A cluster-randomized trial of a brief multi-component intervention to improve tobacco outcomes in substance use treatment

• Main Authors: Joseph Guydish (Author), Caravella McCuistian (Author), Sindhushree Hosakote (Author), Thao Le (Author), Carmen L. Masson (Author), Barbara K. Campbell (Author), Kevin Delucchi (Author)
• Format: Book
• Published: BMC, 2023-06-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 10.1186/s13011-023-00539-w; 1747-597X
• Keywords: Tobacco control; Smoking cessation; Substance use treatment; Policy; Public aspects of medicine; RA1-1270; Social pathology. Social and public welfare. Criminology; HV1-9960
• Source: Substance Abuse Treatment, Prevention, and Policy, Vol 18, Iss 1, Pp 1-11 (2023)

Abstract Background Smoking prevalence is high among people in substance use disorder (SUD) treatment, and program interventions to address smoking are often complex and lengthy. This cluster-randomized trial tested whether a brief multi-component intervention impacted tobacco outcomes among staff and clients. Methods Seven SUD treatment programs were randomly assigned to the multi-component intervention or to waitlist control. The 6-month intervention included a leadership motivation assessment, program incentives, 4 staff training sessions and a leadership learning community session. Survey data were collected from staff and clients at pre- and post-intervention. Outcomes were first compared across condition (intervention vs waitlist control), and then examined pre- to post-intervention with condition collapsed. Results Staff in the intervention (n = 48) and control conditions (n = 26) did not differ at post-intervention on smoking prevalence, self-efficacy to help clients quit, or practices used to help clients quit smoking. Intervention clients (n = 113) did not differ from controls (n = 61) in smoking prevalence or receipt of tobacco services. Pre-post comparisons collapsed across condition showed a decrease in client and staff smoking prevalence, which could not be attributed to the intervention, and a decrease in client receipt of cessation medication. Conclusion The brief multi-component intervention did not support changes in smoking prevalence or in tobacco-related services received by clients. Other intervention features are needed to reduce smoking among SUD clients. Trial registration Randomization occurred at the program level and outcomes measured are program-level measures. Accordingly, the trial is not registered.