokers (77.9% of the sample) smoked a daily median of 10 cigarettes (IQR= 13). Participants reporting daily advertising exposure were 1.41 times more likely to be smokers (p=0.019) than others. Those highly receptive to advertising were 2.34 times more likely to be smokers (p&lt;0.001) than those with low/moderate receptivity. Higher perceived health risk was associated with lower odds of smoking (OR=0.99, 95% CI: 0.98- 0.99, p&lt;0.001). CPD for smokers highly receptive to advertising was 11.1% (95% CI: 2.8%-20.0%) higher than for smokers with low/moderate advertising receptivity. Anti-tobacco message awareness was not associated with smoking status or CPD. </p> </div><div class="section"> <a class="named-anchor" id="S5"> <!-- named anchor --> </a> <h5 class="section-title" id="d1644704e161">Conclusion</h5> <p id="P5">The high rate of smoking among SUD treatment patients is associated with daily exposure and high receptivity to tobacco advertisements, and lower perception of health-related, smoking risks. Tobacco control efforts should target this vulnerable population. </p> </div>