Gass JC, et al. - The physicians aimed to investigate the characteristics and clinical treatment of tobacco smokers in substance use disorders (SUD) clinics. It was noted that Veterans were at least considering quitting smoking while they were enrolled in substance use treatment. It was also found that cigarette smokers presented with greater impairment due to substance use, suggesting that this subgroup was of particular high need. They discussed specific treatment recommendations, including how behavioral health providers in SUD clinics could display better capitalization on the patients' moderate motivation to quit at intake.

• The physicians examined data from veterans enrolled in outpatient treatment for a SUD to evaluate for general characteristics of smokers as compared to non-smokers as well as to examine motivation to quit smoking.
• They used baseline (i.e., pre-treatment) data from 277 Veterans.
• They reviewed charts of smokers in the SUD clinic (SUDC) to evaluate how smoking was handled by SUDC providers, and if smokers attempted cessation.

• 163 (59%) SUDC patients reported that they currently smoke cigarettes (M = 16.3 cigarettes per day, SD = 11.1) among the 277 patients.
• In the clinic, smokers reported greater general impairment than nonsmokers on the Short Index of Problems, F(1248) = 8.9, p = 0.003, as well as greater specific impairment: Physical Problems, F(1258) = 13.5, p = 0.000; Interpersonal Problems, F(1262) = 5.6, p = 0.019; Intrapersonal Problems, F(1260) = 6.5, p = 0.011, and Social Responsibility, F(1262) = 14.7, p = 0.000.
• Compared to their non-smoking counterparts, smokers in the sample were marginally more anxious as measured by the GAD-7, F(1254) = 4.6, p = 0.053, though they were not significantly more depressed (p = 0.19).
• Regarding quitting smoking, smokers reported moderate levels of importance (M = 5.4, SD = 3.1), readiness (M = 5.6, SD = 3.2), and confidence (M = 5.0, SD = 3.0), on a 1-10 scale.
• Review of smokers' medical records revealed that while SUDC providers evaluated tobacco use at intake (90%) and offered treatment (86.5%), a substantially small portion of smokers attempted cessation (41.1%) while enrolled in SUDC.
• Furthermore, no patients were enrolled in smoking-specific behavioral interventions while in SUDC, though 78 patients obtained nicotine replacement or another smoking cessation medication (41% were prescribed by a SUDC provider).