Home > ASME Articles > Tobacco-Free Grounds Policies in Treatment Programs Reduce Smoking for Clients and Staff
As smoking prevalence declines overall, smoking in subgroups becomes increasingly important in terms of tobacco control, health disparities, and social justice. For example, rates of smoking are significantly higher for persons with mental or behavioral health disorders, and a review of smoking prevalence in U.S. addiction treatment programs from 1987 to 2009 found a median annual smoking prevalence of 76.3%.
Previous studies have found that tobacco-free grounds policies in addiction treatment programs have resulted in lower smoking prevalence among staff, but were less clear on the impact on client smoking.
This study asked two questions: first, whether any changes in smoking behavior were observed among clients enrolled in addiction treatment programs from 2015-2016, and, second, whether tobacco-free grounds policies were associated with differences in smoking-related measures.
Using a sample of clients from 25 treatment programs affiliated with the NIDA Clinical Trials Network, surveys were collected in 2015 and 2016. The samples were compared on smoking prevalence, cigarettes per day (CPD), thinking of quitting, past year quit attempts, staff and clients smoking together, attitudes towards quitting, and tobacco-related services.
Programs with (n=6) and without (n=17) tobacco-free grounds at both time points were compared on smoking-related outcomes. And changes in these measures were examined for two programs that adopted tobacco-free grounds between 2015 and 2016.
Results found one difference across such years, such that the mean score for the tobacco Program Service scale increased from 2.37 to 2.48. In programs with tobacco-free grounds policies, compared to those without, both CPD and the rate of staff and clients smoking together were significantly lower.
In the two programs where tobacco-free grounds were implemented during the study years:
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