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Training in Tobacco Treatments in Psychiatry: A National Survey of Psychiatry Residency Training Directors

Received November 15, 2005; revised January 10, 2006; accepted February 1, 2006. Drs. Prochaska, Jacobs, and Hall are affiliated with the Department of Psychiatry, University of California, San Francisco, California. Dr. Louie is affiliated with San Mateo County Mental Health Services, San Mateo, California, and the University of California, San Francisco, California. Dr. Fromont is affiliated with Alta Bates Summit Medical Center, Berkeley, California, and the University of California, San Francisco, California. Address correspondence to Dr. Prochaska, 401 Parnassus Avenue - TRC 0984, San Francisco, CA 94143; JProchaska{at}LPPI.UCSF.EDU (E-mail). Copyright © 2006 Academic Psychiatry.

OBJECTIVE: Nicotine dependence is the most prevalent substance abuse disorder among adult psychiatric patients and is a leading cause of death and disability. This study examines training in tobacco treatment in psychiatry residency programs across the United States. METHOD: The authors recruited training directors to complete a survey of their program’s curriculum related to tobacco treatment, attitudes related to treating tobacco in psychiatry, and perceptions of residents’ skills for addressing nicotine dependence in psychiatric patients. RESULTS: Respondents were representative of the national pool. Half of the programs provided training in tobacco treatments for a median duration of 1 hour. Content areas covered varied greatly. Programs with tobacco-related training expressed more favorable attitudes toward addressing tobacco in psychiatry and were more likely to report confidence in their residents’ skills for treating nicotine dependence. Programs without tobacco training reported a lack of faculty expertise on tobacco treatments. Most training directors reported moderate to high interest in evaluating a model tobacco curriculum for psychiatry and stated they would dedicate an average of 4 hours of curriculum time. CONCLUSIONS: The findings demonstrate the need for and interest in a model tobacco treatment curriculum for psychiatry residency training. Training psychiatrists offers the potential of delivering treatment to one of the largest remaining groups of smokers: patients with mental disorders.

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