Improved rates of treatment success following alcohol and other drug treatment among clients who quit or reduce their tobacco smoking

Introduction and Aims: Alcohol and other drug (AOD) treatment seekers who smoke tobacco are more likely to die of tobacco-related causes than those attributable to their primary drug of concern (PDOC), yet smoking cessation is frequently overlooked in the context of AOD treatment settings. We explored rates of AOD treatment success among participants who quit or continued smoking 12 months after initiating AOD treatment. Design and Methods: Secondary analysis of data from a prospective multisite naturalistic outcome study of 559 smokers recruited from 21 publicly funded specialist AOD services as part of the Patient Pathways National Project. Results: Only 7.1% of participants successfully quit smoking at 12-month follow-up; however, doing so was associated with a 30% increase in treatment success (i.e. reliable reductions in use of their PDOC) (χ² = 8.74, P = 0.003) and a 21% reduction in the severity of PDOC dependence (χ² = 4.559, P = 0.033). Furthermore, those who did not nominate tobacco as a drug of concern reported demographic characteristics indicative of greater social disadvantage. Discussion and Conclusions: Despite low overall rates of smoking cessation, our findings suggest clients who do successfully quit have a greater likelihood of achieving reductions in PDOC use and dependence severity. These results reinforce efforts to promote more comprehensive, routine provision of smoking cessation care (i.e. counselling and nicotine replacement therapy). AOD treatment presents a crucial opportunity to deliver smoking cessation care to all clients who smoke, particularly those who are unconcerned about their use, as this group may stand to benefit most.