Perceived implementation of the Office of Alcoholism and Substance Abuse Services (OASAS) tobacco-free regulation in NY State and clinical practice behaviors to support tobacco cessation: A repeated cross-sectional study

Abstract

This study measured substance use disorder clinicians’ perceptions regarding the implementation extensiveness of the Office of Alcohol and Substance Abuse Services (OASAS) tobacco-free regulation, passed in New York State in July of 2008, at three time-points and across organizations with varying characteristics. Repeated cross-sectional data were collected from clinicians approximately 4 months pre-regulation (Time 0, N = 362), 10–12 months postregulation (Time 1, N = 462), and 20–24 months post-regulation (Time 2, N = 509). Clinician perceptions of implementation extensiveness (number of required policies in effect), use of tobacco cessation-related intake procedures, and use of guideline recommended counseling for treating tobacco dependence are significantly greater at Time 1 and Time 2 compared to Time 0. Additionally, differences are found in perceived implementation extensiveness based on hospital-based status, profit status, and level of care offered, although the pattern of effects differed some over the three time-points under investigation.

Predictors of Tobacco Use Among New York State Addiction Treatment Patients

“…27 Studies assessing clinicians' perspectives on implementation of the OASAS tobacco regulation identified both positive experiences (e.g., increased patient awareness about tobacco abuse) and negative experiences (e.g., enforcement difficulties), 28 coupled with perceived increases in program-level commitment of resources and enforcement efforts over time. 29,30 Before implementing its tobacco control policy, OASAS included tobacco use status in the patient admission record. The resulting data set permits assessment of the relationships between tobacco use and other factors in statewide addiction treatment samples.…”

Implementation of smoking cessation treatment in substance use disorder treatment settings: a review

“…Administrative discharge data showed a statistically significant increase in patients receiving NRT, but the actual rate only increased from 3% to 6% in tobaccousing patients (71). There was some evidence of variable impacts across residential, outpatient, or methadone programs (72,78), and while smoking prevalence decreased among staff, patient smoking rates did not significantly change (79).…”

“…Implementation of tobacco-related intake procedures and behavioral interventions increased relative to the pre-policy period (72). Repeated cross-sectional surveys of counselors in New York and other states showed significant increases in implementation of the 5As, counseling, and availability of medications in New York, but no changes occurred in other states (73).…”

Understanding counselors' implementation of tobacco cessation services with patients

“…We considered various counselor and program level control variables for inclusion in the analyses based on previous studies finding a relationship with TCS delivery in SUD treatment programs (e.g., Eby & Laschober, 2013; Friedmann, Jiang, & Richter, 2008; Guydish et al, 2007; Knudsen & Studts, 2011; Ziedonis, Guydish, Williams, Steinberg, & Foulds, 2006). Variables considered were the percentage of counselors who smoke, the percentage of patients who smoke, program profit status, program hospital-affiliation, level of care, treatment program size, and whether the counselor is a current smoker.…”

“…Like pharmacological treatments, “more counseling is better,” both in terms of the type of behavioral intervention and the duration of the intervention (Fiore et al, 2008). Despite these efforts, availability and use of EBPs for TC in SUD treatment is not extensive (Eby & Laschober, 2013; Knudsen & Studts, 2011; Laschober & Eby, 2013). …”