Nicotine Dependence Underdiagnosed in U.S. Vets

Vets without diagnosis less likely to be diagnosed and treated

WEDNESDAY, Oct. 19 (HealthDay News) -- U.S. veterans are more likely than the general population to have a nicotine dependency, especially if they've struggled with other substances, mental illness, or homelessness, but VA services may be underestimating the scope of the problem, according to research published in the November issue of the U.S. Centers for Disease Control and Prevention's Preventing Chronic Disease.

Jack Tsai, Ph.D., of the VA New England Mental Health and Illness Research, Education, and Clinical Center in West Haven, Conn., and colleagues analyzed 5,031,381 users of VA health services to compare those diagnosed with a nicotine dependence with those who were not.

Administrative data recorded a nicotine dependence rate of 15 percent in users of VA services; however, recent studies puts that number as high as 26 percent, suggesting VA services may be underdiagnosing nicotine dependence. Those who struggled with substance abuse, other mental health problems, and homelessness were found to be at higher risk for nicotine dependence.

"Given that other studies have found higher rates of nicotine dependence among veterans, this risk behavior may be underdiagnosed in VA medical records. Veterans who are homeless or have mental health or substance abuse problems are at highest risk and should be targeted for smoking prevention and cessation interventions. These results support, in principle, efforts to integrate smoking cessation programs with mental health and homeless services," the authors write.

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