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Tobacco dependence diagnosis and treatment in V eterans Health Administration residential substance use disorder treatment programs
Author(s) -
Gifford Elizabeth V.,
Tavakoli Sara,
Wang Ruey,
Hagedorn Hildi J.,
HamlettBerry Kim W.
Publication year - 2013
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/add.12105
Subject(s) - medicine , pharmacotherapy , psychosocial , psychiatry , substance abuse , retrospective cohort study , logistic regression , comorbidity , nicotine replacement therapy , nicotine
Aims To explore tobacco dependence ( TD ) diagnosis and treatment utilization, and identify predictors of nicotine replacement therapy ( NRT ) among veterans with substance use disorders ( SUD s) enrolled in V eterans H ealth A dministration ( VHA ) SUD residential treatment programs ( SRTP s). Design Retrospective cohort study. Setting VHA SRTP s, which treat veterans with SUD and multiple severe psychosocial deficits, from 1 O ctober 2009 to 31 S eptember 2010. Participants Identified tobacco users among veterans with SUD treated in SRTP s during fiscal year 2010 ( FY 10). Measurements Rates of documented TD diagnosis and pharmacotherapy were assessed nationally, regionally and by facility. Patient‐level predictors of NRT were examined using a mixed‐effects logistic regression model with facility as a random effect. Findings A total of 12 097 of the 15 320 veterans in SRTPs in FY 10 (79%) were identified as probable tobacco users. Among these, 33% had a documented TD diagnosis, 34% were treated with pharmacotherapy and only 11% were both diagnosed and treated for TD while in SRTP . NRT was more common among patients with a current documented TD diagnosis, recent history of TD treatment, comorbid mental health disorder, age 55 years or younger and identified as white. Conclusions Most veterans in V eterans H ealth A dministration substance use disorders residential treatment programs appear to use tobacco, yet only one in 10 receives a documented ICD ‐9 TD diagnosis and pharmacotherapy while in a substance use disorders residential treatment program.