title: A qualitative examination of the positive and negative consequences associated with going tobacco-free in substance abuse treatment: the NY State experience.
abstract: BACKGROUND
  In 2008, the New York State (NYS) Office of Alcoholism and Substance Abuse Services (OASAS) required all state-funded or state-certified addiction treatment programs to be 100% tobacco-free. The regulation prohibits the use or possession of all tobacco products by patients, employees, volunteers, and visitors. This includes exterior grounds and vehicles owned, leased, or operated by the facility. Addiction treatment centers are also required to screen patients for tobacco use and incorporate tobacco cessation into treatment programming. This study examined the perceived effectiveness of this regulation from the perspective of counselors and clinical supervisors.
  
  
  METHODS
  Qualitative data were collected from 261 counselors and 80 clinical supervisors working in 50 free-standing substance abuse treatment programs throughout NYS. Questions asked about the perceived positive and negative consequences of the OASAS regulation approximately 1 year after its implementation.
  
  
  RESULTS
  The findings indicate mixed reactions to the regulation. A wide range of positive and negative consequences were identified, which were generally consistent across counselor and clinical supervisor reports. The most commonly reported positive outcomes were positive behavior change (e.g., less smoking, increased intentions to quit) and increased awareness about smoking (e.g., dangers, available assistance to quit). The most commonly reported negative consequences were reinforcing addict behaviors among patients (e.g., lying, "dealing" cigarettes) and enforcement problems (e.g., difficulty enforcing, policing for compliance).
  
  
  CONCLUSIONS
  Findings have implications for the implementation of tobacco-free regulations in substance abuse treatment programs.
authors.affiliation: Department of Psychology, University of Georgia, Athens, GA 30602, USA. leby@uga.edu
authors.forename: Lillian Turner de Tormes
authors.initials: LT
authors.lastname: Eby
authors.forename: Taylor E
authors.initials: TE
authors.lastname: Sparks
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Evans
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Selzer
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D005069:Evaluation Studies as Topic; D005260:Female; D006282:Health Personnel; D006801:Humans; D008297:Male; D008875:Middle Aged; D009518:New York; D010349:Patient Compliance / Q000523:psychology*; D012907:Smoking / Q000331:legislation & jurisprudence* / Q000523:psychology*; D016320:Substance Abuse Treatment Centers / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D020340:Tobacco Use Cessation / Q000379:methods* / Q000523:psychology*