title: Availability of tobacco cessation services in substance use disorder treatment programs: Impact of state tobacco control policy.
abstract: Given the high prevalence of smoking among substance use disorder (SUD) patients, the specialty SUD treatment system is an important target for adoption and implementation of tobacco cessation (TC) services. While research has addressed the impact of tobacco control on individual tobacco consumption, largely overlooked in the literature is the potential impact of state tobacco control policies on availability of services for tobacco cessation. This paper examines the association between state tobacco control policy and availability of TC services in SUD treatment programs in the United States.
  
  
  
  State tobacco control and state demographic data (n=51) were merged with treatment program data from the 2012 National Survey of Substance Abuse Treatment Services (n=10.413) to examine availability of TC screening, counseling and pharmacotherapy services in SUD treatment programs using multivariate logistic regression models clustered at the state-level.
  
  
  
  Approximately 60% of SUD treatment programs offered TC screening services, 41% offered TC counseling services and 26% offered TC pharmacotherapy services. Results of multivariate logistic regression showed the odds of offering TC services were greater for SUD treatment programs located in states with higher cigarette excise taxes and greater spending on tobacco prevention and control.
  
  
  
  Findings indicate cigarette excise taxes and recommended funding levels may be effective policy tools for increasing access to TC services in SUD treatment programs. Coupled with changes to insurance coverage for TC under the Affordable Care Act, state tobacco control policy tools may further reduce tobacco use in the United States.
authors.affiliation: Department of Public Administration and Policy, University of Georgia, 355 S. Jackson Street, Baldwin Hall, Athens, GA 30602, United States. Electronic address: aabraham@uga.edu.
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: Abraham
authors.affiliation: Department of Health Policy and Management, University of Georgia, 100 Foster Drive, 211D Wright Hall, Athens, GA 30602, United States. Electronic address: gbagwell@uga.edu.
authors.forename: Grace
authors.initials: G
authors.lastname: Bagwell-Adams
authors.affiliation: College of Pharmacy, University of Georgia, 250 West Green Street, Athens, GA 30602, United States. Electronic address: jayaward@uga.edu.
authors.forename: Jayani
authors.initials: J
authors.lastname: Jayawardhana
mesh_terms: D006297:Health Services Accessibility / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D006801:Humans; D011640:Public Policy / Q000331:legislation & jurisprudence*; D013219:State Government; D016320:Substance Abuse Treatment Centers / Q000706:statistics & numerical data*; D013660:Taxes / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D019460:Tobacco Industry / Q000331:legislation & jurisprudence*; D020340:Tobacco Use Cessation / Q000706:statistics & numerical data*; D014481:United States
keywords: Counseling; Pharmacotherapy; Screening; State tobacco control policy; Substance use disorder treatment programs; Tobacco cessation services