Mind Your Breath: The Added Value of  Carbon Monoxide Feedback and the  Community Reinforcement Approach  Provided as Part of a Tailored, Inpatient  Smoking Cessation Program for Patients with  Substance Use Disorder

Beijer, de, Ismay

Mind Your Breath: The Added Value of Carbon Monoxide Feedback and the Community Reinforcement Approach Provided as Part of a Tailored, Inpatient Smoking Cessation Program for Patients with Substance Use Disorder

Files

2021 Beijer IAE de s4730429 Master Thesis.pdf (504.67 KB)

Authors

Beijer, de, Ismay

Issue Date

2021-06-29

Language

en

URI

https://theses.ubn.ru.nl/handle/123456789/19698

Abstract

Despite the broad development and practice of smoking cessation programs (SCPs), relapse rates among smokers with substance use disorder (SUD) are prevailing (> 85%). Smokers with comorbid SUD smoke more heavily, have more failed cessation attempts for smoking and other substances, are more likely to die from smoking-related illnesses than smokers without comorbid SUD and are also more likely to experience a SUD relapse. Two potential enhancements to regular SCPs involve the Community Reinforcement Approach (CRA) and carbon monoxide (CO) biofeedback. The current study first evaluated a recently developed SCP offered by IrisZorg, a Dutch Institution in addiction care. The SCP includes pharmacotherapy, individual coaching, and CRA training. Second, the added value of CO-feedback to the SCP was investigated and thereupon participants were randomly assigned to the experimental (CO) or control (non-CO) condition. Measurements were completed at baseline, during two-week- and three-month follow-up. Lastly, experienced barriers and facilitators with regard to the SCP and the CO-feedback were explored using focus groups. Participants involved 37 tobacco smoking adults who were willing to quit or smoke less and received inpatient care. Results indicated mixed findings (significant decreases in cigarette use and motivation) depending on outlier-handling strategy. Throughout analyses, no differences were found across CO-conditions or nicotine dependence and craving. Qualitative exploration led to the identification of multiple barriers and facilitators and several suggestions for improvement of the SCP. Keywords: smoking cessation treatment, comorbid substance use disorder, carbon monoxide feedback, mixed-methods approach