The Impact of Stress, Education, and Neighbourhood Socioeconomic Status on Smoking Cessation in Persons in Treatment for Substance Use Disorders

Introduction: Smoking prevalence remains high among individuals with substance use disorders (SUD) in treatment, yet limited research has explored the factors influencing smoking cessation in this population. This study examines whether stress, educational attainment, and neighbourhood socioeconomic status (SES) are associated with smoking cessation among adults receiving treatment for non-tobacco SUDs. Methods: Data were analysed from a cohort of 1,627 patients in addiction care. Smoking cessation was assessed in relation to self-reported stress levels at treatment entry and neighbourhood SES, determined via postal code data. Logistic regression was used to evaluate the influence of stress, education, and neighbourhood SES on the likelihood of quitting smoking during treatment. Results: Higher educational attainment, lower self-reported stress, and lower neighbourhood SES were associated with increased odds of smoking cessation. However, the overall explained variance in cessation outcomes was minimal. Conclusions: While stress, education, and neighbourhood SES showed statistically significant associations with smoking cessation among individuals in SUD treatment, the clinical relevance appears limited due to the low explanatory power. The observed associations with stress and education align with prior expectations, whereas the inverse relationship with neighbourhood SES warrants further investigation. Additional research is needed to identify other determinants that may more robustly predict or support smoking cessation in this high-risk group.