title: The New York policy on smoking in addiction treatment: findings after 1 year.
abstract: OBJECTIVE
  We assessed changes in smoking prevalence and other measures associated with the July 2008 New York Office of Alcoholism and Substance Abuse Services tobacco policy, which required that all publicly funded addiction treatment programs implement smoke-free grounds, have "no evidence" of smoking among staff, and make tobacco dependence treatment available for all clients.
  
  
  METHODS
  In a random sample of 10 programs, staff and clients were surveyed before the policy and 1 year later. Measures included tobacco-related knowledge, attitudes, and practices used by counselors and received by clients.
  
  
  RESULTS
  Client smoking decreased from 69.4% to 62.8% (P = .044). However, response to the policy differed by program type. Outpatient programs showed no significant changes on any of the staff and client survey measures. In methadone programs, staff use of tobacco-related practices increased (P < .01), client attitudes toward tobacco treatment grew more positive (P < .05), and clients received more tobacco-related services (P < .05). Residential clients were more likely to report having quit smoking after policy implementation (odds ratio = 4.7; 95% confidence interval = 1.53, 14.19), but they reported less favorable attitudes toward tobacco treatment (P < .001) and received fewer tobacco-related services from their program (P < .001) or their counselor (P < .001).
  
  
  CONCLUSIONS
  If supported by additional research, the New York policy may offer a model that addiction treatment systems can use to address smoking in a population where it has been prevalent and intractable. Additional intervention or policy supports may be needed in residential programs, which face greater challenges to implementing tobacco-free grounds.
authors.affiliation: Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, CA, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Guydish
authors.forename: Barbara
authors.initials: B
authors.lastname: Tajima
authors.forename: Agatha
authors.initials: A
authors.lastname: Kulaga
authors.forename: Roberto
authors.initials: R
authors.lastname: Zavala
authors.forename: Lawrence S
authors.initials: LS
authors.lastname: Brown
authors.forename: Alan
authors.initials: A
authors.lastname: Bostrom
authors.forename: Douglas
authors.initials: D
authors.lastname: Ziedonis
authors.forename: Mable
authors.initials: M
authors.lastname: Chan
mesh_terms: D000328:Adult; D005260:Female; D005380:Financing, Government / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000706:statistics & numerical data; D006291:Health Policy; D006801:Humans; D007297:Inpatients / Q000523:psychology / Q000706:statistics & numerical data; D008297:Male; D008691:Methadone / Q000627:therapeutic use; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D058850:Opiate Substitution Treatment / Q000523:psychology / Q000706:statistics & numerical data; D010045:Outpatients / Q000523:psychology / Q000706:statistics & numerical data; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology*; D016540:Smoking Cessation / Q000523:psychology / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000534:rehabilitation*
chemical_list: D008691:Methadone