Drug and alcohol dependence · 2025
Tobacco treatment and policies in mental health and substance use treatment facilities in the US.
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Gu Dian, Xia Fan, Vijayaraghavan Maya
Аннотация
BACKGROUND: The prevalence of tobacco use among people with mental health and substance use disorders in the US is high. State- and facility-level factors could be associated with the provision of tobacco treatment and tobacco-free grounds policy in mental health and substance use treatment facilities. We estimated the latest prevalence of, and factors associated with tobacco treatment provision and tobacco-free grounds policies in these facilities.
METHODS: This cross-sectional study used data from the 2021-2022 National Substance Use and Mental Health Services Survey. Two multivariate Poisson regression models with robust standard errors were employed to estimate state- and facility-level factors associated with two outcomes: 1) provision of any tobacco treatment (screening, behavior counseling, or pharmacotherapy), and 2) having a tobacco-free grounds policy.
RESULTS: Among over 17,300 facilities, 87.2 % provided tobacco treatment, and 38.6 % implemented tobacco-free grounds policies. Private for-profit facilities were less likely to provide tobacco treatment (Adjusted Risk Ratio [ARR] 0.87, 95 % CI 0.86-0.89). Private for-profit and nonprofit facilities, those licensed by state or tribal health agencies, and those in tobacco nation states were less likely to implement tobacco-free grounds policies. In contrast, facilities with opioid treatment programs were more likely to achieve both outcomes.
CONCLUSIONS: Disparities exist in providing tobacco treatment and tobacco-free ground policies, particularly in privately owned facilities. Payers should incentivize the adoption of tobacco treatment and tobacco-free campus policies, and states should incorporate these requirements into licensure and/or accreditation standards for mental health and substance use treatment facilities.
METHODS: This cross-sectional study used data from the 2021-2022 National Substance Use and Mental Health Services Survey. Two multivariate Poisson regression models with robust standard errors were employed to estimate state- and facility-level factors associated with two outcomes: 1) provision of any tobacco treatment (screening, behavior counseling, or pharmacotherapy), and 2) having a tobacco-free grounds policy.
RESULTS: Among over 17,300 facilities, 87.2 % provided tobacco treatment, and 38.6 % implemented tobacco-free grounds policies. Private for-profit facilities were less likely to provide tobacco treatment (Adjusted Risk Ratio [ARR] 0.87, 95 % CI 0.86-0.89). Private for-profit and nonprofit facilities, those licensed by state or tribal health agencies, and those in tobacco nation states were less likely to implement tobacco-free grounds policies. In contrast, facilities with opioid treatment programs were more likely to achieve both outcomes.
CONCLUSIONS: Disparities exist in providing tobacco treatment and tobacco-free ground policies, particularly in privately owned facilities. Payers should incentivize the adoption of tobacco treatment and tobacco-free campus policies, and states should incorporate these requirements into licensure and/or accreditation standards for mental health and substance use treatment facilities.