This study investigated whether organizational changes occurred when nicotine treatments were tested in specialty care clinics. Two intervention clinics (one drug treatment and one HIV-care) participated in clinical trials for nicotine treatment. Three clinics (two drug and one HIV-care) were control clinics. Staff in the intervention clinics (n=57) and in the control clinics (n=62) were surveyed at baseline and 18 months later. Staff surveys concerned nicotine-related knowledge, beliefs about treating smoking, self-efficacy in delivering such treatment, nicotine related practices, and barriers to providing nicotine treatment. Mean scale scores at 18 months were no different in clinics participating in the clinical trials from the control group for any of the five scales (knowledge, practices, barriers, efficacy and beliefs). The presence of a smoking cessation clinical trial did not influence staff knowledge, attitudes, or practices related to smoking in these clinics. More specific organizational intervention may influence staff practices related to addressing smoking among clients in drug treatment and HIV-care clinics.
Get full access to this article
View all access options for this article.
References
1.
BackerT.E.1995Assessing and enhancing readiness for change: Implications for technology transfer. In BackerT.E.DavidS.L.SaucyG. (Eds.), Reviewing the behavioral science knowledge base on technology transfer. Rockville, MD: National Institute on Drug Abuse.
2.
BorrelliB.HechtJ.P.PapandonatosG.D.EmmonsK.M.TatewosianL.R.AbramsD.B.2001Smoking-cessation counseling in the home. Attitudes, beliefs, and behaviors of home healthcare nurses. American Journal of Prevention Medicine, 21, 272–277.
3.
BowmanJ.A.WalshR.A.2003Smoking intervention within alcohol and other drug treatment services: A selective review with suggestions for practical management. Drug and Alcohol Review, 22 (1), 73–82.
4.
BurlingT.A.RamseyT.G.SeidnerA.L.KondoC.S.1997Issues related to smoking cessation among substance abusers. Journal of Substance Abuse, 9, 27–40.
5.
BurnsD.KramerA.YellinF.FuchsD.WachterH.DiGioiaR.A.SanchezW.C.GrossmanR.J.GordinF.M.BiggarR.J.GoedertJ.J.1991Cigarette smoking: A modifier of human immunodeficiency virus type 1 infection?Journal of Acquired Immune Deficiency Syndromes, 4 (1), 76–83.
6.
California Department of Health Services.2004California Adult Tobacco Survey, 2005 questionnaire. Sacramento, CA: Survey Research Group.
CraibK.SchechterM.MontanerJ.LeT.N.SestakP.WilloughbyB.VoigtR.HaleyL.O'ShaughnessyM.V.1992The effect of cigarette smoking on lymphocyte subsets and progression to AIDS in a cohort of homosexual men. Clinical Investigational Medicine, 15 (4), 301–308.
9.
DemasP.SchoenbaumE.WillsT.DollL.KleinR.1995Stress, coping, and attitudes toward HIV treatment in injecting drug users: A qualitative study. AIDS Education and Prevention, 7, 429–442.
10.
DelucchiK. L.TajimaB.GuydishJ. in press Scale development of smoking cessation knowledge, attitudes and practice. Journal of Drug Issues.
11.
DiazP.KingM.PachtE.WewersM.D.GadekJ.E.NagarajaH.N.DrakeJ.ClantonT.L.2000Increased susceptibility to pulmonary emphysema among HIV-seropositive smokers. Annals of Internal Medicine, 132 (5), 369–372.
12.
Fals-StewartW.LogsdonT.BirchlerG.R.2004Diffusion of an empirically supported treatment for substance abuse: An organizational autopsy of technology transfer success and failure. Clinical Psychology: Science and Practice, 11, 177–182.
13.
FioreM.C.BaileyW.C.CohenS.J.DorfmanS.F.GoldsteinM.G.GritzE.R.HeymanR.B.JaénC.R.KottkeT.E.LandoH.A.MecklenburgR.E.MullenP.D.NettL.M.RobinbsonL.StitzerM. L.TommaselloA.C.VillejoL.WewersM. E.2000Treating tobacco use and dependence. Rockville, MD: U.S. Department of Health and Human Services.
14.
FioreM.C.JaénC.R.BakerT.B.BaileyW.C.BenowitzN.L.CurryS.J.DorfmanS.F.FroelicherE.S.GoldsteinM.G.HealtonC.G.HendersonP.N.HeymanR.B.KohH.K.KottkeT.E.LandoH.A.MecklenburgR.E.MermelsteinR.J.MullenP.D.OrleansC.T.RobinsonL.StitzerM.L.TommaselloA.C.VillejoL.WewersM.E.2008Treating tobacco use and dependence: 2008 update. Rockville, MD: U.S. Department of Health and Human Services.
15.
FrazierL.M.MolgaardC.A.FredricksonD.D.EarlyJ.L.SchukmanJ.S.DismukeS.E.2001Barriers to smoking cessation initiatives for Medicaid clients in managed care. Substance Use & Misuse, 36, 1875–1899.
16.
FullerB.E.GuydishJ.TsohJ.ReidM.S.ResnickM.ZammarelliL.ZiedonisD.M.SearsC.McCartyD.2007Attitude toward the integration of smoking cessation treatment into drug abuse clinics. Journal of Substance Abuse Treatment, 32 (1), 53–60.
17.
GlasgowR.E.LichtensteinE.MarcusA.C.2003Why don't we see more translation of health promotion research to practice? Rethinking the efficacy-to-effectiveness transition. American Journal of Public Health, 93, 1261–1267.
18.
GlynnT.ManleyM.1989How to help your patients quit smoking: A National Cancer Institute manual for physicians. Bethesda, MD: Smoking, Tobacco and Cancer Program, Division of Cancer Prevention and Control, National Cancer Institute.
GuydishJ.R.PassalacquaE.TajimaB.ManserS. T.2007Staff smoking and other barriers to nicotine dependence intervention in addiction treatment settings: A review. Journal of Psychoactive Drugs, 39 (4), 423–433.
21.
GuydishJ.TajimaB.ManserS.JessupM.2007Strategies to encourage adoption in multi-site clinical trials. Journal of Substance Abuse Treatment, 32, 177–188.
22.
HahnE.J.WarnickT.A.PlemmonsS.1999Smoking cessation in drug treatment programs. Journal of Addictive Diseases, 18, 89–101.
23.
HeathertonT.F.KozlowskiL.T.FreckerR.C.FagerströmK.O.1991The Fagerström Test for Nicotine Dependence: A revision of the Fagertröm Tolerance Questionnaire. British Journal of Addiction, 86, 1119–1127.
24.
HirschtickR.E.GlassrothJ.JordanM.C.WilcoskyT.C.WallaceJ.M.KvaleP.A.MarkowitzN.RosenM.J.ManguraB.T.HopewellP.C.1995Bacterial pneumonia in persons infected with the human immunodeficiency virus. New England Journal of Medicine, 333 (13), 845–851.
25.
HoffmanA. L.KantorB.LeechT.LinbergD.Order-ConnorsB.SchreiberJ.SladeJ.2004Drug-free is nicotine-free: A manual for chemical dependency treatment programs. New Brunswick, NJ: School of Public Health at the University of Medicine and Dentistry of New Jersey, Tobacco Dependence Program.
26.
HoffmanA.L.SladeJ.1993Following the pioneers. Addressing tobacco in chemical dependency treatment. Journal of Substance Abuse Treatment, 10 (2), 153–160.
27.
HughesJ.2002Do smokers with current or past alcoholism need different or more intensive treatment?Alcohol Clinical Experimental Research, 26, 1934–1935.
28.
HurtR.D.OffordK.P.CroghanI.T.Gomez-DahlL.KottkeT.E.MorseR.M.MeltonL.J.I.1996Mortality following inpatient addictions treatment. Role of tobacco use in a community-based cohort. JAMA, 275 (14), 1097–1103.
KalmanD.1998Smoking cessation treatment for substance misusers in early recovery: A review of the literature and recommendations for practice. Substance Use & Misuse, 33, 2021–2047.
31.
KrupskiW.C.NguyenH.T.JonesD.N.WallaceH.WhitehillT.A.NehlerM.R.2002Smoking cessation counseling: A missed opportunity for general surgery trainees. Journal of Vascular Surgery, 36, 257–262.
32.
MamaryE.M.BahrsD.MartinezS.2002Cigarette smoking and the desire to quit among individuals living with HIV. AISD Patient Care Studies, 16 (1), 39–42.
33.
McCoolR. M.RichterK. P.ChoiW. S.2005Benefits of and barriers to providing smoking treatment in methadone clinics: Findings from a national study. American Journal on Addictions, 14 (4), 358–366.
34.
PollakK.I.ArredondoE.M.YarnallK.S.LipkusI.MyersE.McNeillyM.CostanzoP.2001How do residents prioritize smoking cessation for young “high-risk” women? Factors associated with addressing smoking cessation. Preventive Medicine, 33 (4), 292–299.
35.
RogersE.M.2002Diffusion of preventive innovations. Addictive Behaviors, 27, 989–993.
36.
SimoyanO.M.BadnerV.M.FreemanK.D.2002Tobacco cessation services in dental offices. Are we doing all we can?Addictive Behaviors, 68, 34–40.
37.
SimpsonD.D.2002A conceptual framework for transferring research to practice. Journal of Substance Abuse Treatment, 22, 171–182.
38.
SobellM.B.2002Alcohol and tobacco: Clinical and treatment issues. Alcohol Clinical and Experimental Research, 26, 1954–1955.
39.
SobellL.C.SobellM.B.AgrawalS.2002Self-change and dual recoveries among individuals with alcohol and tobacco problems: Current knowledge and future directions. Alcohol Clinical and Experimental Research, 261, 1936–1938.
40.
StuytE.Order-ConnorsB.ZiedonisD.2003Addressing tobacco through program and system change in mental health and addiction settings. Psychiatric Annals, 33 (7), 447–456.
41.
SullivanM.A.CoveyL.S.2002Nicotine dependence: The role for antidepressants and anxiolytics. Current Opinion Investigational Drugs, 3, 262–271.
42.
TremblayM.GervaisA.LacroixC.O'LoughlinJ.MakniH.ParadisG.2001Physicians Taking Action Against Smoking: An intervention program to optimize smoking cessation counseling by Montreal general practitioners. Canadian Medical Association Journal, 165, 601–607.
43.
VelasquezM.M.HechtJ.QuinnV.P.EmmonsK.M.DiClementeC.C.Dolan-MullenP.2000Application of motivational interviewing to prenatal smoking cessation: Training and implementation issues. Tobacco Control, 9, 36–40.
44.
WestR.2001Multiple substance dependence: Implications for treatment of nicotine dependence. Addiction, 96, 775–776.
45.
ZiedonisD.WilliamsJ.2003Management of smoking in people with psychiatric disorders. Current Opinion in Psychiatry, 16, 305–315.
46.
ZiedonisD.ZammarelliL.SewardG.OliverK.GuydishJ.HobartM.2007Addressing tobacco through organizational change: A case study of an addiction treatment organization. Journal of Psychoactive Drugs, 39 (4), 451–459.
