Smoking Cessation Practices in Community Tx Programs

描述（由申请人提供）： 提供促进戒烟的卫生服务可大大降低癌症相关的发病率和死亡率。然而，在医疗机构内进行的研究很少，以衡量这些服务的提供情况，特别是在那些为烟草使用率高的客户群体提供服务的组织内。关于在药物滥用治疗环境中提供戒烟（和其他烟草使用）服务的国家一级数据很少。此外，也没有关于在这些设施中采用和执行公共卫生服务临床实践指南《治疗烟草使用和依赖》的数据。如果这些医疗机构的咨询人员也可以获得戒烟服务，那么癌症预防可能会取得额外的进展。环境政策也可以预防癌症的客户以及中心的工作人员。拟议的研究将通过建立三个现有的全国代表性设施样本来收集组织层面和顾问层面的数据：362个公共资助的专业药物滥用治疗中心，401个私人资助的中心和400个治疗社区。与项目主管的电话访谈将确定中心是否：1）采用并实施了指南，包括5A、药物治疗和心理社会干预; 2）采用了环境烟草相关政策; 3）为员工戒烟提供保险。将向咨询师分发邮件问卷，以评估他们对戒烟的态度以及他们提供这些服务的程度。这些数据与2002- 2003年从这些机构收集的信息的整合将允许与指南的采用和实施相关的组织特征的多变量建模以及药物治疗采用的纵向分析。本研究收集的信息将代表向烟草相关癌症高风险人群提供服务的宝贵信息，并确定提供此类服务的障碍。

DESCRIPTION (provided by applicant): The delivery of health services to promote smoking cessation may substantially reduce cancer-related morbidity and mortality. However, there has been little research conducted within healthcare settings to measure the delivery of these services, particularly within those organizations that serve client populations with high rates of tobacco use. There is little national-level data on the delivery of smoking cessation (and other tobacco use) services in substance abuse treatment settings. Furthermore, there is no data regarding the adoption and implementation of the Public Health Service clinical practice guideline, Treating Tobacco Use and Dependence in these facilities. Additional gains in cancer prevention may be achieved if smoking cessation services are also available to the counseling staff within these healthcare organizations. Environmental policies may also prevent cancer for clients as well as center staff. The proposed research would gather organizational-level and counselor-level data by building upon three existing nationally representative samples of facilities: 362 publicly funded specialty substance abuse treatment centers, 401 privately funded centers, and 400 therapeutic communities. Telephone interviews with program directors will determine whether centers have: 1) adopted and implemented the guideline, including the 5 A's, pharmacotherapies, and psycho-social interventions; 2) adopted environmental tobacco-related policies; and 3) provide insurance coverage for employee smoking cessation. Mail questionnaires will be distributed to counselors to assess their attitudes toward smoking cessation and the extent to which they deliver these services. Integration of these data with information collected from these facilities in 2002- 2003 will allow for multivariate modeling of the organizational characteristics associated with guideline adoption and implementation as well as a longitudinal analysis of pharmacotherapy adoption. The information collected in this research would represent valuable information about the services delivered to a population at high-risk of tobacco-related cancers and identify barriers to such service delivery.