Implementing a tobacco-free workplace program at a substance use treatment center: a case study

Area of Science:

• Public Health
• Behavioral Health
• Addiction Medicine

Background:

• Individuals with substance use disorders (SUDs) exhibit higher smoking rates and tobacco-related disease burdens.
• Substance use treatment centers often lack evidence-based tobacco cessation support and comprehensive tobacco-free policies.
• This study addresses barriers and facilitators for implementing tobacco-free workplace programs in SUD treatment settings.

Purpose of the Study:

• To identify barriers and facilitators for implementing a sustainable tobacco-free workplace program in a substance use treatment center.
• To understand staff and client perspectives on tobacco use and cessation within the treatment environment.

Main Methods:

• Qualitative case study employing an ethnographic approach.
• Data collection through interviews with staff (n=6) and clients (n=16), and site visits (n=8).
• Thematic analysis guided by the extended Normalization Process Theory.

Main Results:

• Staff generally supported the program, understanding its benefits.
• Challenges included high client smoking rates and staff perceptions of low client interest/ability to quit.
• Facilitators included staff training, leadership support, low staff smoking rates, and access to resources like nicotine replacement products.
• Program implementation and enforcement gradually shifted attitudes and improved cessation care.

Conclusions:

• Substance use treatment centers can integrate tobacco cessation into operations despite client complexities.
• With adequate support, these centers can deliver vital tobacco cessation care, addressing health disparities in this population.