HERLab awarded 4-year grant to study the effect of smoking policies on tobacco use among individuals with substance use disorders.

Dr. Benjamin Lê Cook, and other members of the CHA’s Health Equity Research Lab (HERLab) team, have been awarded a four-year grant by the National Institute of Health/National Cancer Institute to study the effect of smoking policies on tobacco use among individuals with substance use disorders.  

The rates of smoking among those with substance use disorders (SUDs; encompassing both illicit drug and alcohol use disorders) are 2-4 times greater than the general population, and have not declined at the same rate as the general population over the last two decades. Smokers with SUD are at higher risk for cancer and smoking-related complications, with mortality rates four times higher than non-smokers with SUD. This study assesses whether tobacco cessation policies (anti-tobacco campaigns, taxes, insurance coverage of tobacco dependency treatment (TDT)) that have been successful in the general population have the same impact on individuals with substance use disorder.  

In treatment settings, nicotine dependence is commonly dismissed as a lower priority than substance dependence. We also use multiple nationally representative datasets and Medicaid claims data to test a competing hypothesis that smoking cessation, in addition to improving smoking-related outcomes, is also linked to the successful treatment of substance use disorders.

There are three main aims for this research project:

1) Testing the effect of Medicaid tobacco dependence treatment (TDT) coverage on initiation and maintenance of TDT and on quitting smoking among Medicaid beneficiaries with SUD.

2) Testing the effect of increasing cigarette excise taxes on the intensity of smoking and smoking cessation in a broader national sample of individuals with SUD.

3) Assessing the combined effects of TDT and tax policies on tobacco use among Medicaid beneficiaries with SUD.

This project was developed in collaboration with state tobacco control managers and integrated behavioral health providers, and includes a dissemination plan that lays the groundwork for actionable policy changes.