Subjects with military-related PTSD had integrated approach or referral to VA smoking cessation
Tuesday, December 7, 2010 (Last Updated: 12/08/2010)
TUESDAY, Dec. 7 (HealthDay News) -- Incorporating smoking cessation treatment into mental health care may improve abstinence rates for people with military-related posttraumatic stress disorder (PTSD) compared to referral to specialized cessation treatment, according to research published in the Dec. 8 issue of the Journal of the American Medical Association.
Miles McFall, Ph.D., of the Veterans Affairs (VA) Puget Sound Health Care System in Seattle, and colleagues analyzed data from 943 smokers with military-related PTSD who utilized VA outpatient PTSD clinics. Participants were randomized to receive smoking cessation treatment integrated into mental health care for PTSD or referral to VA smoking cessation clinics.
The researchers found that those in integrated care had better abstinence at 12 months (8.9 versus 4.5 percent, for an adjusted odds ratio of 2.26), which was the primary outcome. Seven-day point prevalence abstinence remained significantly different between the groups at 18 months (18.2 versus 10.8 percent). The number of counseling sessions subjects received and the number of days they used cessation medication explained 39.1 percent of the treatment effect.
"This multisite trial, with the advantages of large sample size and enhanced external validity, represents a significant advance in the evidence base on the effectiveness of treating tobacco dependence in smokers with mental disorders and integration of tobacco treatment services into mental health care settings. Critically, integrated care treatments are needed to reverse the clinical practices that have served to maintain the high rates of tobacco use and tobacco-related morbidity and mortality among individuals with mental illness," writes the author of an accompanying editorial.
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