Substance Use Research Event (SURE 2021)

Title: Enhancing Evidence Based Tobacco Treatment in Community Mental Health Centers

Authors: Janet Otachi1 and Chizimuzo Okoli2

1 University of Kentucky College of Social Work

2 University of Kentucky College of Nursing

Purpose: Compared to the US general population, people with mental illnesses (MI) experience disparate rates of tobacco use and related burden due to gaps in tobacco treatment provision. Despite the existence of clinical guidelines for treating tobacco dependence, few providers in behavioral health settings deliver tobacco treatment. Though opportunities exist for enhancing tobacco-free environments and evidence-based tobacco treatment in behavioral health settings, few facilities in the US adopt such policies. Understanding factors that promote or hinder the delivery of evidence-based tobacco treatment in behavioral health settings is critical in guiding the development of tailored interventions to address tobacco use disparity and related burden in this vulnerable population. 

Methods: We administered an electronic survey to 14 community mental health centers (CMHCs) in Kentucky, to assess their existing tobacco control practices and capacity for evidence-based tobacco treatment. 

Results: 159 facilities from the 14 CMHCs responded to the survey. Though most facilities reported having a written policy restricting tobacco use (82.4%), few policies highlighted the impact of tobacco use on physical (18.2%) and mental health (8.8%). Though most facility providers asked their clients about tobacco use, fewer advised, assessed, assisted or arranged for tobacco treatment services.  

Conclusion: Our findings suggest that opportunities exist for supporting tobacco control policies and treatment practices in Kentucky CMHCs. With adequate support from behavioral health providers, tobacco users with MI are capable of successfully quitting their tobacco use. Therefore, opportunities for increasing provider delivery of evidence-based tobacco treatment in behavioral health settings should be encouraged and utilized. 

Poster

Potential Factors to Consider While Approaching Depressed Individuals Who Use Tobacco and Experienced  Childhood Adversities

Authors: Bassema Abu-Farsakh1, Okoli Chizimuzo1  

1 University of Kentucky College of Nursing 

Adverse childhood experiences (ACEs) impact the lives of more than 50% of individuals in the U.S. Moreover, it is one of the leading causes of adopting unhealthy behaviors such as tobacco use and reporting depression diagnosis.  

The eco-bio-developmental model helps explain the relationship between ACE, tobacco, and depression highlighted the crucial need to address ACEs among individuals with health problems associated with childhood trauma and suggested a bidirectional relationship between their outcomes.  

Purpose: This review aimed to address potential confounders that affect both depression and tobacco use among individuals with ACEs history. Identifying the variables may help the clinicians to emphasize on their impact while treating the affected individual. 

Methods: We conducted a comprehensive search for evidence from Psych info, CINAHL, PubMed that considered the relationship between ACEs, tobacco, and depression. 

Results: A total of 22 articles were selected to assess possible confounders between ACEs, tobacco use, and depression. Across these studies, researchers often treated age, gender, race/ethnicity, education, and marital status in the relationship between ACEs, tobacco, and depression as confounders. Moreover, other variables appeared necessary but less likely to be addressed among the identified evidence. These variables included: alcohol use, onset of tobacco use, post-traumatic stress disorder (PTSD)/traumatic life event/ being transferred from a child welfare agency, income/employment/living condition, perceived social support, body mass index, type of ACEs, sum score of ACEs, family wealth, and the state of living. 

Conclusion: Literature identified varies factors that affect both tobacco use and depression. Based on these findings, clinicians may need to keep these factors on their mind while approaching people who used tobacco, were diagnosed with depression, and reported ACEs. 

Poster