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Open Access Tobacco-free Workplace Program at a Substance Use Treatment Center

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Objectives: About 65%-87% of substance use disorder patients smoke cigarettes, compared to 14% of the general adult population. Few substance use treatment centers (SUTCs) have comprehensive tobacco-free workplace (TFW) policies or offer tobacco interventions. Taking Texas Tobacco Free (TTTF) implements an evidence-based TFW program in SUTCs, including at the Billy T. Cattan Recovery Outreach Center (BTC). We present a mixed methods case study of BTC's TTTF implementation, success factors, and challenges. Methods: TTTF provided policy development assistance, training, treatment resources, and technical assistance over ∼9 months. Implementation was tailored using mixed methods. Quantitative data included surveys to stakeholders (Nmax = 7), a pre- and post-training questionnaire assessing knowledge gain, and reported quantities of tobacco use assessments (TUAs) administered and nicotine replacement therapy (NRT) provided. Qualitative data included stakeholder focus groups and interviews (18 participants). Results: All employees reported TFW policy compliance. Employees exhibited a 20% knowledge gain. Clinicians increased self-report of NRT provision and tobacco cessation counseling. During implementation, BTC administered TUAs to 171 patients and dispensed NRT to 70 of 110 tobacco-using patients. Conclusion: Qualitative findings contextualized quantitative outcomes. TTTF implementation changed clinician attitudes, knowledge, and practices regarding tobacco treatment, facilitating patient quit attempts.
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Keywords: CO-MORBIDITIES; SMOKING CESSATION; SMOKING POLICY; SUBSTANCE USE TREATMENT CENTERS

Document Type: Research Article

Affiliations: 1: Research Scientist, University of Houston, Department of Psychological, Health, and Learning Sciences, Houston, TX 2: Assistant Professor, University of Houston, Department of Psychological, Health, and Learning Sciences, Houston, TX 3: Senior Researcher, University of Houston, Department of Psychological, Health, and Learning Sciences, Houston, TX 4: Taking Texas Tobacco Free Program Manager, Integral Care, Austin, TX 5: Research Assistant Professor, University of Houston, HEALTH Research Institute, Houston, TX 6: Center Director, Recovery Outreach Center, Victoria, TX 7: Clinic Coordinator, Recovery Outreach Center, Victoria, TX 8: Director of Clinical Services, Integral Care, Austin, TX 9: Professor, University of Houston, Department of Health & Human Performance, Houston, TX 10: Professor, University of Houston, Department of Psychological, Health, and Learning Sciences, Houston, TX 11: Director of Clinical Innovation and Development, Integral Care, Austin, TX 12: Professor, University of Houston, Department of Psychological, Health, and Learning Sciences, Houston, TX;, Email: [email protected]

Publication date: September 1, 2020

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  • The American Journal of Health Behavior seeks to improve the quality of life through multidisciplinary health efforts in fostering a better understanding of the multidimensional nature of both individuals and social systems as they relate to health behaviors.

    The Journal aims to provide a comprehensive understanding of the impact of personal attributes, personality characteristics, behavior patterns, social structure, and processes on health maintenance, health restoration, and health improvement; to disseminate knowledge of holistic, multidisciplinary approaches to designing and implementing effective health programs; and to showcase health behavior analysis skills that have been proven to affect health improvement and recovery.

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