Prediction of alcohol addicted patients’ smoking status through hospital tobacco control policy: A multi-level-analysis

Abstract

Aims: The goal of the study was the exploration of the influence of tobacco control policies in German in-patient substance abuse treatment centres on the smoking status of alcohol-addicted patients at discharge.

Method: A multi-centre field study with pre–post design was carried out in 40 in-patient treatment centres in Germany. The tobacco control policy questionnaire was answered by the director of each treatment centre (N = 40). Data from 774 alcohol addicted patients could be assessed at admission and discharge. A multi-level-analysis (HLM) was carried out to identify the predictive value of institutional tobacco control policy on smoking status post-rehabilitation.

Findings: Findings uncovered that the strength of tobacco control policy lie in the areas of assessment of smokers, enforcement of smoking restrictions and restrictiveness of smoking policy. Comprehensiveness of smoking restrictions and intensity of smoking-related training of the employees are significant predictors for the variance in quit rates between the institutions. Significant individual predictors for quitting include gender, tobacco dependency and educational status.

Conclusions: Results support findings from other areas like schools and public areas stating the effectiveness of restrictive smoking policies. However, this patient group is especially resistant to change, quit rates are low and effects of tobacco control policy small; the latter partly due to the distal character of policy variables for the individual.