NICOTINE CESSATION & SMOKING BANS IN ALCHOLISM TREATMENT

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APPLICANT'S ABSTRACT: This project aims to discover two processes: the conditions under which nicotine cessation treatment programs will be integrated in substance abuse treatment programs; and, the conditions under which smoke-free policies will be successfully implemented and maintained in substance abuse treatment programs. This project has significant health relevance because there is a strong, positive correlation between heavy drinking and heavy smoking, and consumption of alcohol and tobacco have synergistic negative health effects that lead to increased risks of cancer, especially oral, esophageal, and laryngeal. Co-occurrence of smoking and excessive drinking has implications for alcoholism treatment. Prior empirical research has indicated that smoking cessation improves treatment outcome, and is positively related to the maintenance of sobriety. Currently there is no national data set that records the degree to which substance abuse programs offer nicotine cessation or are smoke-free, and how or why they do. Because we want to learn the reasons treatment programs incorporate nicotine cessation, and the process by which they adopt nicotine cessation, we will collect data via semi-structured, open-ended, in-depth interviews of a random sample (stratified by state) of 1% of the clinical directors of US substance abuse treatment programs. The clinical directors will be queried as to the process that led to their adopting nicotine cessation in their treatment program, or the reasons why they did not. The clinical directors also will be queried as to the process of implementing and maintaining a smoking ban in their treatment program, and how they succeeded or failed, or the reasons they are not smoke-free. The aim is to describe the state of treatment practice with respect to the role of nicotine cessation in alcoholism treatment; as well as compile the collective experiences on the implementation of a smoking ban that can be utilized by alcoholism treatment providers as they grapple with the challenges of health service provision.