Comorbidities Workgroup of the Society for Research on Nicotine and Tobacco (SRNT) Treatment Network
Wednesday, July 18, 2018
Posted by: Natalia Gromov
Alana M Rojewski, Steffani R Bailey, Steven L Bernstein, Nina A Cooperman, Ellen R Gritz, Maher A Karam-Hage, Megan E Piper, Nancy A Rigotti, Graham W Warren.
Comorbidities Workgroup of the Society for Research on Nicotine and Tobacco (SRNT) Treatment Network; Considering Systemic Barriers to Treating Tobacco Use in Clinical Settings in the United States.
Nicotine & Tobacco Research, nty123, https://doi.org/10.1093/ntr/nty123
The Comorbidity Workgroup of the Tobacco Treatment Research Network, within the Society for Research on Nicotine and Tobacco, previously highlighted the need to provide tobacco treatment to patients diagnosed with comorbid physical and mental health conditions. Yet, systemic barriers in the United States healthcare system prevent many patients who present for medical treatment from getting the evidence-based tobacco treatment that they need. The identified barriers include insufficient training in the epidemiologic impact of tobacco use, related disorders, and pharmacological and behavioral treatment approaches; misunderstanding among clinicians about the effectiveness of tobacco treatment; lack of therapeutic support from clinical staff; insufficient use of health information technology to improve tobacco use identification and treatment; and limited time and reimbursement for clinicians to provide treatment. We highlight three vignettes demonstrating the complexities of practical barriers at the healthcare systems level. We consider each of the barriers in turn and discuss evidence-based strategies that could be implemented in the clinical care of patients with comorbid conditions. In addition, in the absence of compelling data to guide implementation approaches, we offer suggestions for potential strategies and avenues for future research.
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