Smoking-related outcomes and associations with tobacco-free policy in addiction treatment, 2015–2016

Abstract

Objective This study assessed changes in smoking-related outcomes in two cross-sectional samples of clients enrolled in addiction treatment and whether tobacco-free grounds policies were associated with smoking-related outcomes. Method Clients in 25 programs were surveyed in 2015 (N = 1,176) and 2016 (N = 1,055). The samples were compared on smoking prevalence, cigarettes per day (CPD), thinking of quitting, past year quit attempts, staff and clients smoking together, attitudes towards quitting, and tobacco-related services. Second, programs with (n = 6) and without (n = 17) tobacco-free grounds at both time points were compared on smoking-related outcomes. Last, we examined changes in these measures for two programs that adopted tobacco-free grounds between 2015 and 2016. Results There was one difference across years, such that the mean score for the tobacco Program Service scale increased from 2.37 to 2.48 (p = 0.043, effect size = 0.02). In programs with tobacco-free grounds policies, compared to those without, both CPD and the rate of staff and clients smoking together were significantly lower. In the two programs where tobacco-free grounds were implemented during study years, client smoking prevalence decreased (92.5% v. 67.6%, p = .005), the rate of staff and clients smoking together decreased (35.6% v. 4.2%, p = .031), mean CPD decreased (10.62 v. 8.24, p < .001) and mean tobacco services received by clients increased (2.08 v. 3.05, p < .001). Conclusion Addiction treatment programs, and agencies responsible for licensing, regulating and funding these programs, should implement tobacco-free grounds policies.

Tobacco Cessation Services in Addiction Treatment: What Do Clients Say?

“…Smokers in programs with tobacco-free grounds also had higher odds of being advised to quit, and of receiving counseling and medication. This is consistent with literature showing increased use of tobacco-related services, and greater clinician support of client smoking cessation in addiction treatment programs with tobacco-free grounds (2).…”

“…These independent variable were selected because quit attempts are associated with both readiness to quit and receipt of cessation services in addiction treatment (5), becauses persons with health concerns are more likely to quit smoking while in addiction treatment (12), and because implementation of tobacco-free grounds is associated with increased cessation services reported by clients (2).…”

“…Of those, 3.8 million receive addiction treatment annually in self-help settings, primary care, or specialty treatment programs (1). Among persons in addiction treatment, smoking is a prevalent comorbid health risk, with smoking rates consistently above 70% from 1987 through 2015 (2). Addiction treatment services reach 2.85 million smokers annually, or 7.5% of all U.S. smokers (3).…”

Effect of increasing the delivery of smoking cessation care in alcohol and other drug treatment centres: a cluster‐randomized controlled trial

“…Reductions in cigarettes smoked per day are likely to have wider‐reaching socio‐economic impacts for the financially stressed individual. In both the addiction setting and the smoke‐free work‐place literature , reduced cigarette consumption is related to the implementation of total smoking bans. On an organizational level, a smoke‐free policy is recommended to support a range of smoking‐related and cessation outcomes.…”

Association of Medicaid Expansion and Health Insurance with Receipt of Smoking Cessation Services and Smoking Behaviors in Substance Use Disorder Treatment

“…Disagreements on policy status were resolved through discussing with a third rater. 29 Demographic characteristics included age, gender, race/ethnicity, education, employment status, and type of program where they were recruited (Outpatient, residential, methadone).…”