title: Comparison of cigarette smoking knowledge, attitudes, and practices among staff in perinatal and other substance abuse treatment settings.
abstract: OBJECTIVE
  Despite the high prevalence and known morbidity and mortality caused by cigarette smoking, 60% to 70% of substance abuse treatment programs lack smoking cessation counseling or fail to offer pharmacotherapy for smoking cessation, including those programs designed to meet the needs of drug-dependent pregnant patients. Previous studies of staff knowledge, attitudes, and practices (S-KAP) at general substance abuse/HIV treatment programs have suggested that staff may contribute to the deficiency in smoking cessation treatment in these settings. It is not known whether similar deficiencies exist at perinatal substance abuse treatment programs.
  
  
  METHODS
  This study compared cigarette S-KAP in perinatal substance abuse (n = 41) and general substance abuse/HIV treatment (Veterans Affairs [VA] medical center, hospital-, and community-based) workforce samples (n = 335).
  
  
  RESULTS
  Significant differences were seen between the 2 groups on all measures, but perinatal staff compared favorably to general staff only on measures of barriers to smoking cessation services. Perinatal staff compared unfavorably on all other measures: knowledge, beliefs/attitudes, self-efficacy, and smoking cessation practices. Pair-wise comparisons of knowledge and beliefs/attitudes revealed a significant difference between perinatal and VA staff; of self-efficacy, between perinatal and staff at all other settings; and of smoking cessation practices, between perinatal and VA and community-based staff.
  
  
  CONCLUSIONS
  These results-showing deficiencies of perinatal staff on most S-KAP measures-are concerning and suggest that identifying gaps in and improving S-KAP in perinatal substance abuse programs is urgently needed, for which the VA may provide an efficacious model.
authors.affiliation: From the Department of Pediatrics (TM-T), Johns Hopkins University School of Medicine, Baltimore, MD, and Mt. Holyoke College, South Hadley, MA, and Prince George's Community College, Kettering, MD; Departments of Mental Health (J-MSL), Johns Hopkins University Bloomberg School of Public Health, and Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology and Public Health (MT), University of Maryland School of Medicine, Baltimore, MD; Department of Internal Medicine (EPB), Pulmonary Division, Johns Hopkins University School of Medicine, Baltimore, MD; and Department of Psychiatry and Behavioral Sciences (MSC), Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Tonya
authors.initials: T
authors.lastname: Miller-Thomas
authors.forename: Jeannie-Marie S
authors.initials: JM
authors.lastname: Leoutsakos
authors.forename: Mishka
authors.initials: M
authors.lastname: Terplan
authors.forename: Emily P
authors.initials: EP
authors.lastname: Brigham
authors.forename: Margaret S
authors.initials: MS
authors.lastname: Chisolm
mesh_terms: D001291:Attitude of Health Personnel; D003625:Data Collection; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D018743:Perinatal Care / Q000706:statistics & numerical data; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy; D012907:Smoking / Q000523:psychology*; D016540:Smoking Cessation / Q000523:psychology; D016320:Substance Abuse Treatment Centers / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology