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Tobacco Use and Health-Related Quality of Life (HRQoL) Among Clients in Substance Use Disorders Treatment

Health-related quality of life (HRQoL) is a measure of those aspects of overall quality of life that can be clearly shown to affect health, either physical or mental. In that way, it serves as a subjective assessment of the burden of disease and can be used to evaluate patient-centered outcomes.

In substance use disorder (SUD) research, HRQoL has been proposed as a measure of the negative impacts of substance use across life domains, as a way to identify subjective experiences important to clients, and as an assessment of recovery beyond substance use outcomes.

This study, conducted in 24 SUD treatment programs affiliated with the NIDA Clinical Trials Network (10 residential, 7 outpatient, 7 methadone maintenance), used HRQoL to examine relationships of smoking status and tobacco-related variables among clients in substance use disorder treatment.

Participants (N=2,068, 46.6% female) completed surveys reporting demographics, smoking status, and past-month days they experienced physical and/or mental health distress.

Current smokers (n=1,596; 77.2% of sample) answered questions on tobacco-related variables (smoking status, nicotine dependence, menthol smoking, electronic-cigarette use, health concerns, and cost as reasons affecting reducing/quitting smoking with HRQoL in four categories:

  • good health,
  • physical health distress,
  • mental health distress, or
  • both physical and mental health distress.

Current smokers were significantly more likely than former smokers to report frequent physical and mental health distress than good health, as were smokers with higher nicotine dependence.

Smokers reporting both frequent physical and mental health distress were more sensitive to cigarettes’ cost, and less likely to use e-cigarettes.

Conclusions: Findings of poor HRQoL among nicotine-dependent smokers with additional SUDs strengthen the imperative to provide smoking cessation interventions in addiction treatment. These clients experience poor subjective well-being, which may have a reciprocal relationship with smoking and substance use, impacting treatment progress. If smoking cessation treatment is provided and smoking cessation can be achieved, it may have a positive impact on clients’ HRQoL which, in turn, may mediate improved substance use disorder treatment outcomes as well.

Citation: Campbell BK, Yip D, Le T, Gubner NR, Guydish JR. Relationship Between Tobacco Use and Health-Related Quality of Life (HRQoL) Among Clients in Substance Use Disorders Treatment. Journal of Psychoactive Drugs 2018 (in press).

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