{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T19:33:58Z","timestamp":1777750438001,"version":"3.51.4"},"reference-count":15,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2017,9,18]],"date-time":"2017-09-18T00:00:00Z","timestamp":1505692800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J Soc Psychiatry"],"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The prevalence of smoking among mental health and addiction (MHA) patients is 3 times higher than it is in the general population, yet this patient population has received little help to combat smoking. Considering this, psychosocial care centers (CAPS \u2013 Centros de Aten\u00e7\u00e3o Psicossocial) are strategic locations for integrating tobacco dependence treatment (TDT) into existing treatment activities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Our team provided an 8-hour training package to the staff of CAPS that have not been providing specialized TDT for smokers. Our curriculum included the following topics focused on the implementation of treatment for MHA smokers: management, epidemiology, medications, psychotherapy, and smoking\/mental health assessment instruments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Our team trained the staff of 17 CAPS units within 10 cities \u2013 which included more than 186 health professionals. There were many barriers encountered as we provided this training. A summary of problems we faced were as follows: resistance to incorporating TDT in addiction\/mental health-care units, resistance to the implementation of cognitive-behavioral therapy (CBT) (psychodynamic therapy and harm reduction were preferred) and treatment for smoking is already implemented in primary care network; resistance to the use of medication in addiction treatment (a preference for psychotherapy and psychosocial approach).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>We learned a number of important lessons as we worked to improve the delivery of TDT to MHA patients in Brazil: provide clinicians an opportunity to explore how they feel\/think about providing TDT to their clients at the very outset of the training, rather than focusing on a specific type of behavioral therapy for TDT (such as CBT), which some may find objectionable; use more generic descriptions of behavioral therapy such as \u2018supportive counseling\u2019; include training professionals who are open to other forms of behavioral therapy in addition to psychoanalysis and discuss the important impact that MHA units can have in improving the quality of life for their patients who smoke.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0020764017731462","type":"journal-article","created":{"date-parts":[[2017,9,18]],"date-time":"2017-09-18T06:58:26Z","timestamp":1505717906000},"page":"669-673","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":14,"title":["Implementing evidence-based smoking cessation treatment in psychosocial care units (CAPS) in Brazil"],"prefix":"10.1177","volume":"63","author":[{"given":"Jo\u00e3o Mauricio","family":"Castaldelli-Maia","sequence":"first","affiliation":[{"name":"Global Bridges: Healthcare Alliance for Tobacco Dependence Treatment, Rochester, MN, USA"},{"name":"ABC Center for Mental Health Studies, Santo Andr\u00e9, Brazil"},{"name":"Department of Neuroscience, Medical School, Funda\u00e7\u00e3o do ABC, Santo Andr\u00e9, Brazil"},{"name":"Department of Psychiatry, Medical School, University of S\u00e3o Paulo, S\u00e3o Paulo, Brazil"},{"name":"Clima Clinic, S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nilson R","family":"da Silva","sequence":"additional","affiliation":[{"name":"Global Bridges: Healthcare Alliance for Tobacco Dependence Treatment, Rochester, MN, USA"},{"name":"Department of Neuroscience, Medical School, Funda\u00e7\u00e3o do ABC, Santo Andr\u00e9, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta RD","family":"Campos","sequence":"additional","affiliation":[{"name":"Global Bridges: Healthcare Alliance for Tobacco Dependence Treatment, Rochester, MN, USA"},{"name":"ABC Center for Mental Health Studies, Santo Andr\u00e9, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helena F","family":"Moura","sequence":"additional","affiliation":[{"name":"Global Bridges: Healthcare Alliance for Tobacco Dependence Treatment, Rochester, MN, USA"},{"name":"CAPS-AD Guar\u00e1, Bras\u00edlia, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gustavo","family":"Zabert","sequence":"additional","affiliation":[{"name":"Global Bridges: Healthcare Alliance for Tobacco Dependence Treatment, Rochester, MN, USA"},{"name":"Universidad Nacional del Comahue, Neuqu\u00e9n, Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beatriz M","family":"Champagne","sequence":"additional","affiliation":[{"name":"Global Bridges: Healthcare Alliance for Tobacco Dependence Treatment, Rochester, MN, USA"},{"name":"InterAmerican Heart Foundation, Dallas, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine E","family":"Kemper","sequence":"additional","affiliation":[{"name":"Global Bridges: Healthcare Alliance for Tobacco Dependence Treatment, Rochester, MN, USA"},{"name":"Mayo Clinic, Rochester, MN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J Taylor","family":"Hays","sequence":"additional","affiliation":[{"name":"Global Bridges: Healthcare Alliance for Tobacco Dependence Treatment, Rochester, MN, USA"},{"name":"Mayo Clinic, Rochester, MN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2017,9,18]]},"reference":[{"key":"bibr1-0020764017731462","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2011.06.007"},{"key":"bibr2-0020764017731462","volume-title":"II Relat\u00f3rio Final do III Inqu\u00e9rito Nacional ao Consumo de Subst\u00e2ncias Psicoativas na Popula\u00e7\u00e3o Geral, Portugal 2012","author":"Balsa 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