Policy and Practice Changes Associated with a Tobacco-Free Initiative in Residential Substance Use Disorder Treatment

ABSTRACT

A California-sponsored, 18-month, tobacco-free intervention in residential substance use disorder (SUD) programs was associated with increases in tobacco-free grounds and tobacco-related client services. The current study examined whether positive results would be replicated in 11 programs participating subsequently. Program directors (N = 11) completed surveys of tobacco-related policies pre- and post-intervention. Pre- (n = 163) and post-intervention (n = 128) cross-sectional staff surveys examined tobacco-related training, beliefs, practices, smoking policy, and smoking status. Directors reported increases in tobacco-free grounds (from 3 to 8 programs), tobacco-related staff training (1 to 10 programs), tobacco cessation staff services (1 to 9 programs) and nicotine replacement therapy (NRT) provision (6 to 10 programs). At post-intervention, staff were more likely to report smoke-free workplaces (p = 0.008), positive beliefs about treating tobacco use (p = 0.017) and less likely to report current smoking (p = 0.003). Clinical staff were more likely to report tobacco-related training receipt (p = 0.001), program-level NRT provision (p = 0.009) and conducting tobacco-related client services (p < 0.0001) post-intervention. Findings of increases in tobacco-free grounds and tobacco cessation client services corroborated prior results. These and the additional finding of decreases in staff smoking strengthen evidence that initiatives supporting tobacco-free policies can be successfully implemented in SUD treatment.

KEYWORDS:

• Tobacco-free policy
• tobacco cessation
• substance use disorder treatment

Disclosure statement

Joseph Guydish and Caravella McCuistian were editor and editorial intern of the Journal of Psychoactive Drugs, respectively, when the manuscript was submitted and were recused from the journal review and decision process. The authors report there are no other competing interests to declare.

Additional information

Funding

This work was supported by the California Tobacco Control Program [CTCP 18-10025] and a NIDA training grant [T32DA007250]. The content is solely the responsibility of the authors and does not represent the official views of the State of California or the National Institutes of Health who had no role in data collection, analysis, or interpretation of the data, nor in development or submission of this manuscript.