Sex and Tobacco Use in Service Discontinuation in Rural Primary Care Settings

Purpose: Screening, brief intervention and referral to treatment in Alabama (SBIRT) integrates alcohol and substance use screenings in health care clinics in western Alabama. This study explores the relationships between sex and tobacco use with discontinuation of SBIRT services. Method: Risk for alcohol and substance consumption was measured using the United States Alcohol Use Disorders Identification Test (US-AUDIT) and the Drug Abuse Screening Test (DAST-10). A convenience sample of 112 patients was utilized. A multivariable Bayesian binary regression model was estimated to determine risk factors for discontinuation. Results: Overall, 64 (58.20%) individuals chose to discontinue services following their screening. Male tobacco users with positive screens for risky alcohol and/or drug use were more likely to discontinue services than non-tobacco users (aOR = 2.57, 95% CI = 1.11, 5.54). Discussion/Conclusion: SBIRT programs may need to address engagement and interventions specifically around tobacco use in relation to risky alcohol and substance use. Gender differences may reflect the need for individualized interventions.