Changes in Substance Use Treatment Providers’ Delivery of the 5A’s for Non-Cigarette Tobacco Use in the Context of a Comprehensive Tobacco-Free Workplace Program Implementation

Ammar D. Siddiqi, Tzuan A. Chen, Maggie Britton, Isabel Martinez Leal, Brian J. Carter, Virmarie Correa-Fernández, Anastasia Rogova, Bryce Kyburz, Teresa Williams, Kathleen Casey and Lorraine R. Reitzel ()
Additional contact information
Ammar D. Siddiqi: Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., Houston, TX 77030, 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
Maggie Britton: Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., Houston, TX 77030, USA
Isabel Martinez Leal: Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., Houston, TX 77030, USA
Brian J. Carter: Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., Houston, TX 77030, 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
Anastasia Rogova: Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., Houston, TX 77030, USA
Bryce Kyburz: Integral Care, 1430 Collier St., Austin, TX 78704, USA
Teresa Williams: Integral Care, 1430 Collier St., Austin, TX 78704, USA
Kathleen Casey: Integral Care, 1430 Collier St., Austin, TX 78704, USA
Lorraine R. Reitzel: Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., Houston, TX 77030, USA

IJERPH, 2023, vol. 20, issue 3, 1-16

Abstract: Tobacco use treatment is not prioritized in substance use treatment centers (SUTCs), leading to tobacco-related health inequities for patients with substance use disorders (SUDs) and necessitating efforts to enhance providers’ care provision. Training providers on how to treat tobacco use increases their intervention on patients’ smoking, but limited work addresses its effects on their non-cigarette tobacco use intervention provision. This study redressed this gap using data from 15 unaffiliated SUTCs in Texas (serving 82,927 patients/year) participating in a tobacco-free workplace program (TFWP) that included provider education on treating tobacco use, including non-cigarette tobacco use. SUTC providers completed surveys before (n = 259) and after (n = 194) TFWP implementation. Past-month screening/intervention provision for non-cigarette tobacco use (the 5A’s; ask, advise, assess, assist, arrange) and provider factors theoretically and practically presumed to underlie change [i.e., beliefs about concurrently treating tobacco use disorder (TUD) and other SUDs, self-efficacy for tobacco use assessment (TUA) delivery, barriers to treating tobacco dependence, receipt of tobacco intervention training] were assessed. Generalized linear or linear mixed models assessed changes over time from before to after TFWP implementation; low vs. high SUTC-level changes in provider factors were examined as moderators of changes in 5A’s delivery. Results indicated significant improvement in each provider factor and increases in providers’ asking, assisting, and arranging for non-cigarette tobacco use over time ( p s < 0.04). Relative to their counterparts, SUTCs with high changes in providers’ beliefs in favor of treating patients’ tobacco use had greater odds of advising, assessing, assisting, and arranging patients, and SUTCs with greater barrier reductions had greater odds of advising and assisting patients. Results suggest that TFWPs can address training deficits and alter providers’ beliefs about treating non-tobacco TUD during SUD care, improve their TUA delivery self-efficacy, and reduce intervention barriers, ultimately increasing intervention provision for patients’ non-cigarette tobacco use. SUTCs with the greatest room for improvement in provider beliefs and barriers to care provision seem excellent candidates for TFWP implementation aimed at increasing non-cigarette tobacco use care delivery.

Keywords: tobacco control; behavioral health; provider self-efficacy; non-cigarette tobacco use; brief intervention; tobacco use cessation; workplace program; barriers; substance use disorder; provider training (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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