Holt Alison G, Hussong Andrea, Castro M Gabriela, Bossenbroek Fedoriw Kelly, Schmidt Allison M, Prentice Amy, Ware Orrin D
School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Tob Use Insights. 2024 May 14;17:1179173X241254803. doi: 10.1177/1179173X241254803. eCollection 2024.
Tobacco use is associated with morbidity and mortality. Many individuals who present to treatment facilities with substance use disorders (SUDs) other than tobacco use disorder also smoke cigarettes or have a concomitant tobacco use disorder. Despite high rates of smoking among those with an SUD, and numerous demonstrated benefits of comprehensive SUD treatment for tobacco use in addition to co-occurring SUDs, not all facilities address the treatment of comorbid tobacco use disorder. In addition, facilities vary widely in terms of tobacco use policies on campus. This study examined SUD facility smoking policies in a national sample of N = 16,623 SUD treatment providers in the United States in 2021. Most facilities with outpatient treatment (52.1%) and facilities with residential treatment (67.8%) had a smoking policy that permitted smoking in designated outdoor area(s). A multinomial logistic regression model found that among facilities with outpatient treatment (n = 13,778), those located in a state with laws requiring tobacco free grounds at SUD facilities, those with tobacco screening/education/counseling services, and those with nicotine pharmacotherapy were less likely to have an unrestrictive tobacco smoking policy. Among facilities with residential treatment (n = 3449), those with tobacco screening/education/counseling services were less likely to have an unrestrictive tobacco smoking policy. There is variability in smoking policies and tobacco use treatment options in SUD treatment facilities across the United States. Since tobacco use is associated with negative biomedical outcomes, more should be done to ensure that SUD treatment also focuses on reducing the harms of tobacco use.
烟草使用与发病率和死亡率相关。许多因除烟草使用障碍之外的物质使用障碍（SUDs）而前往治疗机构的人也吸烟或同时患有烟草使用障碍。尽管患有物质使用障碍的人群吸烟率很高，而且除了共病的物质使用障碍之外，综合物质使用障碍治疗对烟草使用有诸多已证实的益处，但并非所有机构都对共病的烟草使用障碍进行治疗。此外，各机构在校园内的烟草使用政策方面差异很大。本研究调查了2021年美国全国范围内N = 16,623名物质使用障碍治疗提供者样本中的物质使用障碍治疗机构的吸烟政策。大多数门诊治疗机构（52.1%）和住院治疗机构（67.8%）都有一项允许在指定户外区域吸烟的吸烟政策。多项逻辑回归模型发现，在门诊治疗机构（n = 13,778）中，位于有法律要求物质使用障碍治疗机构实行无烟场地的州的机构、提供烟草筛查/教育/咨询服务的机构以及提供尼古丁药物治疗的机构，实行无限制吸烟政策的可能性较小。在住院治疗机构（n = 3449）中，提供烟草筛查/教育/咨询服务的机构实行无限制吸烟政策的可能性较小。美国各地物质使用障碍治疗机构的吸烟政策和烟草使用治疗选择存在差异。由于烟草使用与负面的生物医学结果相关，应采取更多措施确保物质使用障碍治疗也注重减少烟草使用的危害。
