The New York policy on smoking in addiction treatment: findings after 1 year.
The New York policy on smoking in addiction treatment: findings after 1 year.
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DOI：
10.2105/ajph.2011.300590
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发表时间：
2012-05
影响因子：
12.7
通讯作者：
Chan M
中科院分区：
文献类型：
--
作者：
Guydish J;Tajima B;Kulaga A;Zavala R;Brown LS;Bostrom A;Ziedonis D;Chan M
我们评估了吸烟流行率的变化以及与2008年7月纽约酒精中毒和物质滥用服务办公室烟草政策相关的其他措施，该政策要求所有公共资助的成瘾治疗项目实施无烟理由，在工作人员中没有吸烟的证据，并向所有客户提供烟草依赖治疗。在随机抽样的10个项目中，员工和客户在政策实施前和一年后进行了调查。测量包括咨询师和客户接受的与烟草相关的知识、态度和做法。客户吸烟率从69.4%降至62.8%(P=0.044)。然而，对该政策的反应因项目类型而异。门诊计划在任何工作人员和客户调查指标上都没有显著变化。在美沙酮项目中，工作人员对烟草相关实践的使用增加(P<；.01)，客户对烟草治疗的态度变得更加积极(P<；.05)，客户获得更多与烟草相关的服务(P<；.05)。居民客户报告在政策实施后戒烟的可能性更大(优势比=4.7；95%可信区间=1.53，14.19)，但他们对烟草治疗的态度较差(P<；.001)，从他们的项目(P<；.001)或他们的顾问(P<；.001)那里获得的烟草相关服务也较少。如果得到更多研究的支持，纽约的政策可能会提供一种模式，供成瘾治疗系统用来解决吸烟问题普遍且难以解决的人群中的问题。住宅项目可能需要额外的干预或政策支持，这些项目在实施无烟场地方面面临着更大的挑战。
We assessed changes in smoking prevalence and other measures associated with the July 2008 New York Office of Alcoholism and Substance Abuse Services tobacco policy, which required that all publicly funded addiction treatment programs implement smoke-free grounds, have “no evidence” of smoking among staff, and make tobacco dependence treatment available for all clients. In a random sample of 10 programs, staff and clients were surveyed before the policy and 1 year later. Measures included tobacco-related knowledge, attitudes, and practices used by counselors and received by clients. Client smoking decreased from 69.4% to 62.8% (P = .044). However, response to the policy differed by program type. Outpatient programs showed no significant changes on any of the staff and client survey measures. In methadone programs, staff use of tobacco-related practices increased (P < .01), client attitudes toward tobacco treatment grew more positive (P < .05), and clients received more tobacco-related services (P < .05). Residential clients were more likely to report having quit smoking after policy implementation (odds ratio = 4.7; 95% confidence interval = 1.53, 14.19), but they reported less favorable attitudes toward tobacco treatment (P < .001) and received fewer tobacco-related services from their program (P < .001) or their counselor (P < .001). If supported by additional research, the New York policy may offer a model that addiction treatment systems can use to address smoking in a population where it has been prevalent and intractable. Additional intervention or policy supports may be needed in residential programs, which face greater challenges to implementing tobacco-free grounds.