Antismoking Interventions in Residential Substance Abuse Treatment

Objective: To develop and evaluate an educational strategy to increase motivation to quit smoking and improve attendance at antismoking classes in a residential substance abuse treatment program. Methods: The 241 patients admitted in 2004 who smoked reported the number of cigarettes smoked daily at the time of admission. Attendance at the antismoking classes was noted to determine if there was a relationship between attending the classes and a change in the number of cigarettes smoked at discharge. The 193 patients admitted in 2005 additionally attended four 1-hour motivational classes to encourage quitting smoking. Rates of attendance at the antismoking classes and smoking rates at discharge were again noted. Results: Smoking rates in 2004 (n = 194; 81%) and 2005 (n = 161, 83%), P = 0.43, were similar. Voluntary participation in antismoking classes increased from 40% to 64% (P < 0.001). There was a greater reduction in the number of cigarettes smoked between admission and discharge in the quality improvement period compared with the reference period (P = 0.025). In both years, attendance Lit antismoking classes was strongly associated with quitting, P < 0.001. Of those who attended antismoking classes, 133 (74%) reported a reduction in smoking compared with only 27 (15%) of those who declined to attend, P < 0.001. Among smokers, nonattendance of antismoking classes was associated with increased likelihood of having all irregular discharge, P < 0.001. Conclusion: This study suggests the benefit of relatively brief, Specific educational efforts to increase motivation to quit smoking in this high-use population.