Counselors’ Knowledge of the Adoption of Tobacco Cessation Medications in Substance Abuse Treatment Programs

Abstract

This study assessed counselors’ knowledge of the adoption of evidence-based tobacco cessation medications (TCMs) - varenicline, bupropion, and five nicotine replacement therapies (NRTs) - and predictors of adoption in diverse substance abuse treatment settings. We used MERITS I data from 658 counselors working in 26 programs. Adoption of varenicline was reported by 16% of counselors, bupropion by 11%, and NRTs by 27%. Knowledge of the adoption of all types of TCMs was more likely to be reported by counselors who worked in treatment programs that adhered less to a 12-step orientation and restricted outdoor smoking for employees. Several additional unique predictors of varenicline and NRTs were identified.

Relationship Between Low-Income Patient Census and Substance Use Disorder Treatment Programs’ Availability of Tobacco Cessation Services

“…These findings are similar to previous research on the adoption of diverse TCS in SUD treatment programs (e.g., Eby & Laschober, 2013; Friedmann et al, 2008; Guydish et al, 2012; Knudsen & Studts, 2010; Knudsen et al, 2012; Rothrauff & Eby, 2010). Thus, although low-income patients may not be at a particular disadvantage in terms of access to TCS in general compared to other patients, they may not have extensive access to the full range of EBTs to aid their TC attempts.…”

“…In fact, TC treatment is positively associated with greater abstinence from alcohol and other drugs, decreased risk of alcohol and drug relapse, and decreased alcohol consumption (Baca & Yahne, 2009; Barrett, Tichauer, Leyton, & Pihl, 2006; Prochaska, Delucchi, & Hall, 2004; Satre, Kohn, & Weisner, 2007; Weinberger & Sofuoglu, 2009). However, TCS are not extensively adopted in treatment programs (Eby & Laschober, 2013; Friedmann, Jian, & Richter, 2008; Guydish et al, 2012; Knudsen & Studts, 2010; Knudsen, Studts, & Studts, 2012; Rothrauff & Eby, 2010), which may hamper access to EBTs among low-income smokers.…”

Substance Use Disorder Counselors' Reports of Tobacco Cessation Services Availability, Implementation, and Tobacco-related Knowledge

“…26,30–33 This is understandable because the FDA does not currently approve TC pharmacotherapy with adolescents. 9 The especially low implementation of pharmacotherapy may also suggest that because counselors are generally not allowed to prescribe pharmacotherapy they may not be comfortable using physician prescribed medications with adolescents.…”

Sustained, New, Never, and Discontinued Tobacco Cessation Services Adopters

“…Because many patients need help to quit smoking (Tobacco Use Recovery Now!, 2009), SUD treatment programs are prime settings for providing evidence-based tobacco cessation services (TCS) recommended by national guidelines including counseling and pharmacotherapy (Fiore et al, 2008). Given the generally low adoption of TCS in SUD treatment programs (Friedmann, Jiang, & Richter, 2008; Knudsen & Studts, 2011; Muilenburg, Laschober, & Eby, 2014a,b; Rothrauff & Eby, 2011), the current study longitudinally examines SUD program administrator reports of TC counseling and TC pharmacotherapy adoption patterns (sustained, new, never, and discontinued), as these are necessary conditions for implementation patterns, and their program-level predictors to better understand the adoption process.…”