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Implementation and Outcomes of a Comprehensive Tobacco Free Workplace Program in Opioid Treatment Centers

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  • Matthew Taing

    (Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA
    Health Research Institute, The University of Houston, 4349 Martin Luther King Blvd., Houston, TX 77204, USA
    These authors contributed equally to this work.)

  • Vijay Nitturi

    (Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA
    Health Research Institute, The University of Houston, 4349 Martin Luther King Blvd., Houston, TX 77204, USA
    These authors contributed equally to this work.)

  • Tzuan A. Chen

    (Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA
    Health Research Institute, The University of Houston, 4349 Martin Luther King Blvd., Houston, TX 77204, USA)

  • Bryce Kyburz

    (Integral Care, 1430 Collier Street, Austin, TX 78704, USA)

  • Isabel Martinez Leal

    (Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA
    Health Research Institute, The University of Houston, 4349 Martin Luther King Blvd., Houston, TX 77204, USA)

  • Virmarie Correa-Fernández

    (Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA
    Health Research Institute, The University of Houston, 4349 Martin Luther King Blvd., Houston, TX 77204, USA)

  • Ezemenari M. Obasi

    (Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA
    Health Research Institute, The University of Houston, 4349 Martin Luther King Blvd., Houston, TX 77204, USA)

  • Teresa Williams

    (Integral Care, 1430 Collier Street, Austin, TX 78704, USA)

  • Kathleen Casey

    (Integral Care, 1430 Collier Street, Austin, TX 78704, USA)

  • Daniel P. O’Connor

    (Health Research Institute, The University of Houston, 4349 Martin Luther King Blvd., Houston, TX 77204, USA
    Department of Health & Human Performance, The University of Houston, 3875 Holman Street, Garrison Gymnasium, Room 104, Houston, TX 77204, USA)

  • Litty Koshy

    (Health Research Institute, The University of Houston, 4349 Martin Luther King Blvd., Houston, TX 77204, USA)

  • Maggie Britton

    (Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA
    Health Research Institute, The University of Houston, 4349 Martin Luther King Blvd., Houston, TX 77204, USA)

  • Kelli Drenner

    (Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA)

  • Lorraine R. Reitzel

    (Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA
    Health Research Institute, The University of Houston, 4349 Martin Luther King Blvd., Houston, TX 77204, USA)

Abstract

Tobacco use is exceedingly high among individuals receiving care for opioid addiction, but not commonly addressed by clinicians in treatment settings. Taking Texas Tobacco Free (TTTF) is a comprehensive tobacco-free workplace (TFW) program that builds treatment centers’ capacity to address tobacco use with evidence-based tobacco cessation policies and practices. Here, we examine the process and outcomes of TTTF’s implementation within 7 opioid addiction centers. Program goals were structured according to the RE-AIM framework. Pre- and post-implementation data were collected from client facing and non-client facing employees to assess changes in education, training receipt, knowledge, and intervention behaviors, relative to program goals. Centers reported tobacco screenings conducted and nicotine replacement therapy (NRT) delivered through 6 months post-implementation. Overall, 64.56% of employees participated in TTTF-delivered tobacco education, with a 54.9% gain in tobacco control and treatment knowledge ( p < 0.0001), and significant increases in exposure to education about tobacco use and harms among individuals with opioid use disorder ( p = 0.0401). There were significant gains in clinicians’ receipt of training in 9/9 tobacco education areas ( ps ≤ 0.0118). From pre- to post-implementation, there were mean increases in the use of the 5A’s (ask, advise, assess, assist, and arrange) and other evidence-based interventions for tobacco cessation, with statistically significant gains seen in NRT provision/referral ( p < 0.0001). Several program goals were achieved or exceeded; however, 100% center participation in specialized clinical trainings was among notable exceptions. One program withdrew due to competing pandemic concerns; all others implemented comprehensive TFW policies. Overall, TTTF may have improved participating opioid treatment centers’ capacity to address tobacco use, although study limitations, including lower post-implementation evaluation response rates, suggest that results require replication in other opioid addiction treatment settings.

Suggested Citation

  • Matthew Taing & Vijay Nitturi & Tzuan A. Chen & Bryce Kyburz & Isabel Martinez Leal & Virmarie Correa-Fernández & Ezemenari M. Obasi & Teresa Williams & Kathleen Casey & Daniel P. O’Connor & Litty Kos, 2021. "Implementation and Outcomes of a Comprehensive Tobacco Free Workplace Program in Opioid Treatment Centers," IJERPH, MDPI, vol. 19(1), pages 1-17, December.
    • Handle: RePEc:gam:jijerp:v:19:y:2021:i:1:p:239-:d:711457
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    References listed on IDEAS

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    4. Kathy Le & Tzuan A. Chen & Isabel Martinez Leal & Virmarie Correa-Fernández & Ezemenari M. Obasi & Bryce Kyburz & Teresa Williams & Kathleen Casey & Matthew Taing & Daniel P. O’Connor & Lorraine R. Re, 2021. "Organizational Factors Moderating Changes in Tobacco Use Dependence Care Delivery Following a Comprehensive Tobacco-Free Workplace Intervention in Non-Profit Substance Use Treatment Centers," IJERPH, MDPI, vol. 18(19), pages 1-16, October.
    5. Kathy Le & Tzuan A. Chen & Isabel Martinez Leal & Virmarie Correa-Fernández & Ezemenari M. Obasi & Bryce Kyburz & Teresa Williams & Kathleen Casey & Haleem A. Brown & Daniel P. O’Connor & Lorraine R. , 2021. "Organizational-Level Moderators Impacting Tobacco-Related Knowledge Change after Tobacco Education Training in Substance Use Treatment Centers," IJERPH, MDPI, vol. 18(14), pages 1-14, July.
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    7. Matthew Taing & Bryce Kyburz & Isabel Martinez Leal & Kathy Le & Tzu-An Chen & Virmarie Correa-Fernandez & Teresa Williams & Daniel P. O’Connor & Ezemenari M. Obasi & Kathleen Casey & Litty Koshy & Lo, 2020. "Clinician Training in the Adaptation of a Comprehensive Tobacco-Free Workplace Program in Agencies Serving the Homeless and Vulnerably Housed," IJERPH, MDPI, vol. 17(17), pages 1-15, August.
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    Cited by:

    1. Ammar D. Siddiqi & Maggie Britton & Tzuan A. Chen & Brian J. Carter & Carol Wang & Isabel Martinez Leal & Anastasia Rogova & Bryce Kyburz & Teresa Williams & Mayuri Patel & Lorraine R. Reitzel, 2022. "Tobacco Screening Practices and Perceived Barriers to Offering Tobacco Cessation Services among Texas Health Care Centers Providing Behavioral Health Treatment," IJERPH, MDPI, vol. 19(15), pages 1-15, August.
    2. Cassidy R. LoParco & Tzuan A. Chen & Isabel Martinez Leal & Maggie Britton & Brian J. Carter & Virmarie Correa-Fernández & Bryce Kyburz & Teresa Williams & Kathleen Casey & Anastasia Rogova & Hsien-Ch, 2022. "Organization-Level Factors Associated with Changes in the Delivery of the Five A’s for Smoking Cessation following the Implementation of a Comprehensive Tobacco-Free Workplace Program within Substance," IJERPH, MDPI, vol. 19(19), pages 1-13, September.
    3. Brian J. Carter & Ammar D. Siddiqi & Tzuan A. Chen & Maggie Britton & Isabel Martinez Leal & Virmarie Correa-Fernández & Anastasia Rogova & Bryce Kyburz & Teresa Williams & Kathleen Casey & Lorraine R, 2023. "Educating Substance Use Treatment Center Providers on Tobacco Use Treatments Is Associated with Increased Provision of Counseling and Medication to Patients Who Use Tobacco," IJERPH, MDPI, vol. 20(5), pages 1-17, February.
    4. Ammar D. Siddiqi & Tzuan A. Chen & Maggie Britton & Isabel Martinez Leal & Brian J. Carter & Virmarie Correa-Fernández & Anastasia Rogova & Bryce Kyburz & Teresa Williams & Kathleen Casey & Lorraine R, 2023. "Changes in Substance Use Treatment Providers’ Delivery of the 5A’s for Non-Cigarette Tobacco Use in the Context of a Comprehensive Tobacco-Free Workplace Program Implementation," IJERPH, MDPI, vol. 20(3), pages 1-16, February.

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