Addressing Tobacco Through Organizational Change in a Hospital-Based Mental Health Center in China: The Intervention and Lessons Learned in a Pilot Implementation Project

Abstract

Nicotine dependence continues to be the single most preventable cause of morbidity and mortality in China and the United States. While evidence-based treatments exist, these interventions are only recently beginning to be integrated into routine clinical psychiatric practice in China. This is the first report of an organizational change intervention designed to integrate evidence-based practices for addressing tobacco at a hospital-based mental health center in China. This organizational change intervention, called Addressing Tobacco Through Organizational Change (ATTOC), has been used in mental health and substance abuse treatment settings in the United States. The ATTOC intervention was implemented within the center in an effort to reduce rates of smoking among patients and staff, increase treatment options for tobacco addiction, and restrict tobacco use in this setting, with the ultimate goal of creating a tobacco-free campus. The intervention resulted in eliminating tobacco use in the building, restricting tobacco use on the campus surrounding the building to selected sites, improving documentation of a patient's tobacco use status, and increasing tobacco addiction treatment services. This report includes a discussion of the cultural context of tobacco use in China and the lessons learned from the global collaboration.

Keywords:

• tobacco
• nicotine
• addiction
• organizational change

ACKNOWLEDGMENTS

The authors would like to thank Drs. Chaoming Wang, Liang Xie, Yuejing Wu, Wanjun Guo, Bo Zhang, and Jennifer Wu and nurses Xuehua Huang, Xiaozhen Song, Qinglan Tao, Ya Wang, Xiaohong Gong, and Bingrong Cao for their support of the project. We would also like to acknowledge a University of Massachusetts Medical School Global Initiatives Program grant for supporting this project.