Implementation and Outcomes of a Comprehensive Tobacco Free Workplace Program in Opioid Treatment Centers

Matthew Taing, Vijay Nitturi, Tzuan A. Chen, Bryce Kyburz, Isabel Martinez Leal, Virmarie Correa-Fernández, Ezemenari M. Obasi, Teresa Williams, Kathleen Casey, Daniel P. O’Connor, Litty Koshy, Maggie Britton, Kelli Drenner and Lorraine R. Reitzel
Additional contact information
Matthew Taing: Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA
Vijay Nitturi: Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA
Tzuan A. Chen: Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA
Bryce Kyburz: Integral Care, 1430 Collier Street, Austin, TX 78704, USA
Isabel Martinez Leal: Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA
Virmarie Correa-Fernández: Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA
Ezemenari M. Obasi: Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA
Teresa Williams: Integral Care, 1430 Collier Street, Austin, TX 78704, USA
Kathleen Casey: Integral Care, 1430 Collier Street, Austin, TX 78704, USA
Daniel P. O’Connor: Health Research Institute, The University of Houston, 4349 Martin Luther King Blvd., Houston, TX 77204, USA
Litty Koshy: Health Research Institute, The University of Houston, 4349 Martin Luther King Blvd., Houston, TX 77204, USA
Maggie Britton: Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA
Kelli Drenner: Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA
Lorraine R. Reitzel: Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA

IJERPH, 2021, vol. 19, issue 1, 1-17

Abstract: Tobacco use is exceedingly high among individuals receiving care for opioid addiction, but not commonly addressed by clinicians in treatment settings. Taking Texas Tobacco Free (TTTF) is a comprehensive tobacco-free workplace (TFW) program that builds treatment centers’ capacity to address tobacco use with evidence-based tobacco cessation policies and practices. Here, we examine the process and outcomes of TTTF’s implementation within 7 opioid addiction centers. Program goals were structured according to the RE-AIM framework. Pre- and post-implementation data were collected from client facing and non-client facing employees to assess changes in education, training receipt, knowledge, and intervention behaviors, relative to program goals. Centers reported tobacco screenings conducted and nicotine replacement therapy (NRT) delivered through 6 months post-implementation. Overall, 64.56% of employees participated in TTTF-delivered tobacco education, with a 54.9% gain in tobacco control and treatment knowledge ( p < 0.0001), and significant increases in exposure to education about tobacco use and harms among individuals with opioid use disorder ( p = 0.0401). There were significant gains in clinicians’ receipt of training in 9/9 tobacco education areas ( ps ≤ 0.0118). From pre- to post-implementation, there were mean increases in the use of the 5A’s (ask, advise, assess, assist, and arrange) and other evidence-based interventions for tobacco cessation, with statistically significant gains seen in NRT provision/referral ( p < 0.0001). Several program goals were achieved or exceeded; however, 100% center participation in specialized clinical trainings was among notable exceptions. One program withdrew due to competing pandemic concerns; all others implemented comprehensive TFW policies. Overall, TTTF may have improved participating opioid treatment centers’ capacity to address tobacco use, although study limitations, including lower post-implementation evaluation response rates, suggest that results require replication in other opioid addiction treatment settings.

Keywords: tobacco control; opioid addiction; substance use; implementation science (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (4)

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