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Volume 27
Issue 1
January 2025
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AN OPT-OUT TOBACCO TREATMENT GROUP INTERVENTION WITHIN AN INTENSIVE SUBSTANCE
USE DISORDERS TREATMENT PROGRAM: INITIAL OUTCOMES IN THE VETERANS HEALTH
ADMINISTRATION

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Stephanie Bertucci, MSW,
Stephanie Bertucci, MSW
Minneapolis Veterans Affairs Health Care System (MVAHCS), Patient Advocacy
Program
,
Minneapolis, MN
,
USA
Corresponding Author: Stephanie Bertucci, MSW, MVAHCS, One Veterans Dr.,
Minneapolis, MN 55417, USA. Telephone: 612-467-1109; E-mail:
stephanie.bertucci@va.gov
  https://orcid.org/0000-0002-8016-1001
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Erica Schultz, PharmD,
Erica Schultz, PharmD
Veterans Integrated Service Networks (VISN) 23 Midwest Health Care Network
(MVAHCS)
,
Eagan, MN
,
USA
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Brittany Stevenson, PhD,
Brittany Stevenson, PhD
Minneapolis Veterans Affairs Health Care System (MVAHCS), Clinical Investigators
Team
,
Minneapolis, MN
,
USA
Department of Psychiatry and Behavioral Sciences, University of Minnesota
,
Minneapolis, MN
,
USA
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Steven S Fu, MD
Steven S Fu, MD
Minneapolis Veterans Affairs Health Care System (MVAHCS), Primary Care
,
Minneapolis, MN
,
USA
Center for Care Delivery and Outcomes Research
,
Minneapolis, MN
,
USA
Department of Medicine, University of Minnesota Medical School Minneapolis
,
MN
,
USA
  https://orcid.org/0000-0002-2246-9825
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Nicotine & Tobacco Research, Volume 27, Issue 1, January 2025, Pages 12–17,
https://doi.org/10.1093/ntr/ntae134
Published:
31 May 2024
Article history
Received:
28 August 2023
Revision received:
17 May 2024
Accepted:
27 May 2024
Published:
31 May 2024
Corrected and typeset:
23 June 2024

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   Stephanie Bertucci, Erica Schultz, Brittany Stevenson, Steven S Fu, An
   Opt-out Tobacco Treatment Group Intervention Within an Intensive Substance
   Use Disorders Treatment Program: Initial Outcomes in the Veterans Health
   Administration, Nicotine & Tobacco Research, Volume 27, Issue 1, January
   2025, Pages 12–17, https://doi.org/10.1093/ntr/ntae134
   
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ABSTRACT

Introduction

Despite steadily declining rates of tobacco use in the United States,
individuals suffering from substance use disorders (SUD) and other mental
illnesses continue to use tobacco at alarmingly high rates, resulting in
increased mortality. Given the synergistic consequences to those who suffer from
both tobacco use disorders (TUD) and other SUD, embedding tobacco treatment into
structured SUD programs using an opt-out approach may yield a greater impact.
The current study compares clinical outcomes (ie, quit attempts and prescription
of tobacco cessation medications) for an opt-out versus opt-in approach to
tobacco treatment.

Aims and Methods

Tobacco use information was collected prior to and after implementation of an
opt-out, eight-session, tobacco group treatment intervention. Patient
self-report and medical chart review were utilized to identify individuals who
began a tobacco cessation medication during treatment as well as those who
reported quitting tobacco, defined as sustained tobacco abstinence for at least
7 days. The analysis includes a total of N = 332 Veterans who enrolled in the
intensive outpatient program.

Results

Those enrolled in the opt-out tobacco treatment group reported a significantly
higher rate of quitting tobacco (24.57%) than those in the opt-in group (2.55%;
p < .001). Likewise, the opt-out group was prescribed tobacco cessation
medications at a significantly higher rate than the opt-in group (55.00%
compared to 14.65%; p < .001).

Conclusions

An opt-out treatment approach to TUD in SUD treatment settings produced improved
outcomes, including significantly more patients engaged in TUD treatment and a
higher overall rate of SUD treatment completion.

Implications

Given the disproportionately high rate of tobacco use among those seeking
treatment for SUD, enhanced tobacco cessation interventions could result in both
improved tobacco as well as other substance use outcomes. The implementation of
an opt-out tobacco treatment intervention embedded into SUD programming is
supported by our findings of reduced tobacco use among patients.

Topic:
 * smoking cessation
 * tobacco
 * veterans
 * treatment outcome
 * tobacco use
 * substance use disorders

Issue Section:
Original Investigations

Published by Oxford University Press on behalf of the Society for Research on
Nicotine and Tobacco 2024.
This work is written by (a) US Government employee(s) and is in the public
domain in the US.



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