Forthcoming Publication on Tobacco Cessation Services in Adolescent-Only Substance Abuse Treatment Programs
Muilenburg, J. L., Laschober, T. C., & Eby, L. T. (in press). Substance use disorder counselors’ reports of tobacco cessation services availability, implementation, and tobacco-related knowledge. Journal of Adolescent Health.
Laschober, T. C., Muilenburg, J. L., & Eby, L. T. (in press). Factors linked to substance use disorder counselors’ (non)implementation likelihood of tobacco cessation 5 A’s, counseling, and pharmacotherapy. Journal of Addictive Behaviors Therapy & Rehabilitation.
Study Background: Despite efforts to promote the use of tobacco cessation services (TCS), implementation extensiveness remains limited. This study investigated three factors (cognitive, behavioral, environmental) identified by social cognitive theory as predictors of substance use disorder counselors’ likelihood of use versus non-use of tobacco cessation (TC) 5 A’s (ask patients about tobacco use, advise to quit, assess willingness to quit, assist in quitting, arrange for follow-up contact), counseling, and pharmacotherapy with their patients who smoke cigarettes.
Methods: Data were collected in 2010 from 942 counselors working in 257 treatment programs that offered TCS. Cognitive factors included perceived job competence and TC attitudes. Behavioral factors encompassed TC-related skills and general training. External factors consisted of TC financial resource availability and coworker TC attitudes. Data were analyzed using logistic regression models with nested data.
Results: Approximately 86% of counselors used the 5 A’s, 76% used counseling, and 53% used pharmacotherapy. When counselors had greater TC-related skills and greater general training they were more likely to implement the 5 A’s. Implementation of counseling was more likely when counselors had more positive attitudes toward TC treatment, greater general training, greater financial resource availability, and when coworkers had more positive attitudes toward TC treatment. Implementation of pharmacotherapy was more likely when counselors had more positive attitudes toward TC treatment, greater general training, and greater financial resource availability.
Conclusion: Findings indicate that interventions to promote TCS implementation should consider all three factors simultaneously as suggested by social cognitive theory.
Muilenburg, J. L., Laschober, T. C., & Eby, L. T. (in press). Prevalence of and factors related to tobacco ban implementation in substance use disorder treatment programs. Administration and Policy in Mental Health and Mental Health Services Research.
This study examined the prevalence of and factors (psychological climate for change and staff attributes) related to indoor and outdoor tobacco bans for patients, employees, and visitors in U.S. substance use disorder treatment programs. Data were collected from a random sample of 1,026 program administrators. Almost all programs banned tobacco use indoors and around one third banned tobacco use outdoors. When there was no tobacco ban, the majority of programs restricted smoking to designated indoor and/or outdoor areas. Further, all psychological climate for change factors (perceived program support, perceived tobacco culture, and tobacco ban beliefs) but none of the staff attributes (percentage licensed/certified clinicians, percentage clinicians with master’s degrees, total staff with education in health-related field) were significantly related to the implementation of comprehensive tobacco bans (both indoors and outdoors).
Eby, L. T., Butts, M. M., Hoffman, B. J., & Sauer, J. B. (in press). Cross-lagged relations between mentoring received from supervisors and employee OCBs: disentangling causal direction and identifying boundary conditions. Journal of Applied Psychology.
Eby, L. T., Laschober, T. C., & Muilenburg, J. L. (in press). Sustained, new, never, and discontinued tobacco cessation services adopters. Journal of Substance Abuse Treatment.
This study examined longitudinal adoption patterns of tobacco cessation (TC) counseling and TC pharmacotherapy in substance use disorder treatment programs and baseline predictors (program characteristics and program culture) of these patterns 12-months later. Telephone survey data were collected in 2010 from 685 randomly sampled program administrators working in geographically representative treatment programs across the U.S. Regarding TC counseling, about 41% of programs never adopt, 33% sustain, and 27% change adoption patterns. Concerning TC pharmacotherapy, about 62% of programs never adopt, 19% sustain, and 18% change adoption patterns. The three most consistent predictors of counseling adoption patterns are TC reimbursement, TC financial resource availability, and smoking culture. For TC pharmacotherapy adoption patterns, the most consistent predictors include profit status, TC reimbursement, level of care, TC financial resource availability, and smoking culture. Findings provide insights into program characteristics and program culture as both potential barriers and facilitators of longitudinal TCS adoption.