title: Drug abuse staff and clients smoking together: A shared addiction.
abstract: Smoking is endemic in drug abuse treatment populations, and smoking prevalence in this population appears unresponsive to existing tobacco control strategies. Clinical and policy guidelines encourage programs to address smoking among clients, and research has identified key barriers to doing so. This report explores the practice of staff and clients smoking together in drug treatment programs, and how this practice is associated with other tobacco-related measures. Clients (N=1113) were surveyed and program directors were interviewed in a national sample of 24 drug abuse treatment programs affiliated with the NIDA Clinical Trials Network. Clients were asked whether they observed staff and clients smoking together in their program and, using program as the unit of analysis, this measure was tested for its association with client-level and program-level tobacco-related outcomes. Higher rates of staff and client smoking together were associated with higher staff smoking prevalence (p=0.006), lower rates of client thoughts about quitting in the next 30days (p=0.027), more negative client attitudes toward quitting smoking (p=0.004), and with clients receiving fewer tobacco-related services (p=0.024). These findings illuminate an actionable, low cost policy intervention to address smoking in drug abuse treatment, which is to prohibit the practice of staff smoking together with clients. In the interest of the health of clients whom they serve, counselors, program directors, state regulatory agencies, and federal funding agencies should act to end this practice.
authors.affiliation: Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, 3333 California St., Ste. 265, San Francisco, CA 94118, United States. Electronic address: joseph.guydish@ucsf.edu.
authors.forename: Joseph
authors.initials: J
authors.lastname: Guydish
authors.affiliation: Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, 3333 California St., Ste. 265, San Francisco, CA 94118, United States.
authors.forename: Thao
authors.initials: T
authors.lastname: Le
authors.affiliation: OHSU/PSU School of Public Health, Oregon Health and Sciences University, 3181 SW Sam Jackson Park Road, Portland, OR 97239-3098, United States.
authors.forename: Barbara
authors.initials: B
authors.lastname: Campbell
authors.affiliation: Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, 3333 California St., Ste. 265, San Francisco, CA 94118, United States.
authors.forename: Deborah
authors.initials: D
authors.lastname: Yip
authors.affiliation: Department of Neuroscience, University of Nevada, Reno, 1664 N. Virginia Street, Reno 89557, United States.
authors.forename: Suzhe
authors.initials: S
authors.lastname: Ji
authors.affiliation: Department of Psychiatry, University of California San Francisco, 401 Parnassus Ave. San Francisco, CA 94143, United States.
authors.forename: Kevin
authors.initials: K
authors.lastname: Delucchi
mesh_terms: D000328:Adult; D001290:Attitude; D016739:Behavior, Addictive / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010361:Patients; D011613:Psychotherapy; D012907:Smoking / Q000453:epidemiology / Q000523:psychology*; D016540:Smoking Cessation; D012959:Socioeconomic Factors; D016320:Substance Abuse Treatment Centers; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
keywords: Drug treatment; Nicotine; Policy; Tobacco