Best practice for tobacco smoking policies within an acute substance use disorder care facility: considerations from a withdrawal management setting in British Columbia, Canada.

IF 4 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Natasha Caton, Mark Lysyshyn, Nicole Cowan, Evan Wood
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引用次数: 0

Abstract

Smoking-related illness has historically been a major cause of death in persons with substance use disorders. Smoking cessation has the potential to support improved substance use disorder outcomes, as well as improved physical and mental health outcomes in persons receiving other substance use disorder treatment. However, tobacco abstinence-oriented policies within substance use disorder care settings may create barriers to clients who are uninterested in quitting smoking being able to access other potentially lifesaving substance use disorder treatment. In British Columbia, where the drug toxicity crisis has become the leading cause of unnatural death, reducing barriers to accessing substance use disorder treatment is a key public health priority. We present a reflection on considerations from a withdrawal management setting of a smoking policy change within that facility and review the potential benefits and harms of permissive smoking policies within substance use disorder care environments. Benefits include the elimination of a barrier to accessing other substance use treatment, patient autonomy over participation in smoking cessation treatment and the potential for less covert smoking and associated risks. Risks include ongoing physical and mental health harms of smoking, potentially poorer other substance use treatment outcomes, risks of tobacco relapse to other clients and secondhand smoke exposure to staff and other clients. Further research will be needed to explore the impacts of this policy change and evaluate the potential role for other smoking cessation innovations, including expansion of nicotine replacement options such as provision of nicotine electronic cigarette devices.

急性物质使用障碍护理机构内吸烟政策的最佳实践:来自加拿大不列颠哥伦比亚省戒断管理设置的考虑。
吸烟相关疾病历来是物质使用障碍患者死亡的主要原因。戒烟有可能支持改善物质使用障碍的结果,并改善接受其他物质使用障碍治疗的人的身心健康结果。然而,在物质使用障碍护理环境中,以烟草戒断为导向的政策可能会对那些对戒烟不感兴趣的客户造成障碍,使他们无法获得其他可能挽救生命的物质使用障碍治疗。在不列颠哥伦比亚省,药物毒性危机已成为非自然死亡的主要原因,减少获得药物使用障碍治疗的障碍是一项关键的公共卫生优先事项。我们提出了对该设施内吸烟政策改变的戒断管理设置的考虑,并审查了在物质使用障碍护理环境中允许吸烟政策的潜在利益和危害。益处包括消除获得其他药物使用治疗的障碍,患者自主参与戒烟治疗,以及减少隐蔽吸烟和相关风险的可能性。风险包括吸烟对身心健康的持续危害、可能较差的其他药物使用治疗结果、对其他客户的烟草复发风险以及对工作人员和其他客户的二手烟暴露。需要进一步的研究来探索这一政策变化的影响,并评估其他戒烟创新的潜在作用,包括扩大尼古丁替代选择,如提供尼古丁电子烟装置。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Tobacco Control
Tobacco Control 医学-公共卫生、环境卫生与职业卫生
CiteScore
9.10
自引率
26.90%
发文量
223
审稿时长
6-12 weeks
期刊介绍: Tobacco Control is an international peer-reviewed journal covering the nature and consequences of tobacco use worldwide; tobacco''s effects on population health, the economy, the environment, and society; efforts to prevent and control the global tobacco epidemic through population-level education and policy changes; the ethical dimensions of tobacco control policies; and the activities of the tobacco industry and its allies.
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