Comparing client and staff reports on tobacco-related knowledge, attitudes, beliefs and services provided in substance use treatment

Abstract

INTRODUCTION Smoking is highly prevalent in substance use disorder (SUD) programs, but few studies have explored the tobacco-related attitudes of staff and clients in the same program. The aim of this study was to compare staff and client reports on 10 tobacco-related items and associate them with tobacco measures implemented in the programs. METHODS A cross-sectional survey was conducted in 18 residential SUD programs from 2019 to 2020. Overall, 534 clients and 183 clinical staff self-reported their tobacco use, knowledge, attitudes, beliefs, and practices/services regarding smoking cessation. Ten comparable items were asked of both clients and staff. Differences in their responses were tested using bivariate analyses. We examine the association between selected tobacco-related items on making a quit attempt and planning to quit in the next 30 days. RESULTS In all, 63.7% of clients were current cigarette users versus 22.9% of staff. About half of clinicians (49.4%) said they had the skills to help patients quit smoking, while only 34.0% of clients thought their clinicians had these skills (p=0.003). About 28.4% of staff reported encouraging their patients to use nicotine replacement treatment (NRT), and 23.4% of patients said they had been encouraged to use these products. Client reports of planning a quit attempt were positively correlated with whether both staff and clients reported that the use of NRT was encouraged (clients: r=0.645 p=0.004; staff: r=0.524 p=0.025). CONCLUSIONS A low level of tobacco-related services was provided by staff and received by clients. In programs where smokers were encouraged to use NRT, a higher percentage of smokers planned a quit attempt. Tobacco-related training among staff, and communication about tobacco use with clients, should be improved to make tobacco services more visible and accessible in SUD treatment.

Smoking Policies of Outpatient and Residential Substance Use Disorder Treatment Facilities in the United States

“… 37 Additionally, staff education and training can help abate biases around tobacco use and reduce barriers to integrating comprehensive tobacco cessation programs in SUD treatment settings. 40 , 41 These training programs are important as barriers to the integration of more comprehensive tobacco cessation programs in SUD facilities have historically included staff attitudes, lack of staff training, clinical lore (including misconceptions such as “tobacco is not a real drug”), smoking culture, staff smoking, resource limitations, and resistance to smoke free grounds. 42 , 43 For facilities that offer tobacco related treatment, especially, having smoke-free campus policies for everyone including patients, staff, and others, will best support the health and success of their patients.…”