Combining tobacco cessation with
other substance use treatment
increases patients’ likelihood of
quitting, said Dr. Kim Hamlett-Berry, who directs the Tobacco
and Health Policy Office in the
Department of Veterans Affairs.
redouble their efforts to reach out to these groups, said Clark.
“What we need from psychology is more targeted, specific
strategies to help these communities,” he said.
Researchers have documented many effective measures for
reducing tobacco use, said Shane Davis, PhD, of the Centers for
Disease Control and Prevention. Comprehensive, smoke-free
policies for workplaces, restaurants and bars are particularly
effective, with research showing that such laws reduce smoking-related heart attacks and have no adverse economic impact on
restaurants or bars. But even given this evidence, only 25 states
have a comprehensive smoke-free air law, Davis said.
Government regulations can also reduce smoking by
raising prices through tax increases, with every 10 percent
price increase leading to a 4 percent drop in adult cigarette
consumption. High prices are particularly effective in keeping
adolescents from starting the habit, Davis said.
An effective way to encourage people to quit is to arouse
strong negative emotions in smokers — a fact that has
underpinned the CDC’s hard-hitting $54 million advertising
campaign, which showed former smokers coping with serious
consequences of smoking such as paralysis from strokes,
heart attacks and limb amputations. The number of calls to
1-800-QUIT-NOW, a free national tobacco cessation call center,
doubled when the campaign ran last spring, Davis said.
At the same time, federal legislators must limit advertising by
”You must make what you’re doing interesting and connect with your audience,” said Dr. Felipe Gonzalez Castro, director of the health psychology program at the University of Texas at El Paso.
Photos by Nick Crettier
cigarette companies, she added. Cigarette companies have been
targeting minority and low-income populations through direct
mail, by sponsoring social and cultural events, and in display
advertising — areas that are all largely unregulated, she noted.
Hard to reach groups
While these measures reduce smoking among the general
population, they may not reach some of America’s heaviest
smokers: people with mental illness. Psychiatric patients smoke
two to four times more than mentally healthy smokers, said
Kim Hamlett-Berry, PhD, who directs the Tobacco and Health
Policy Office in the Department of Veterans Affairs. As a
result, those with psychiatric illness are more likely to die from
smoking-related diseases than from complications from their
mental illness or substance use disorders, she said.
People with alcohol dependence and other substance use
disorders also smoke at higher rates. In fact, 50 percent of
people treated for alcohol dependence end up dying from
smoking-related diseases, researchers have found.
“Many clinicians believe that we can’t be taking away
smoking from these populations because they will replace them
with more harmful substances,” Hamlett-Berry said. However,
research shows that combining smoking cessation with
substance use treatment increases patients’ likelihood of success
by 25 percent.
To address these concurrent problems, VA treatment centers
have instituted and integrated smoking-cessation programs into