Initiation of a tobacco treatment program within an inpatient substance use treatment facility: A case study

Tobacco use prevalence is disproportionately high among individuals with mental health conditions, including substance use disorders. Clinical practice guidelines recommend tobacco treatment for those receiving treatment for substance use given the health and psychosocial benefits from tobacco cessation. Despite this, there are several barriers to the provision of tobacco treatment in substance use treatment settings, and many patients in these settings do not receive treatment. This case study describes the acquisition of an inpatient substance use treatment facility by a major hospital system and the subsequent integration of a tobacco treatment service within this setting. In this case, we describe barriers, such as initial staff and patient hesitance toward the service, logistical challenges in service provision, and policy issues that needed to be addressed within the setting. Data derived from medical chart reviews of admitted patients show that following the introduction of the program, engagement with tobacco cessation pharmacotherapy and counseling substantially increased, which suggests acceptability and integration of the services. This case serves as a model of the adoption process of a comprehensive tobacco treatment program in substance use treatment settings as a way to reduce tobacco-related disparities in this priority population.