Prevalence of tobacco smoking and provision of tobacco treatment in an innovative low-threshold substance use disorder bridge clinic.

Abstract

Substance use disorder Bridge Clinics have been established across the country to increase access to addiction treatment and remove barriers to care. Bridge Clinics are innovative low-threshold treatment models designed to provide rapid access to addiction treatment and harm reduction services. It is not clear how tobacco use, or treatment, is handled in BCs and no work has characterized smoking prevalence nor provision of treatment services in this setting. We used health record data during Bridge Clinic encounters at Massachusetts General Hospital in Boston, Massachusetts from 2019 to 2023 (N = 1592 unique patients) to examine cigarette smoking prevalence, provision of tobacco treatment within our healthcare system, and subsequent quitting 12 months after the initial encounter. At the initial Bridge encounter, 66 % of patients were currently smoking tobacco, with the highest prevalence observed among those with any stimulant use disorder (80 %). Stimulant use disorder combined with opioid and alcohol use disorder was the combination with the highest smoking prevalence (84 %). Smoking prevalence increased with the number of substance diagnoses (OR: 1.36 per disorder; 95 % CI: 1.25-1.49). 60 days following the initial Bridge encounter, 18 % of patients received either nicotine replacement or varenicline. At 12-month follow-up, 9 % of patients with a documented quit status had quit smoking. Individuals seen for addiction treatment at a low-threshold Bridge Clinic, a population at high risk for overdose, are engaging with tobacco treatment. Provision of tobacco treatment is lower than what is observed in the general population and providers should increase evidence-based tobacco treatment provision.