Abstract A003: Group tobacco education at short- and long-term substance use disorder programs
Authors: Lathan Christopher S. , Jackson Rebecca K. 
Published: August 2020

Background: The use of tobacco remains the main cause of preventable disease and death in the United States, with 37.8 million American adults still smoking in 2016. Dana-Farber Cancer Institute's Cancer Care Equity Program (CCEP) hired a Community Health Educator (CHE) to implement a tobacco education program in conjunction with CCEP's lung cancer screenings and smoking cessation counseling. This entailed completing Tobacco Treatment Specialist Training and developing an education curriculum in English and Spanish. In May 2016, CCEP met with a Federally Qualified Health Center (FQHC) in Roxbury, MA, to begin integrating tobacco education for some of their behavioral health programs focused on Substance Use Disorder (SUD). Despite a 5% reduction in the number of smokers since 2005, the rate of active smokers among SUD patients remains higher than that of the general adult population. From 2009 to 2011, adults with SUD represented 8.7% of the population yet used 18.2% of all cigarettes smoked by adults.

Methods: Information on the health impacts of tobacco when combined with alcohol and other substances, as well as the impact of tobacco on long-term abstinence, was added to the curriculum to reflect the needs of SUD patients. Two additional local cessation counseling programs were added to reflect where the patients received medical treatment. A bilingual flyer for the FQHC's smoking cessation program was distributed to staff and during the group to facilitate referrals. The weekly groups began at the two-week Acute Treatment Services (ATS) program and expanded monthly to four long-term residential recovery programs.

Results: A total of 67 groups were conducted reaching 1,074 individuals. The majority (50) of the groups were conducted at ATS, which serves a patient population not limited to Boston, limiting the ability of the CHE to provide referrals to local cessation counseling programs. However, nicotine replacement therapy medications were available for interested patients. In the residential programs, the patients had established providers, allowing for more referrals to cessation counseling. Preliminary results indicate that although most individuals were familiar with and had used pharmacotherapy in the past, few had considered cognitive and behavioral treatment strategies to quit smoking. These include precessation treatment options, self-monitoring of smoking behaviors, self-management skills, urge coping strategies, maximizing support for nonsmoking, relapse prevention strategies, dealing with slips, and lifestyle balance.

Conclusion: Despite the high number of patients with knowledge of the health effects of smoking and pharmacotherapy options, the groups illustrated a need for cognitive and behavioral treatment strategies among SUD treatment patients. Additionally, further evaluation in the form of a post-survey is needed to assess attitudes about the curriculum content and its effectiveness, given the challenges in documenting referrals to cessation counseling services.

Citation Format: Christopher S. Lathan, Rebecca K. Jackson. Group tobacco education at short- and long-term substance use disorder programs [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A003.