Abstract
Given the high prevalence of tobacco use among persons with behavioral health disorders, there has been much discussion about if and when tobacco cessation services should be provided to consumers. Approximately 1700 staff (who served adults and youth) from 38 public behavioral healthcare agencies in Virginia completed a survey on their attitudes and practices regarding tobacco cessation services for consumers. Results showed that most staff (88%) think tobacco cessation services should be offered and do not interfere with treatment. Most staff (57%) always/usually screened consumers for tobacco use, but few (14%) always/usually provided tobacco cessation counseling. Reported barriers included consumers not wanting to quit and a lack of staff training. Most staff reported that their organizations do not have policies regarding tobacco cessation services. Use of tobacco cessation practices was related to staff confidence using the practices, preparedness, and years of experience. Steps to improving the use of tobacco cessation practices in this setting are discussed.
Similar content being viewed by others
References
Centers for Disease Control. Vital signs: Current cigarette smoking among adults aged > 18 years with mental illness—United States, 2009-2011. Morbidity and Mortality Weekly Report. 2013; 62: 1-7. Available online at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6205a2.htm?s_cid=mm6205a2_w. Accessed August 4, 2015.
Guydish J, Passalacqua E, Tajima B, et al. Smoking prevalence in addiction treatment: a review. Nicotine and Tobacco Research. 2011; 13(6): 401-411.
Kalman D, Morissette SB, George TP. Co-morbidity of smoking in patients with psychiatric and substance use disorders. American Journal of Addiction. 2005; 14(2): 106-123.
Jamal A, Agaku IT, O’Connor E, et al. Current cigarette smoking among adults—United States, 2005–2013. Morbidity and Mortality Weekly Report. 2014; 63(47): 1108-1112.
Mokdad AH, Marks JS, Stroup DF, et al. Actual causes of death in the United States, 2000. Journal of the American Medical Association. 2004; 291(10): 1238-1245.
US Department of Health and Human Services. The health consequences of smoking—50 years of progress: a report of the Surgeon General. Atlanta, GA: US Department of Health and Human Services, CDC; 2014. Available online at http://www.surgeongeneral.gov/library/reports/50-years-of-progress/. Accessed August 4, 2015.
Schroeder, SA, Morris, CD. Confronting a neglected epidemic: tobacco cessation for persons with mental illnesses and substance abuse problems. Annual Review of Public Health. 2010; 31: 237-314.
Leffingwell TR, Babitzke AC. Tobacco intervention practices of licensed psychologists. Journal of Clinical Psychology. 2006; 62(3): 313-323.
Phillips KM, Brandon TH. Do psychologists adhere to the clinical practice guidelines for tobacco cessation? A survey of practitioners. Professional Psychology: Research and Practice. 2004; 35(3): 281.
Friedman PD, Jiang L, and Richter K. Cigarette smoking cessation services in outpatient substance abuse treatment programs in the United States. Journal of Substance Abuse Treatment. 2008; 34: 165-172.
Hunt JJ, Cupertino AP, Garrett S, et al. How is tobacco treatment provided during drug treatment? Journal of Substance Abuse Treatment. 2012; 42(1): 4-15.
Knudsen HK, Studts JL, Boyd S, et al. Structural and cultural barriers to the adoption of smoking cessation services in addiction treatment organizations. Journal of Addictive Diseases. 2010; 29(3): 294-305.
Richter KP, Choi WS, McCool RM, et al. Smoking cessation services in U.S. methadone maintenance facilities. Psychiatric Services. 2004; 55(11): 1258-1264.
Chun J, Guydish J, Chan YF. Smoking among adolescents in substance abuse treatment: a study of programs, policy, and prevalence. Journal of Psychoactive Drugs. 2007; 39(4): 443-449.
Breland AB, Nasim A, Irons JG, et al. Tobacco use among African–American youth receiving behavioral healthcare services. Journal of Behavioral Health and Services Research. 2013; 40(1): 88-96.
Akpanudo SM, Price JH, Jordan T, et al. Clinical psychologists and smoking cessation: treatment practices and perceptions. Journal of Community Health. 2009; 34(6): 461-471.
Sidani JE, Price JH, Dake JA, et al. Practices and perceptions of mental health counselors in addressing smoking cessation. Journal of Mental Health Counseling. 2011; 33(3): 264-282.
Zvolensky MJ, Baker K, Yartz AR, et al. Mental health professionals with a specialty in anxiety disorders: Knowledge, training, and perceived competence in smoking cessation practices. Cognitive and Behavioral Practice. 2005; 12(3): 312-318.
Himelhoch S, Daumit G. To whom do psychiatrists offer smoking-cessation counseling? American Journal of Psychiatry. 2003; 160(12): 2228-2230.
Price JH, Ambrosetti LM, Sidani JE, et al. Psychiatrists' smoking cessation activities with Ohio community mental health center patients. Community Mental Health Journal. 2007; 43(3): 251-266.
Guydish J, Passalacqua E, Tajima B, et al. Staff smoking and other barriers to nicotine dependence intervention in addiction treatment settings: a review. Journal of Psychoactive Drugs. 2007; 39(4): 423-433.
Brown CH, Medoff D, Dickerson FB, et al. Factors influencing implementation of smoking cessation treatment within community mental health centers. Journal of Dual Diagnosis. 2015; 11(2): 145-150.
Chisolm MS, Brigham EP, Lookatch SJ, et al. Cigarette smoking knowledge, attitudes, and practices of patients and staff at a perinatal substance abuse treatment center. Journal of Substance Abuse Treatment. 2010; 39(3): 298-305.
Weinberger AH, Reutenauer EL, Vessicchio JC, et al. Survey of clinician attitudes toward smoking cessation for psychiatric and substance abusing clients. Journal of Addictive Diseases. 2008; 27(1): 55-63.
Richter KP, Hunt JJ, Cupertino AP, et al. Understanding the drug treatment community's ambivalence towards tobacco use and treatment. International Journal of Drug Policy. 2012; 23(3): 220-228.
Delucchi KL, Tajima B, Guydish J. Development of the Smoking Knowledge, Attitudes, and Practices (S-KAP) instrument. Journal of Drug Issues. 2009; 39(2): 347-364.
Willis, Gordon Bruce. Cognitive interviewing: a tool for improving questionnaire design. Thousand Oaks, CA: Sage, 2005.
Prochaska JJ, Delucchi K, Hall SM. A meta-analysis of smoking cessation interventions with individuals in substance abuse treatment or recovery. Consulting and Clinical Psychology 2004; 72(6): 1144-1156.
Orleans CT, Hutchinson D. Tailoring nicotine addiction treatments for chemical dependency patients. Journal of Substance Abuse Treatment. 1993; 10(2): 197-208.
Irving LM, Seidner AL, Burling TA, et al. Drug and alcohol abuse inpatients' attitudes about smoking cessation. Journal of Substance Abuse. 1994; 6(3): 267-278.
Cookson C, Strang J, Ratschen E, et al. Smoking and its treatment in addiction services: clients’ and staff behavior and attitudes. BMC Health Services Research. 2014; 14 (304).
Bobo JK, Slade J, Hoffman AL. Nicotine addiction counseling for chemically dependent patients. Psychiatric Services. 1995; 46(9): 945-947.
Laschober TC, Muilenburg JL, Eby LT. Factors linked to substance use disorder counselors’ (non)implementation likelihood of tobacco cessation 5 A’s, counseling, and pharmacotherapy. Journal of Addictive Behaviors Therapy in Rehabilitation. 2015; 4(1): 134.
Malte CA, McFall M, Chow B, et al. Survey of providers' attitudes toward integrating smoking cessation treatment into posttraumatic stress disorder care. Psychology of Addictive Behaviors. 2013; 27(1): 249-255.
Knudsen HK, Muilenburg J, Eby LT. Sustainment of smoking cessation programs in substance use disorder treatment organizations. Nicotine and Tobacco Research. 2013; 15(6): 1060-1068.
Heatherton TF, Kozlowski LT, Frecker RC, et al. The Fagerström test for nicotine dependence: a revision of the Fagerström tolerance questionnaire. British Journal of Addiction. 1991; 86: 1119-1127.
DiClemente CC, Prochaska JO, Fairhurst S, et al. The process of smoking cessation: an analysis of precontemplation, contemplation and contemplation/action. Journal of Consulting and Clinical Psychology. 1991; 59: 295-304.
Muilenburg JL, Laschober TC, Eby LT. Organizational factors as predictors of tobacco cessation pharmacotherapy adoption in addiction treatment programs. Journal of Addiction Medicine. 2014; 8(1): 59-65.
McKay CD, Dickerson F. Peer supports for tobacco cessation for adults with serious mental illness: a review of the literature. Journal of Dual Diagnosis. 2012; 8(2): 104-112.
Bombard JM, Pederson LL, Nelson DE, et al. Are smokers only using cigarettes? Exploring current polytobacco use among an adult population. Addictive Behaviors. 2007; 32: 2411-2419.
Popova L, Ling PM. Alternative tobacco product use and smoking cessation: a national study. American Journal of Public Health. 2013; 103(5): 923-30.
Acknowledgments
This work was funded by a grant from the Virginia Foundation for Healthy Youth, #8520666. The authors would also like to thank Jessica Irons, PhD for her assistance with survey development and analysis for previous presentations on this topic.
Conflict of Interest
The authors have no conflicts of interest to report.
Author information
Authors and Affiliations
Corresponding author
Additional information
This research was performed at Virginia Commonwealth University, 1112 East Clay Street, Suite B-08, Richmond, VA 23298, USA.
Rights and permissions
About this article
Cite this article
Koch, J.R., Breland, A. Behavioral Healthcare Staff Attitudes and Practices Regarding Consumer Tobacco Cessation Services. J Behav Health Serv Res 44, 399–413 (2017). https://doi.org/10.1007/s11414-015-9477-4
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11414-015-9477-4