Substance use and smoking cessation: Results of a qualitative systematic review
Sarah Gentry, Jean Craig, Richard Holland and Caitlin Notley
Dr Sarah Gentry Academic Foundation Doctor, Norwich Medical School, University of East Anglia
Dr Caitlin Notley Lecturer in Mental Health & Society for the Study of Addiction Research Fellow, Norwich Medical School, University of East Anglia
Most people in treatment/recovery for substance misuse also smoke tobacco. Many express a desire to quit and there is evidence for effective interventions that also improve substance misuse outcomes, yet smoking cessation interventions are rarely offered. This study reviews qualitative literature on barriers and facilitators to smoking cessation and perceptions of patients and professionals about timing of interventions and impact on treatment/recovery from other substances.
Eight databases were systematically searched and a thematic synthesis of published qualitative data performed.
10,939 titles were screened. 20 papers reporting on 19 studies were included.
Key themes include: contrasting perceptions of the effect of smoking cessation on recovery, with some reports that both together is ‘too much’ and could jeopardise treatment, and others that addictions are interlinked and complete lifestyle change beneficial. Many service users were motivated for smoking cessation but perceived limited support from professionals. Professionals were concerned about effects of offering smoking cessation on the therapeutic relationship and insufficient training, time, leadership, facilitative organisational culture, clear referral pathways and funding.
Findings suggest openness to provision of smoking cessation interventions among people in substance misuse treatment/recovery, but timing of delivery, and barriers and facilitators to success must be considered when developing interventions.
Dr Sarah Gentry is an Academic Foundation Doctor. Her research interests include evidence synthesis, substance misuse with a particular interest in smoking cessation, eHealth and the care of people living with human immunodeficiency virus (HIV).
Dr Caitlin Notley is a Lecturer in Mental Health and a Research Fellow of the Society for the Study of Addiction. She has an expertise in qualitative methods. Her current programme focuses on tobacco smoking relapse prevention, where she has led a qualitative study alongside an HTA funded trial and a systematic review of barriers and facilitators for smoking relapse prevention amongst postpartum women. As part of her SSA fellowship she is exploring relapse prevention for particularly vulnerable and at risk groups and has a related research interest in e cigarette use.