{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T03:59:57Z","timestamp":1781668797157,"version":"3.54.5"},"reference-count":23,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:00:00Z","timestamp":1768780800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:00:00Z","timestamp":1768780800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Addict"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Objectives<\/jats:title>\n                    <jats:p>Disproportionate use of tobacco among psychiatric patients exacerbates psychiatric symptoms, increases suicide risk, alters therapeutic drug levels, and negatively affects adherence. Patient\u2010directed discharge (PDD) rates are higher among patients who smoke, and smoking cessation treatments have been reported to reduce this risk. This study investigates the association of tobacco use and cessation treatments with PDD rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis was performed on a random sample of 25,829 adult patients admitted voluntarily to inpatient psychiatric facilities nationwide. Exclusion criteria included medical discharge, electroconvulsive therapy, hospital stays longer than 29 days, and incomplete demographic or smoking status data. Binary logistic regression with a Firth correction assessed the associations between PDD rates and smoking status, smoking cessation treatments, demographic variables, comorbidities, and smoking use patterns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Smoking was significantly associated with an increased likelihood of PDD (\u03c7\u00b2\u2009=\u200949.42,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.0001, OR\u2009=\u20092.16). Nicotine replacement therapy (NRT) alone significantly reduced PDD rates (\u03c7\u00b2\u2009=\u20098.16,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.01, OR\u2009=\u20091.42), whereas bupropion and varenicline did not show significant effects. Smoking\u2010related PDD rates remained elevated despite treatment compared to non\u2010smokers (\u03c7\u00b2\u2009=\u200922.02,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.0001, OR\u2009=\u20091.86).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion and Conclusions<\/jats:title>\n                    <jats:p>A significant association was found between smoking status and PDD rate. NRT alone was associated with lower PDD rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Scientific Significance<\/jats:title>\n                    <jats:p>This study is the first to investigate the association of individual smoking cessation treatments with PDD rates. Contrary to previous findings, the risk remained elevated despite treatment in our large national sample.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ajad.70107","type":"journal-article","created":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T04:27:58Z","timestamp":1768883278000},"page":"489-495","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Nicotine use and patient\u2010directed discharge rate in psychiatric inpatients: A retrospective cohort"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9822-9342","authenticated-orcid":false,"given":"Steven","family":"Sprenger","sequence":"first","affiliation":[{"name":"TriStar Centennial Medical Center, Department of Psychiatry Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robyn","family":"Meadows","sequence":"additional","affiliation":[{"name":"HCA Healthcare Brentwood Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivia","family":"Gawrych","sequence":"additional","affiliation":[{"name":"TriStar Centennial Medical Center, Department of Psychiatry Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,19]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjms.2023.04.007"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1520\/JFS15576J"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11126-019-09671-y"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.55.11.1265"},{"key":"e_1_2_8_6_1","unstructured":"GeneralS. The Health Consequences of Smoking\u201450 Years of Progress: a Report of the Surgeon General. US Department of Health and Human Services. Citeseer;\u00a02014. Accessed February 24 2025.https:\/\/www.cdc.gov\/tobacco\/data_statistics\/sgr\/50th-anniversary\/index.htm"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6845a2"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2009.188136"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.4790"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.abrep.2020.100255"},{"issue":"5","key":"e_1_2_8_11_1","article-title":"Pharmacological interventions for smoking cessation: an overview and network meta\u2010analysis","volume":"2013","author":"Cahill K","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_12_1","unstructured":"United States Public Health Service Office of the Surgeon General National Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health. Smoking Cessation: a Report of the Surgeon General. US Department of Health and Human Services; 2020. Accessed February 24 2025.http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK555591\/"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2010.02946.x"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRA.0000000000000764"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2013.09.014"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1080\/17476348.2017.1361823"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.2020.68"},{"issue":"3","key":"e_1_2_8_18_1","article-title":"Smoking cessation for improving mental health","volume":"3","author":"Taylor GM","year":"2021","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-011045"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1124\/jpet.102.033852"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S1121"},{"key":"e_1_2_8_22_1","unstructured":"Label: WELLBUTRIN SR\u2010 bupropion hydrochloride tablet film\u2010coated. Package Insert. Published online April 22 2024. Accessed March 18 2025.https:\/\/dailymed.nlm.nih.gov\/dailymed\/drugInfo.cfm?setid=cbc8c074-f080-4489-a5ae-207b5fadeba3"},{"key":"e_1_2_8_23_1","unstructured":"Label: CHANTIX\u2010 varenicline tartrate tablet film\u2010coated. Published online January 8 2025. Accessed March 18 2025.https:\/\/dailymed.nlm.nih.gov\/dailymed\/drugInfo.cfm?setid=f0ff4f27-5185-4881-a749-c6b7a0ca5696"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1176\/ps.2006.57.8.1192"}],"container-title":["The American Journal on Addictions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajad.70107","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ajad.70107","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajad.70107","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T03:45:51Z","timestamp":1781667951000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ajad.70107"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,19]]},"references-count":23,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1111\/ajad.70107"],"URL":"https:\/\/doi.org\/10.1111\/ajad.70107","archive":["Portico"],"relation":{},"ISSN":["1055-0496","1521-0391"],"issn-type":[{"value":"1055-0496","type":"print"},{"value":"1521-0391","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,19]]},"assertion":[{"value":"2025-04-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}