title: Tobacco smoking policies in Australian alcohol and other drug treatment services, agreement between staff awareness and the written policy document.
abstract: Comprehensive smoke-free policy in the alcohol and other drug (AOD) setting provides an opportunity to reduce tobacco related harms among clients and staff. This study aimed to examine within AOD services: staff awareness of their service's smoking policy compared to the written policy document and staff and service factors associated with accurate awareness of a total ban and perceived enforcement of a total ban.
  
  
  
  An audit of written tobacco smoking policy documents and an online cross-sectional survey of staff from 31 Australian AOD services. In addition, a contact at each service was interviewed to gather service-related data.
  
  
  
  Overall, 506 staff participated in the survey (response rate: 57%). Nearly half (46%) perceived their service had a total ban with 54% indicating that this policy was always enforced. Over one-third (37%) reported a partial ban with 48% indicating that this policy was always enforced. The audit of written policies revealed that 19 (61%) services had total bans, 11 (36%) had partial bans and 1 (3%) did not have a written smoking policy. Agreement between staff policy awareness and their service's written policy was moderate (Kappa 0.48) for a total ban and fair (Kappa 0.38) for a partial ban. Age (1 year increase) of staff was associated with higher odds of correctly identifying a total ban at their service.
  
  
  
  Tobacco smoking within Australian AOD services is mostly regulated by a written policy document. Staff policy awareness was modest and perceived policy enforcement was poor.
authors.affiliation: School of Medicine & Public Health, Faculty of Health & Medicine, The University of Newcastle, 1 University Drive, Callaghan, NSW, 2308, Australia. Eliza.Skelton@newcastle.edu.au.
authors.forename: Eliza
authors.initials: E
authors.lastname: Skelton
authors.affiliation: School of Medicine & Public Health, Faculty of Health & Medicine, The University of Newcastle, 1 University Drive, Callaghan, NSW, 2308, Australia.
authors.forename: Billie
authors.initials: B
authors.lastname: Bonevski
authors.affiliation: School of Medicine & Public Health, Faculty of Health & Medicine, The University of Newcastle, 1 University Drive, Callaghan, NSW, 2308, Australia.|Hunter New England Population Health, Hunter New England Local Health District, Longworth Avenue, Wallsend, NSW, 2287, Australia.
authors.forename: Flora
authors.initials: F
authors.lastname: Tzelepis
authors.affiliation: National Drug and Alcohol Research Centre, The University of New South Wales, 22-32 King Street, Randwick, NSW, 2031, Australia.
authors.forename: Anthony
authors.initials: A
authors.lastname: Shakeshaft
authors.affiliation: School of Medicine & Public Health, Faculty of Health & Medicine, The University of Newcastle, 1 University Drive, Callaghan, NSW, 2308, Australia.
authors.forename: Ashleigh
authors.initials: A
authors.lastname: Guillaumier
authors.affiliation: School of Medicine & Public Health, Faculty of Health & Medicine, The University of Newcastle, 1 University Drive, Callaghan, NSW, 2308, Australia.|Drug & Alcohol Clinical Services, Newcastle Community Health Centre, Hunter New England Local Health District, Level 3 670 Hunter Street, Suite 8, Newcastle West, NSW, 2302, Australia.
authors.forename: Adrian
authors.initials: A
authors.lastname: Dunlop
authors.affiliation: School of Medicine & Public Health, Faculty of Health & Medicine, The University of Newcastle, 1 University Drive, Callaghan, NSW, 2308, Australia.
authors.forename: Sam
authors.initials: S
authors.lastname: McCrabb
authors.affiliation: Clinical Research Design, Information Technology and Statistical Support, Hunter Medical Research Institute, 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia.
authors.forename: Kerrin
authors.initials: K
authors.lastname: Palazzi
mesh_terms: D000293:Adolescent; D000328:Adult; D001315:Australia; D001364:Awareness; D003153:Community Health Services / Q000458:organization & administration*; D003430:Cross-Sectional Studies; D005260:Female; D006291:Health Policy; D006293:Health Promotion / Q000331:legislation & jurisprudence*; D006801:Humans; D008297:Male; D008875:Middle Aged; D061845:Smoke-Free Policy / Q000331:legislation & jurisprudence*; D012907:Smoking / Q000331:legislation & jurisprudence*; D000074606:Smoking Prevention; D012926:Social Control, Formal; D014028:Tobacco Smoke Pollution / Q000517:prevention & control
chemical_list: D014028:Tobacco Smoke Pollution
keywords: Alcohol and other drug treatment; Enforcement; Policy; Smoke-free; Tobacco smoking