A qualitative examination of the positive and negative consequences associated with going tobacco-free in substance abuse treatment: the NY State experience.
A qualitative examination of the positive and negative consequences associated with going tobacco-free in substance abuse treatment: the NY State experience.
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DOI：
10.1093/ntr/nts027
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发表时间：
2012-12
期刊：
影响因子：
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通讯作者：
L. Eby;Taylor E. Sparks;E. Evans;J. Selzer
中科院分区：
文献类型：
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作者：
L. Eby;Taylor E. Sparks;E. Evans;J. Selzer
2008年，纽约州酒精中毒和药物滥用服务办公室(OASAS)要求所有州资助或州认证的成瘾治疗项目100%无烟。该规定禁止患者、员工、志愿者和访客使用或拥有所有烟草产品。这包括外部场地和设施拥有、租赁或运营的车辆。成瘾治疗中心还被要求对患者进行烟草使用筛查，并将戒烟纳入治疗计划。本研究从辅导员和临床监督员的角度考察了这一规则的感知有效性。方法收集来自全纽约50个独立药物滥用治疗项目的261名咨询师和80名临床监督员的定性数据。被问及OASAS条例在实施约一年后的积极和消极影响。结果调查结果表明，对该规定的反应不一。确定了广泛的积极和消极后果，这些结果在咨询师和临床主管的报告中总体上是一致的。最常见的积极结果是积极的行为改变(例如，减少吸烟，增加戒烟意向)和提高对吸烟的认识(例如，危险，戒烟的可用帮助)。最常见的负面后果是加强患者的成瘾者行为(例如，撒谎、“买卖”香烟)和执法问题(例如，难以执行、为遵守规定而维持治安)。结论研究结果对在药物滥用治疗项目中实施无烟法规有一定的指导意义。
INTRODUCTION In 2008, the New York State (NYS) Office of Alcoholism and Substance Abuse Services (OASAS) required all state-funded or state-certified addiction treatment programs to be 100% tobacco-free. The regulation prohibits the use or possession of all tobacco products by patients, employees, volunteers, and visitors. This includes exterior grounds and vehicles owned, leased, or operated by the facility. Addiction treatment centers are also required to screen patients for tobacco use and incorporate tobacco cessation into treatment programming. This study examined the perceived effectiveness of this regulation from the perspective of counselors and clinical supervisors. METHODS Qualitative data were collected from 261 counselors and 80 clinical supervisors working in 50 free-standing substance abuse treatment programs throughout NYS. Questions asked about the perceived positive and negative consequences of the OASAS regulation approximately 1 year after its implementation. RESULTS The findings indicate mixed reactions to the regulation. A wide range of positive and negative consequences were identified, which were generally consistent across counselor and clinical supervisor reports. The most commonly reported positive outcomes were positive behavior change (e.g., less smoking, increased intentions to quit) and increased awareness about smoking (e.g., dangers, available assistance to quit). The most commonly reported negative consequences were reinforcing addict behaviors among patients (e.g., lying, "dealing" cigarettes) and enforcement problems (e.g., difficulty enforcing, policing for compliance). CONCLUSION Findings have implications for the implementation of tobacco-free regulations in substance abuse treatment programs.