Structural and Cultural Barriers to the Adoption of Smoking Cessation Services in Addiction Treatment Organizations

ABSTRACT

Few studies have examined associations between the availability of smoking cessation services in addiction treatment organizations and specific cultural, staffing, and resource barriers. Telephone interviews were conducted with administrators of 897 addiction treatment organizations in the United States. These data revealed that few programs had adopted the full bundle of five recommended tobacco-related intake procedures, and that less than half of programs offered any smoking cessation services. Barriers to adoption of the intake bundle and availability of services included organizational culture and low levels of staff skills. Adoption of cessation services was associated with center type, location in a hospital setting, levels of care, and organizational size. Although a substantial proportion of organizations offer smoking cessation services, expansion of these services and greater adoption of tobacco-related intake procedures are needed to address the needs of nicotine-dependent individuals in addiction treatment.

KEYWORDS:

• Smoking cessation
• addiction treatment organizations
• health services research

Primary data collection and manuscript preparation was supported by the National Institute on Drug Abuse (R01DA020757). Data on structural characteristics of these treatment organizations were collected with support by NIDA (R01DA13110, R01DA14482, and R01DA14976). The opinions expressed are those of the authors and do not represent the official position of the funding agency.

Notes

*Significant difference by center type, p < .001

^aSignificant difference between private and public centers (p < .05, two-tailed test).

^bSignificant difference between private centers and TCs (p < .05, two-tailed test).

^a Significant difference between private centers and TCs (p < .05, two-tailed test).

^b Significant difference between public centers and TCs (p < .05, two-tailed test).